Science Glossary

Skin condition with pimples or clogged pores. Acne isn’t just for teenagers—it can reappear or worsen during the menopause transition. As estrogen declines and androgens like testosterone remain steady or become relatively higher, the skin may produce more oil, leading to clogged pores and breakouts. This hormonal acne often shows up around the chin, jawline, or neck. Some women may also notice that products that used to work no longer help. Treatments may include topical retinoids, anti-inflammatory products, or medications that address hormonal balance, like spironolactone.

The building blocks of protein. Amino acids are small molecules that link together to form proteins, which your body uses to build and repair tissues, make enzymes and hormones, and support immune function. There are 20 different amino acids, and 9 of them are essential, meaning you must get them from food. During the menopause transition, getting enough high-quality protein (rich in essential amino acids) becomes more important to maintain muscle mass, support recovery, and slow age-related muscle loss (sarcopenia).

Hormones like testosterone, found in both men and women. Androgens are often labeled as “male hormones,” but women produce them too. Testosterone is the most well-known, but other androgens such as androstenedione and DHEA also play important roles. These hormones help support libido, energy, mood, and muscle mass. During menopause, even if androgen levels don’t drop as sharply as estrogen, the changing ratio can lead to noticeable effects. Higher androgen activity (relative to falling estrogen) can contribute to acne, increased facial hair, or scalp hair thinning. On the flip side, low androgens may play a role in fatigue, low libido, or muscle weakness.

Joint pain. Arthralgia means joint pain, and it’s a surprisingly common complaint during the menopausal transition. Women often describe stiffness, aching, or pain in joints like the knees, hands, hips, or shoulders—sometimes even waking up sore without clear injury. While joint pain can have many causes (arthritis, overuse, autoimmune conditions), in perimenopause and beyond, declining estrogen is likely a contributing factor. Estrogen plays a role in keeping joints lubricated and inflammation under control, so as levels drop, joints may become more sensitive, inflamed, or painful.

A traditional Indian healing system that uses herbs, diet, and lifestyle. Ayurveda is a holistic system of medicine developed in India thousands of years ago. It focuses on balancing the body through personalized combinations of herbs, food, breathing practices, and daily routines. In the context of menopause, some women turn to Ayurvedic approaches to support symptoms like hot flashes, anxiety, or sleep issues. While not based on Western clinical trials, certain Ayurvedic herbs (like ashwagandha or shatavari) are being studied for hormone-related benefits. It’s important to talk to a healthcare provider before combining Ayurvedic supplements with hormone therapy or prescription medications.

The number of calories your body needs to stay alive at rest. BMR is the amount of energy your body uses to maintain basic functions like breathing, heartbeat, and temperature while at rest. It’s influenced by age, sex, muscle mass, and hormones. During perimenopause and postmenopause, BMR often slows down — partly due to estrogen decline and partly due to muscle loss (sarcopenia). This means your body burns fewer calories at rest, which can contribute to gradual weight gain if activity or eating habits don’t adjust.

A number based on height and weight to check if you're underweight, normal, or overweight. BMI=weight/height2. BMI is a quick calculation used to estimate body fat: weight (kg) divided by height (m²). It’s often used in clinical settings to screen for weight-related health risks. During the menopause transition, body composition shifts—many women gain fat and lose muscle, even without major changes in diet or exercise. While BMI doesn’t show exactly where fat is stored (or how much of your weight is muscle), a rising BMI in midlife can reflect increased visceral fat, which is more strongly linked to health risks like heart disease and insulin resistance.

A test done using a DEXA machine to measure bone strength and check for osteoporosis. A bone density scan (also called a DEXA scan) is a painless, low-dose X-ray that measures how strong and dense your bones are. It usually focuses on the spine and hip—the areas most at risk of fracture. This scan becomes especially important during and after menopause, when dropping estrogen levels speed up bone loss. Detecting low bone density early (osteopenia) allows for lifestyle changes or treatment to help prevent osteoporosis and fractures later.

A measure of how strong and dense your bones are. BMD tells us how much mineral (mostly calcium) is packed into a segment of bone. It’s measured by a DEXA scan and used to diagnose osteopenia or osteoporosis. After menopause, estrogen levels drop sharply, speeding up bone loss and lowering BMD. Tracking BMD helps assess your risk of fractures and decide whether lifestyle changes, supplements, or medications are needed to protect bone health.

A marker in your blood that shows inflammation. CRP is a substance made by the liver in response to inflammation. A high-sensitivity CRP (hs-CRP) test can pick up even low levels of inflammation in the body, and is often used to estimate heart disease risk. During perimenopause and postmenopause, changes in hormone levels—particularly the drop in estrogen—may increase systemic inflammation, which can be reflected in a higher CRP. While CRP alone doesn’t diagnose anything specific, it's one piece of the puzzle when assessing midlife health risks.

