Mayo Clinic Health Matters What's Happening to my Body? Navigating the Different Stages of Menopause
Dec 9, 2025
Denise Milstine, an internist specializing in women's health at Mayo Clinic, sheds light on the complexities of perimenopause and menopause. She delves into the puzzling symptoms like headaches and joint pain, and clarifies the biology of hormonal changes. Milstine emphasizes the importance of tailored hormone therapy and non-hormonal alternatives. She highlights the need for greater awareness and education on menopause, and offers strategies for women to advocate for their health with clinicians. The conversation reframes menopause as an empowering life transition.
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Perimenopause Is A Hormone Transition
- Perimenopause is a multi-year transition where menstrual cycles become irregular as ovulation becomes unpredictable.
- Hormone rises and falls lose their cadence, causing varied bleeding patterns and unexpected symptoms.
Symptom Burden Varies By Demographics
- Menopause symptoms vary by race and socioeconomic status, with Black women often experiencing more severe, longer symptoms.
- Asian women tend to report lower symptom burden and shorter duration, per the SWAN study.
Menopause Affects Bones And Vaginal Health
- Menopause sharply accelerates bone loss and changes vaginal tissue, increasing osteoporosis and sexual/urinary symptoms.
- Vaginal dryness, painful sex, and urinary incontinence are common and treatable but often under-discussed.
