Menopause Isn’t One Moment: Understanding Menopause at Every Stage

The world is awash in misinformation about menopause – including the misconception that it is a single moment in time. Unlike when a woman gets her first period, there is no instant in which menopause “starts.” It comes on gradually, with symptoms that come and go over many years of a woman’s life.

Some women even experience the transition between fertility and post-menopause without noticing many symptoms at all. If there is no one-size-fits-all set of experiences, why should women settle for a one-size-fits-all approach to menopause care?

“Most women arrive at menopause under-informed, under-supported and surprised

by the breadth of their symptoms,” said Monica Aszterbaum, MD, OBGYN with Hoag. “For years there’s been very little open conversation about menopause compared to fertility and motherhood, which has left women feeling isolated and alone during this transitional period in their lives.”

Dr. Aszterbaum and her colleagues are bringing menopause into the light with a dedicated Menopause Program, an interdisciplinary, evidence-based approach to perimenopause and menopause care that comprehensively addresses the unique health concerns of women in midlife.

Through personalized care, expert guidance, and innovative therapies to help women navigate the physical, hormonal, and emotional changes experienced throughout menopause, the Hoag Menopause Program brings together a dedicated, multidisciplinary team of specialists in endocrinology, gynecology, mental health, and other areas.

Each month more than 30 Hoag physicians from over 10 specialties meet to share knowledge, review patient case studies, and strengthen the network of specialists who care for women across the lifespan. This ever-expanding council includes clinicians in obstetrics, gynecology, urogynecology, urology, breast oncology, breast health, dermatology, weight management, rheumatology, neurology, and more.

“Our program includes certified menopause specialists through The Menopause Society, the international interdisciplinary medical society that sets the standard for evidence-based menopause care,” Dr. Aszterbaum said. “Today, there is a significant and growing body of menopause literature, and one of our most important roles is helping patients navigate this landscape by directing them to credible, evidence-based sources to ensure they receive accurate, current information.”

One of the main objectives of the Menopause Program is continuous learning. Physicians collaborate regularly to educate themselves on the most current, evidence-based, and clinically credible data on women’s care – expertise they pass on to their patients as the team works together to elevate women’s health care to the next level.

The misconceptions Dr. Aszterbaum and her colleagues are working to dispel include:

Symptoms and duration. Despite a persistent misconception that menopause happens at 51, perimenopause, the time leading up to menopause, is very much part of the menopause process. When estrogen and progesterone begin to fluctuate and decline, symptoms such as hot flashes, weight gain, mood changes and irregular periods can emerge. For many women, this process starts in their 40s, but for some it can begin in their mid-30s.

Treatments and therapies. For decades, one of the most effective treatments for menopause symptoms effectively disappeared. Hormone therapy, including estrogen replacement therapy, was widely used and reached its peak in the 1990s. But its use declined significantly following the Women’s Health Initiative (WHI) study in 2002, which raised concerns about potential risks.

“That moment changed the trajectory of menopause care and research,” Dr. Aszterbaum said. “Today, supported by decades of additional data and clinical experience, we are in a far more informed era with clearer guidelines and a stronger understanding of which patients benefit most from hormone therapy. At the same time, new nonhormonal options and other promising innovations continue to emerge.”

As information and treatments become available, Hoag is committed to providing women with evidence-based, scientific approaches to treat their medical conditions with compassion and empathy – at every stage of this journey.

Learn about Hoag’s Menopause Program.