A type of therapy that helps you change unhelpful thoughts and behaviors. CBT is a structured, short-term form of therapy that focuses on how your thoughts, feelings, and behaviors are connected. In menopause care, CBT has been shown to help reduce symptoms like hot flashes, insomnia, anxiety, and mood swings—without medication. It doesn’t change hormone levels, but it can change how your brain and body respond to symptoms. CBT techniques can be self-guided, done with a therapist, or accessed through digital programs designed specifically for menopause-related distress.

A mix of estrogens, most commonly derived from the urine of pregnant mares, used in some hormone replacement therapies. Conjugated estrogens (CEE) are a blend of several estrogen forms, such as estrone sulfate and equilin sulfate, traditionally derived from the urine of pregnant horses. This formulation was one of the earliest types of hormone replacement therapy (HRT) and is still prescribed under brand names like Premarin. While CEE can effectively treat hot flashes, vaginal dryness, and other menopausal symptoms, it has a different hormonal profile than bioidentical estradiol and may affect the body differently.

A hormone released when you're stressed. Cortisol is your body’s main stress hormone, produced by the adrenal glands. It helps regulate blood sugar, blood pressure, energy levels, and your sleep-wake cycle. During the menopause transition, fluctuating estrogen levels can make women more sensitive to cortisol spikes, which may contribute to fatigue, sleep disruption, anxiety, and weight gain (especially around the abdomen). Chronically high cortisol can also affect bone and muscle health—two areas already under pressure during midlife.

A hormone made by your adrenal glands that helps make estrogen and testosterone. DHEA is a hormone produced mainly by the adrenal glands and serves as a building block for other hormones, such as estrogen and testosterone. DHEA levels naturally decline with age, and during the menopause transition, this drop can contribute to low energy, reduced libido, and mood changes. A vaginal form of DHEA is approved for treating vaginal dryness and pain during sex in postmenopausal women, as it provides local estrogen-like effects without significantly affecting hormone levels in the rest of the body.

A scan that measures bone density (same as bone density scan). A DEXA scan (Dual-Energy X-ray Absorptiometry) is the gold-standard test for measuring bone density. It uses a very low dose of X-rays to assess how much calcium and other minerals are in your bones—usually at the hip and spine. As estrogen declines during and after menopause, bone loss speeds up, increasing the risk of osteopenia and osteoporosis. A DEXA scan can detect this loss early and guide decisions about lifestyle changes, supplements, or medications to protect bone health.

European Medicines Agency, which checks medicine safety in the EU. The EMA is the European Union’s regulatory body that reviews and approves medications, ensuring they’re safe, effective, and of high quality. Like the FDA in the U.S., the EMA also evaluates hormone therapies and menopause-related treatments. If a treatment is EMA-approved, it has gone through a rigorous evaluation process for both risks and benefits.

The study of hormones and how they affect the body. Endocrinology is the branch of medicine that focuses on hormones and the glands that produce them, including the ovaries, thyroid, adrenal glands, and pituitary. During the menopause transition, hormone systems shift significantly, making this a relevant field for understanding symptoms like irregular cycles, hot flashes, weight changes, and mood fluctuations. Menopause specialists often have backgrounds in gynecology, endocrinology, or both.

A test where a small sample of the uterus lining is taken. An endometrial biopsy involves removing a small tissue sample from the lining of the uterus (endometrium) to check for abnormal cells. It may be done if you have irregular bleeding, spotting after menopause, or before starting hormone therapy. Since estrogen stimulates the uterine lining, unopposed estrogen therapy (without progestogen) can increase the risk of overgrowth, making this test important in ruling out early signs of cancer or other conditions.

Essential fatty acids your body cannot make on its own, so you must get them from food. Essential fats, such as omega-3 and omega-6 fatty acids, are crucial for hormone production, brain function, inflammation control, and cell health. These fats must come from your diet: sources include fish, flaxseeds, nuts, and plant oils. During and after menopause, getting enough essential fats can support cardiovascular health, joint flexibility, and mood, especially as estrogen’s protective effects fade.

The strongest and most active form of estrogen. Estradiol (also called E2) is the main form of estrogen produced by the ovaries during the reproductive years. It plays a vital role in regulating the menstrual cycle and supporting bones, skin, brain, blood vessels, and mood. As the ovaries wind down during perimenopause and eventually stop producing estradiol after menopause, many of these systems begin to shift. Declining estradiol levels are closely linked to symptoms like hot flashes, vaginal dryness, mood swings, and bone loss. Most modern hormone therapies use body-identical estradiol to replace what the body no longer makes.

