Menopause and health: symptoms and medical approach

Menopause is a natural stage in which the ovaries stop producing oestrogen and periods come to a permanent end. Among the most common symptoms of menopause are hot flushes, night sweats, mood changes, dryness of the skin and mucous membranes, and sleep disturbances. It is not a disease, but it is a transition that benefits from medical support in order to protect hormonal health, bone health, and everyday wellbeing.

In Spain, the average age of menopause is around 51–52 years, according to the Spanish Association for the Study of Menopause. Before that point there is a transitional phase, the perimenopause, which typically lasts between four and eight years and during which many of the changes you will notice begin to appear.

Hormonal Changes and How They Affect the Body and Skin

The driving force behind this entire process is the gradual decline of oestrogen and progesterone. These hormones do not only regulate the menstrual cycle: they influence body temperature, mood, bone density, fat distribution, and skin quality.

When oestrogen levels fall, the skin produces less collagen and retains less water. The result is typically skin that is thinner, drier, and more prone to fine lines and pigmentation spots. This is why many women find that their usual routine stops working at this stage. Adapting facial care to mature skin — with hydration, antioxidants, and daily sun protection — makes a real difference.

Hormonal changes also affect bone health. The loss of oestrogen accelerates bone resorption, and during menopause up to 20% of bone mass can be lost, according to the Endocrine Society. The same source notes that one in two postmenopausal women will develop osteoporosis during their lifetime. This is why bone health becomes a priority at this stage.

Most Common Symptoms and Their Impact on Quality of Life

Symptoms vary greatly from woman to woman, both in intensity and duration. The most common are:

• Hot flushes and night sweats. These are vasomotor symptoms. They last an average of around seven years, and more than half of women experience them for even longer.
• Sleep disturbances. Sometimes caused by the night sweats themselves, sometimes by changes in sleep patterns.
• Mood changes and brain fog. Irritability, anxiety or difficulty concentrating.
• Vaginal dryness and discomfort during intercourse. Due to thinning of the mucous membranes.
• Changes in skin and hair. Increased dryness, loss of firmness and, in some women, the appearance or worsening of pigmentation spots.

The impact on quality of life lies not in each symptom in isolation, but in their combined effect. Poor sleep feeds low mood, fatigue reduces the motivation to be active, and lack of activity worsens weight control and bone health. Understanding this chain helps to decide where to begin.

It is worth remembering that the menopause does not affect all women equally. Some barely notice any changes, while others find their daily routine disrupted for years. Factors such as genetics, weight, smoking and level of physical activity influence both the intensity of symptoms and long-term risk. This is why two women of the same age may need very different approaches, and why comparisons between friends rarely help when making decisions.

It is also worth distinguishing between symptoms that are bothersome and signs that should be reviewed. Hot flushes or mood changes are an expected part of the process. However, bleeding after the menopause, a new pain or a low mood that does not lift are reasons to seek medical advice without delay, as they may have causes unrelated to the menopause itself.

Evidence-based medical treatment options

Not all women require treatment, but those with symptoms that interfere with their daily life have options with strong scientific backing. The key is individualisation: age, time since menopause, personal and family medical history, and personal preferences.

Hormonal treatment

Menopausal hormonal treatment replenishes oestrogens, with or without progesterone depending on each case. It is the most effective option for hot flushes and night sweats, and also helps with vaginal dryness and bone protection. In women who begin it close to the menopause and without contraindications, the benefits generally outweigh the risks. The decision is always made following a medical assessment that reviews your clinical history.

Non-hormonal treatments

When hormonal treatment is not appropriate or not desired, non-hormonal medications are available for hot flushes, local treatments for vaginal dryness and specific options to protect bone health. Calcium and vitamin D supplementation is also considered according to each person's individual needs.

The role of follow-up

Menopause is a good time to review your overall health, not just your symptoms. Bone density, blood pressure, metabolic profile and recommended screenings are all part of the care. A preventive medical check-up makes it possible to detect changes early that might otherwise go unnoticed. At Clínica Valorian we approach this stage through evidence-based medicine, combining symptom management with a broad perspective on hormonal health and long-term prevention.

Lifestyle habits for a healthy transition

Habits cannot replace medical treatment when it is needed, but they do make a notable difference to how this stage is experienced. Those with the greatest impact include:

• Strength and impact exercise. Training your muscles and putting load through your skeleton slows bone loss and improves mood and weight control.
• Nutrition with adequate protein and calcium. This protects muscle and bone. Pulses, dairy products or their fortified alternatives, and oily fish are great allies.
• Looking after your sleep. Keep regular hours, a cool bedroom, and reduce screens and alcohol in the evening.
• Quitting smoking and moderating alcohol. Both worsen hot flushes and accelerate bone loss.
• Daily sun protection. Mature skin is more sensitive to sun damage and pigmentation, and the Costa del Sol demands consistency throughout the entire year.

When to seek advice and what to expect from medical follow-up

It is worth seeking advice when symptoms affect your sleep, your mood or your daily life, when dryness causes discomfort during intimacy, or if any abnormal bleeding occurs after menopause. It is also a good time for anyone who simply wants to understand what is happening to their body and feel prepared.

At an initial appointment, the doctor will review your medical history, your symptoms and your risk factors. From there, they may request blood tests, assess bone density and propose a plan that combines, where appropriate, treatment and lifestyle changes. Follow-up appointments serve to fine-tune what is and is not working, because symptoms change over time.

It is helpful to arrive at your appointment prepared. Keeping a note for a few weeks of when hot flushes occur, how you are sleeping, and what makes symptoms better or worse provides valuable information that memory rarely retains with accuracy. It is also worth bringing a list of the medications and supplements you are taking, your family history of osteoporosis or cardiovascular problems, and the specific questions you want answered. With that information, the plan is built around your reality, not around an average case.

The goal of follow-up is not simply to relieve occasional discomfort. It is to look after your health over a ten- or twenty-year horizon: protecting your bones, monitoring your heart and metabolism, and maintaining wellbeing during a stage that, given current life expectancy, many women live through for more than thirty years. Seen in this light, menopause ceases to be an ending and becomes the beginning of a phase of life that can be actively and intentionally cared for.

If your symptoms are beginning to affect your daily life, the next concrete step is to request a personalised medical assessment where you can raise your questions and review your options. Menopause is much easier to navigate when you have a team by your side that understands it for what it truly is: a stage of women's health that deserves attention, not resignation.