The main estrogen before menopause. Estradiol (E2) is the most potent and dominant estrogen during your reproductive years. It’s produced mainly by the ovaries and influences nearly every tissue in the body. As E2 declines in perimenopause and drops sharply after the final menstrual period, many women begin to notice both short-term symptoms (like hot flashes) and long-term changes (like increased bone loss). Prescription hormone therapy that includes estradiol typically aims to mimic this natural form.

A gentle estrogen found during pregnancy and in some vaginal creams. Estriol is the weakest of the three major estrogens and is found in high amounts during pregnancy. In menopause care, it’s used in some vaginal creams or suppositories to relieve symptoms like dryness or pain during sex. Because it acts locally and has a short half-life, it’s often considered a safer option for vaginal treatment in women who can’t take systemic hormone therapy—though data is still evolving.

A group of hormones that affect periods, skin, bones, and more. Estrogen isn’t a single hormone but a family of hormones, including estradiol, estrone, and estriol. Together, they support reproductive health, skin elasticity, bone strength, brain function, and temperature regulation. During the menopause transition, estrogen levels fluctuate wildly and eventually decline, leading to a wide range of symptoms. Estrogen therapy can help relieve many of these symptoms and prevent long-term issues, but it's not one-size-fits-all and should be tailored to your health history.

A weaker estrogen, more common after menopause. Estrone becomes the dominant estrogen after menopause, when the ovaries stop producing estradiol. It's made mostly in body fat and is less potent than estradiol. While it still plays a role in tissues like the uterus and breast, estrone alone usually isn’t enough to prevent menopausal symptoms or bone loss, which is why it's not typically used in hormone therapy.

The U.S. Food and Drug Administration approves drugs and monitors safety. The FDA is the U.S. government agency responsible for regulating and approving medications, including hormone therapies used during and after menopause. For a drug to be FDA-approved, it must go through clinical trials showing it is both safe and effective. The FDA also monitors product quality and manufacturing standards. If a menopause treatment—like estradiol patches or vaginal DHEA—is FDA-approved, it means it has been studied for its intended use and has met strict safety criteria.

A hormone that helps eggs grow in the ovaries. FSH is released by the pituitary gland and plays a key role in the menstrual cycle by helping follicles (which contain eggs) develop in the ovaries. As menopause approaches and ovarian function declines, the body releases more FSH in an effort to stimulate the ovaries, often unsuccessfully. That’s why FSH levels rise during perimenopause and remain high after menopause. Although some blood tests use FSH to “confirm” menopause, levels can fluctuate wildly in perimenopause and aren’t always reliable for diagnosis on their own.

A brain chemical that calms the nervous system. GABA (gamma-aminobutyric acid) is an inhibitory neurotransmitter—in simple terms, it slows things down and helps your brain relax. It plays a key role in reducing anxiety, promoting sleep, and stabilizing mood. Estrogen helps regulate GABA, so when estrogen levels fluctuate during perimenopause, GABA activity can be disrupted. This may contribute to symptoms like mood swings, irritability, and insomnia. Some treatments, including certain antidepressants and lifestyle strategies like yoga or meditation, can help support GABA function.

A group of symptoms like dryness and irritation in the vagina and urinary area due to low estrogen. GSM is the term used to describe physical changes in the vagina, vulva, bladder, and urethra caused by declining estrogen. Symptoms may include vaginal dryness, burning, itching, pain during sex, increased UTIs, or urgent urination. These changes often don’t improve without treatment and may worsen over time. GSM is common but underdiagnosed—many women don’t bring it up, and many doctors don’t ask. Local estrogen (like vaginal creams or tablets) and non-hormonal options (like moisturizers or vaginal DHEA) are effective ways to treat it.

A hormone that makes you feel hungry. Ghrelin is often called the “hunger hormone” because it signals your brain that it’s time to eat. It’s produced mainly in the stomach and tends to rise before meals and fall after eating. During the menopause transition, hormonal shifts—including lower estrogen and changes in sleep patterns—can influence ghrelin levels. This may partly explain why some women notice increased appetite or weight gain, even without major changes in eating habits. Poor sleep, common in perimenopause, can also boost ghrelin and make cravings harder to resist.

Rules to make sure products are safe and made properly. GMP refers to a set of standards required for the proper manufacturing, testing, and quality control of products like supplements and medications. A “GMP-certified” label means that the product was made under clean, consistent, and well-documented conditions. This is especially important when choosing supplements marketed for menopause relief—like herbs or vitamins—since not all products are tested for safety or ingredient accuracy unless they follow GMP. Look for this certification if you're buying over-the-counter remedies.

A brain part that helps with memory and mood. The hippocampus is deeply involved in forming memories and regulating emotional responses. It contains many estrogen receptors, which means it’s sensitive to hormonal changes. During the menopause transition, fluctuating or declining estrogen levels may affect how the hippocampus functions, contributing to brain fog, forgetfulness, or shifts in mood. These changes are usually temporary, but they reflect how much estrogen influences brain health.

When muscles grow bigger, usually from exercise. Hypertrophy means an increase in muscle size, typically as a result of strength training or resistance exercise. During and after menopause, building and maintaining muscle becomes harder due to hormonal changes and age-related muscle loss (sarcopenia). Resistance training can help counteract these changes, support metabolism, protect bone health, and improve overall strength and mobility. In short: lifting weights is not just safe during menopause—it’s essential.

A hormone communication loop between your brain and ovaries that controls your menstrual cycle and reproductive hormones. The HPO axis is the system that keeps your menstrual cycle running. It involves a feedback loop between the hypothalamus (which releases GnRH), the pituitary gland (which releases FSH and LH), and the ovaries (which produce estrogen and progesterone). As menopause approaches, this system starts to falter—the ovaries respond less to hormonal signals, leading to irregular cycles and symptoms like hot flashes and mood swings. Eventually, the loop winds down completely, marking the end of reproductive function.

A brain area that controls hormones and body temperature. The hypothalamus is a part of the brain that acts like your body’s thermostat and hormone coordinator. It helps regulate body temperature, hunger, sleep, and your response to stress. It also sends signals to the pituitary gland to control hormone production, including reproductive hormones. During the menopause transition, fluctuating estrogen levels can affect how the hypothalamus functions, one reason why hot flashes, night sweats, and disrupted sleep become common.

Trouble falling or staying asleep. Insomnia is one of the most common and disruptive symptoms during the menopause transition. It can show up as difficulty falling asleep, frequent waking during the night, or waking too early and not being able to fall back asleep. Hormonal changes—especially declining estrogen and progesterone—affect brain chemicals that regulate sleep, such as GABA and melatonin. Hot flashes, night sweats, anxiety, and changes in cortisol levels can also make sleep more fragile. Managing insomnia during menopause often requires a mix of strategies, including sleep hygiene, CBT-I (a form of cognitive behavioral therapy for insomnia), and in some cases, hormone therapy or non-hormonal medications.

A hormone that tells your brain you’re full. Leptin is released by fat cells and helps regulate appetite by signaling to your brain that you’ve had enough to eat. It also plays a role in metabolism, reproduction, and immune function. During menopause, leptin signaling can become less efficient, especially as estrogen declines and visceral fat increases. This may partly explain why appetite control, weight gain, and cravings can shift during this time, even if eating habits haven’t changed much.

An essential amino acid that triggers muscle building. Leucine is one of the essential amino acids and plays a key role in muscle protein synthesis—the process your body uses to build and repair muscle. It acts as a signal to "switch on" this process, especially after exercise or protein intake. During and after menopause, when estrogen drops and muscle loss speeds up, getting enough leucine from protein-rich foods (like eggs, dairy, meat, soy, or legumes) becomes crucial for preserving strength and supporting metabolism.

The lower part of your spine. The lumbar spine is made up of the five vertebrae in your lower back. It supports much of your body’s weight and is a key area measured during a DEXA scan, since it's one of the first places where bone loss from menopause shows up. Maintaining strength in the lumbar spine is crucial for posture, movement, and preventing fractures, especially as estrogen decline increases the risk of bone thinning in this region.

A hormone that triggers ovulation. LH is made by the pituitary gland and plays a key role in the menstrual cycle. It triggers the release of an egg (ovulation) mid-cycle and supports early hormone production in the ovary. During perimenopause, as the ovaries become less responsive, LH levels start to rise in an effort to stimulate them. After menopause, LH stays elevated, but without regular ovulation or consistent estrogen production. High LH levels are part of the hormonal signature that marks the end of fertility.

How fast your body burns calories. Metabolic rate refers to how much energy your body uses to maintain basic functions like breathing, digestion, and circulation. As you age—especially during and after menopause—your basal metabolic rate tends to slow down, meaning your body burns fewer calories at rest. This is partly due to muscle loss and partly due to hormonal changes, including lower estrogen. A slower metabolism can make weight gain more likely, even without eating more. Resistance training and maintaining muscle mass are key to keeping metabolism healthy in midlife.

The process your body uses to turn food into energy. Metabolism refers to all the chemical processes that keep your body running—converting food into energy, building and repairing tissues, and regulating temperature, hormones, and more. During menopause, metabolism often slows down, in part due to lower estrogen and age-related muscle loss. This can lead to weight gain, fatigue, and changes in body composition even if your eating habits haven’t changed. Supporting metabolism with strength training, protein, sleep, and stress management becomes increasingly important in midlife.

Disrespectful or harmful attitudes toward women. Misogynistic beliefs often shape the way menopause is misunderstood or dismissed in society and healthcare. Women’s symptoms are too often minimized, not taken seriously, or misdiagnosed—a reflection of systemic gender bias rather than medical fact. This can lead to delayed treatment, under-researched therapies, and a lack of access to appropriate care during the menopause transition. Challenging misogynistic attitudes is part of improving women’s health outcomes and making menopause education evidence-based and respectful.

Tiny structures inside your cells that act like power plants—they turn food and oxygen into energy your body can use. Mitochondria generate the energy (ATP) that your body needs for everything from thinking and moving to hormone production. As estrogen levels decline during menopause, mitochondrial function may decline too, affecting everything from fatigue and brain fog to aging-related changes. Estrogen supports mitochondrial health, especially in muscles, brain, and heart tissue— so its loss may play a hidden role in the drop in energy many women notice during this life stage.

Lab-made proteins designed to target a specific molecule in the body. Monoclonal antibodies are custom-designed molecules that can target specific cells, proteins, or receptors in the body, like immune cells, inflammation, or cancer cells. They’re used to treat a range of conditions, from autoimmune diseases to osteoporosis. In menopause care, certain monoclonal antibodies are being studied or used for bone health (such as denosumab, which helps prevent bone breakdown) or for treating hot flashes by targeting brain pathways involved in thermoregulation.

Muscle pain, or myalgia, is common during the menopausal transition. It can affect a small area or the entire body and may be mild or severe. Myalgia is a symptom rather than a disease itself, and it can result from various causes, including overuse or strain of muscles, infections (like the flu), autoimmune diseases (such as lupus or fibromyalgia), certain medications, and chronic conditions (like chronic fatigue syndrome). During menopause transition, myalgia may be connected to changes in estrogen levels, which affect inflammation, pain sensitivity, and how muscles recover.

The study of how the brain and hormones work together. Neuroendocrinology looks at the interaction between the nervous system (especially the brain) and the endocrine system (which produces hormones). This field helps explain how hormonal changes during menopause can impact things like memory, mood, sleep, and even temperature regulation. For example, the brain regions that control body temperature and emotional response—like the hypothalamus and amygdala—are influenced by estrogen. Understanding neuroendocrinology helps make sense of why menopause affects so much more than just periods.

Techniques used to look at the structure and activity of the brain. Neuroimaging includes tools like MRI (Magnetic Resonance Imaging), fMRI (Functional Magnetic Resonance Imaging), and PET (Positron Emission Tomography). These methods allow researchers and doctors to see how the brain looks and works—whether it's detecting changes in blood flow, metabolism, or structural changes. In menopause research, neuroimaging has shown that estrogen affects how the brain uses energy and maintains blood flow, which helps explain why symptoms like brain fog and mood shifts appear when hormones decline.

A brain cell that sends and receives messages. Neurons are the basic building blocks of your nervous system. They transmit electrical and chemical signals, allowing you to think, move, feel, and remember. Your brain has billions of neurons that form complex networks. Estrogen affects how well neurons communicate, grow, and survive—especially in areas like the hippocampus and prefrontal cortex, which are involved in memory and mood. As estrogen declines, neuronal communication can become less efficient, contributing to cognitive changes during menopause.  

The study of the brain and nervous system. Neuroscience explores how the brain, spinal cord, and nerves work—including how we think, feel, remember, and respond to stress. It connects biology, psychology, and physiology. In the context of menopause, neuroscience helps explain how declining estrogen affects brain regions involved in mood, memory, sleep, and temperature regulation. This is why symptoms like brain fog, anxiety, and disrupted sleep are not "in your head"—they’re rooted in real, hormone-driven changes in the brain.

A chemical messenger that helps brain cells communicate with each other. Neurotransmitters carry signals between nerve cells in the brain and body. Some make you feel calm (like GABA), others boost mood (like serotonin and dopamine), and some regulate sleep or appetite. During the menopause transition, changes in estrogen can disrupt how these chemicals function, which may lead to mood swings, anxiety, irritability, or sleep problems. Estrogen interacts closely with many neurotransmitter systems, so its decline can affect how your brain processes emotions and stress.

A pill that acts like estrogen in some body parts and blocks it in others. SERM stands for Selective Estrogen Receptor Modulator. Oral SERMs, such as raloxifene or ospemifene, are medications that bind to estrogen receptors— mimicking estrogen’s effects in some tissues (like bones or the vaginal wall) while blocking it in others (like breast tissue). They’re often used to treat or prevent osteoporosis or vaginal discomfort without the risks associated with systemic estrogen therapy. SERMs can be helpful for women who can’t take traditional hormone replacement therapy but still need symptom relief.

Lower bone strength, but not as severe as osteoporosis. Osteopenia is the early stage of bone loss, where bones are weaker than normal but not yet fragile enough to be classified as osteoporosis. It's common during the menopause transition, as estrogen levels drop and bone turnover increases. A DEXA scan can detect osteopenia, and it’s often a sign to take preventive action, such as strength training, calcium and vitamin D, reducing alcohol, and possibly starting treatment to prevent further loss.

A condition where bones become weak and break easily. Osteoporosis is a disease that causes bones to lose density and strength, making them more likely to fracture, especially in the hips, spine, and wrists. Estrogen plays a key role in maintaining bone mass, so when levels drop during and after menopause, bone loss speeds up. Many women don’t know they have osteoporosis until they break a bone. A DEXA scan can detect bone thinning early, and treatments like weight-bearing exercise, calcium, vitamin D, and certain medications (including hormone therapy) can help prevent or slow bone loss.

When an egg is released from the ovary. Ovulation happens mid-cycle and is triggered by a surge in luteinizing hormone (LH). It's essential for fertility and also leads to the production of progesterone. During perimenopause, ovulation becomes irregular and eventually stops, even before periods fully end. This shift can cause unpredictable cycles, missed periods, heavier bleeding, or skipped ovulation symptoms. The loss of regular ovulation also marks a shift in hormone balance, particularly lower progesterone, which can affect mood, sleep, and bleeding patterns.

A test to check for cervical cell changes. A Pap smear is a routine screening test that looks for abnormal changes in cervical cells that could lead to cancer. It’s usually done during a pelvic exam. Even after menopause, women with a cervix still need Pap smears at intervals recommended by their doctor. Vaginal dryness or tissue thinning can make the test uncomfortable, but using a gentle approach—or treating dryness with estrogen cream ahead of time—can make it more manageable.

The part of the nervous system that calms the body. The parasympathetic nervous system is your body’s "rest and digest" system. It slows the heart rate, supports digestion, and helps you relax and recover after stress. During menopause, this calming system can become harder to access due to hormone shifts and heightened stress sensitivity. Practices like deep breathing, mindfulness, and restorative sleep can help activate the parasympathetic response and support nervous system balance during this transition.

An enzyme that breaks down a molecule needed for relaxing blood vessels. Some medications block it to help with sexual function (both in men and women). PDE5 inhibitors, like sildenafil (Viagra), help improve blood flow by blocking the PDE5 enzyme. Though originally used for erectile dysfunction in men, these medications are sometimes prescribed off-label for women experiencing low genital blood flow, arousal difficulties, or sexual pain during menopause. They don’t address low libido caused by hormones or emotions, but in the right cases, they can improve blood flow and sensitivity.

A hormone that helps reduce appetite. Peptide YY is released by the gut after eating and sends a signal to the brain to reduce appetite and slow down digestion. It works alongside other hormones like leptin and ghrelin to regulate hunger and fullness. During and after menopause, appetite-regulating hormones can shift, often leading to increased hunger or less satisfaction from food. While research is ongoing, hormonal changes during this time may affect how well Peptide YY functions, contributing to midlife weight gain.

Positron Emission Tomography, a type of brain imaging that shows how active different areas of the brain are. A PET (Positron Emission Tomography) scan uses a small amount of radioactive tracer to measure activity and metabolism in the brain. It’s often used in research to study how brain function changes with aging, menopause, or disease. PET scans have shown that after menopause, brain areas linked to memory and thinking may use energy less efficiently—changes that may correlate with symptoms like brain fog. These findings help us understand how hormonal shifts affect brain health.  

Mood and body symptoms before your period. PMS includes symptoms like irritability, fatigue, bloating, and breast tenderness that occur before a period and improve once bleeding starts. During perimenopause, hormonal fluctuations can make PMS symptoms more intense or unpredictable, sometimes overlapping with early menopause symptoms like sleep changes or mood shifts. The difference? PMS is tied to the cycle, while perimenopausal symptoms may linger or come and go irregularly.

An overnight sleep study that records your brain waves, breathing, heart rate, oxygen levels, and body movements while you sleep. Polysomnography is used to diagnose sleep disorders such as sleep apnea, restless legs syndrome, or insomnia. It records detailed data while you sleep, often in a sleep clinic. During perimenopause, many women experience disrupted sleep due to hot flashes, night sweats, and hormone-driven changes to brain chemistry. A sleep study may help identify underlying causes and guide treatment if poor sleep persists despite lifestyle changes or hormone therapy.

A natural or synthetic hormone often used with estrogen in HRT. Progestogen refers to a group of hormones that includes natural progesterone and synthetic progestins. In women who still have a uterus, progestogen is added to estrogen therapy to protect the endometrial lining from overgrowth, which can lead to cancer. Progestogens may also help with sleep and anxiety in some women. The type, dose, and delivery (pill, capsule, IUD) can influence how well it’s tolerated and how it works in the body.

When an organ like the uterus or bladder slips out of place. Pelvic organ prolapse happens when muscles and tissues that support the uterus, bladder, or rectum weaken, often after childbirth and as estrogen declines with age. This can lead to a feeling of pressure, heaviness, or something “falling out” in the vagina. Menopause can worsen symptoms, especially if combined with chronic coughing, constipation, or heavy lifting. Treatment options range from pelvic floor physical therapy to pessaries or surgery, depending on severity.

The process of building new proteins in the body. Protein synthesis is how your body creates new proteins from amino acids. It happens constantly—repairing muscles, making enzymes, and supporting tissues. After menopause, the body becomes less efficient at turning dietary protein into muscle, partly due to lower estrogen and increased inflammation.

Involving both mental and social factors. Psychosocial health refers to how mental well-being and social environments interact, and it plays a big role during menopause. Changes in mood, sleep, and self-image, combined with work stress, caregiving roles, or relationship shifts, can weigh heavily. Many menopause symptoms don’t happen in isolation—they’re influenced by what’s happening in your life, support systems, and sense of agency. Addressing psychosocial factors is just as important as managing physical symptoms.

Substances that cause bowel movements, sometimes misused for weight loss. Purgatives include laxatives, herbal teas, and pills that stimulate the bowels. While they may be used occasionally for constipation, regular or extreme use—especially for weight control—can lead to dehydration, nutrient loss, and dependence. During menopause, some women experience bloating or slower digestion, but it’s important to address these issues with sustainable strategies like hydration, fiber, or addressing hormonal contributors, not purging methods that harm the gut.

A sleep stage with dreaming and brain activity. REM (Rapid Eye Movement) sleep is one of the key stages of your sleep cycle. It’s when most dreaming occurs and when the brain is especially active, processing emotions, memory, and learning. Estrogen helps regulate neurotransmitters like serotonin and acetylcholine that influence REM sleep. During perimenopause and postmenopause, disrupted sleep patterns, night sweats, and hormonal fluctuations can reduce REM sleep quality and duration. This may leave you feeling mentally foggy, emotionally off, or less refreshed even after a full night in bed.

Age-related loss of muscle mass. Sarcopenia refers to the gradual loss of muscle mass, strength, and function as we age—a process that accelerates after menopause. Estrogen plays a role in maintaining muscle tissue, and its decline contributes to both muscle breakdown and reduced muscle repair. This shift can affect balance, energy levels, metabolism, and even increase the risk of falls. Resistance training, protein intake, and staying physically active are key to slowing sarcopenia and maintaining strength in midlife and beyond.

Medicines that act like estrogen in some tissues but not others. Selective Estrogen Receptor Modulators (SERMs) are drugs that bind to estrogen receptors and either activate or block them depending on the tissue. For example, raloxifene acts like estrogen in bones (protecting against osteoporosis) but blocks estrogen in the breast (lowering cancer risk). SERMs are used as alternatives to hormone therapy for some women—especially those at higher risk for breast cancer—but they can have side effects, including hot flashes or leg cramps.

Deep sleep that helps your brain and body recover. Slow-wave sleep (also called deep sleep or stage 3 sleep) is the most physically restorative part of your sleep cycle. It’s when your body repairs tissue, builds muscle, releases growth hormone, and clears brain waste. Estrogen and progesterone support this sleep stage, so during perimenopause, declining hormone levels may reduce the time spent in deep sleep. This can lead to feeling unrefreshed even after 7–8 hours in bed and may contribute to fatigue, irritability, or trouble concentrating.

Antidepressants that affect both serotonin and norepinephrine. SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) increase the levels of two brain chemicals—serotonin and norepinephrine—that are involved in mood regulation and pain processing. Medications like venlafaxine and desvenlafaxine are sometimes used during menopause to treat hot flashes, anxiety, or mood symptoms. Like SSRIs, they don’t affect hormone levels directly but may be helpful for women who can’t or don’t want to take hormone therapy.

Antidepressants that increase serotonin. SSRIs (Selective Serotonin Reuptake Inhibitors) are commonly prescribed antidepressants that boost serotonin, a neurotransmitter that influences mood, sleep, and anxiety. Some SSRIs—such as paroxetine and escitalopram—are also used to treat hot flashes and mood symptoms in menopause, even in women without depression. They don’t change hormone levels, but they can ease some of the brain chemistry disruptions caused by falling estrogen. Side effects vary and should be discussed with a healthcare provider.

Hormones made from cholesterol, like estrogen and cortisol. Steroid hormones are fat-based hormones derived from cholesterol. They include estrogen, progesterone, testosterone, cortisol, and aldosterone—all of which influence mood, metabolism, reproductive function, stress response, and more. During the menopause transition, levels of several steroid hormones shift dramatically, especially estrogen and progesterone. These changes ripple through many body systems, contributing to hot flashes, mood changes, bone loss, and altered stress tolerance.

A science field that looks at how different body systems work together. Systems biology studies how complex networks in the body—like hormones, metabolism, immunity, and the nervous system—interact as a whole, rather than in isolation. This approach is especially useful in understanding menopause, where changes in one system (like hormone levels) have ripple effects on mood, sleep, bones, weight, and brain function. Instead of treating symptoms one by one, systems biology supports a more holistic view of midlife health.

Problems with the thyroid gland, which controls metabolism. The thyroid gland produces hormones that regulate how fast your body uses energy. Symptoms of thyroid imbalance—like fatigue, weight changes, hair thinning, anxiety, or cold sensitivity—can mimic or overlap with menopause symptoms. Hypothyroidism (underactive thyroid) is more common in women over 40, and menopause can sometimes mask or confuse the diagnosis. A simple blood test (TSH) can help check thyroid function, and thyroid conditions are usually treatable with medication.

Infections in the bladder or urinary system. UTIs become more common after menopause due to changes in the urinary tract linked to estrogen loss. Thinning of the vaginal and urethral tissues, shifts in pH, and reduced natural lubrication can make it easier for bacteria to grow. Symptoms may include burning, urgency, frequent urination, or pelvic discomfort. Local estrogen treatments (like vaginal creams or tablets) can help reduce UTI frequency by restoring tissue health and microbial balance.

A local hormone treatment for vaginal dryness and pain. Vaginal DHEA is a non-estrogen hormonal therapy used to treat vaginal dryness, irritation, and pain with sex in postmenopausal women. It works by converting into small amounts of estrogen and androgens locally, within the vaginal tissue, without significantly affecting hormone levels in the rest of the body. It’s available by prescription and may be a good option for women who cannot or prefer not to use systemic hormone therapy.

Related to blood vessel control (like flushing or sweating). The term "vasomotor" refers to how blood vessels expand or contract, especially in response to temperature or nerve signals. During menopause, estrogen withdrawal alters the brain’s control of vasomotor responses, leading to hot flashes, night sweats, and flushing. These are signs of the body’s thermoregulation going off balance due to hormonal shifts.

Hot flashes and night sweats. VMS are the most well-known symptoms of menopause. They’re caused by sudden, temporary changes in how the brain regulates body temperature, triggered in part by estrogen withdrawal. Hot flashes can feel like a sudden wave of heat, often with sweating, flushing, or a racing heart, while night sweats disrupt sleep. VMS affect about 75% of women during perimenopause and early postmenopause. Hormone therapy is the most effective treatment, but other options include SSRIs, SNRIs, lifestyle adjustments, and newer non-hormonal medications.

Cracks or collapses in the spine’s bones due to weakened bone. These fractures happen when bones in the spine—especially in women with low bone mineral density—become too weak to support everyday pressure. They can occur suddenly or from minor movements like bending or lifting. Vertebral compression fractures are common signs of osteoporosis and may cause back pain, height loss, or a curved spine. Often, women don’t realize they’ve had one until it shows up on a scan or leads to chronic discomfort.

Fat stored around your organs, not under your skin. Visceral fat builds up deep in the abdomen, around organs like the liver and intestines. Unlike subcutaneous fat (under the skin), visceral fat is more hormonally active and linked to higher risks of insulin resistance, heart disease, and inflammation. During menopause, estrogen loss often leads to a shift in fat distribution—away from hips and thighs and toward the abdomen—increasing visceral fat even without major weight gain. Exercise and muscle-building can help counteract this shift.