The first sign of menopause is usually subtle.  This includes irregular periods and/or spotting that relate to fluctuating hormone levels in your body.  Before body stop producing estrogen, as in the case of menopause, people go through a period of perimenopause, characterized by hormonal fluctuation.  Other symptoms during this perimenopause include hot flashes, night sweat, and irritability.

After a period of perimenopause, menopause starts.  The most obvious sign indicating you're officially in menopause is the absence of a period for 12 consecutive months.  Other symptoms of menopause include:

·         Absence of a period for one full year

·         mood swings and irritability

·         hot flashes

·         night sweats

·         poor sleep

·         cognitive changes (trouble remembering names, directions, losing focus/train of thought)

·          vaginal dryness

·         vaginal/vulvar itching

·         generalized itching

What can cause early menopause?

1)      Smoking

2)      Removal of the pituitary gland where many key hormones are produced.

3)      Medical treatments, including chemotherapy and radiation.

4)      Certain diseases, including genetic and autoimmune disorder.

5)      Removal of ovary can disrupt hormonal actions.

6)      A radical diet: Going vegan or limiting certain food

7)      Body fat: Being too low (under 19.5%) or too high high (over 25%) in body fat can interfere with hormonal balance.

What can you do when you are approaching menopause?

One of the most important things you can do is to eat well and make sure you have a balanced diet. Women over 50 need 2.4mcg of vitamin B12 and 1.5 milligrams of vitamin B6 each day. After menopause, a woman's calcium needs go up to maintain bone health. Women 51 and older should get 1,200 milligrams of calcium each day. Vitamin D also is important to bone health. Women 51 to 70 should get 600 IU of vitamin D each day. Women ages 71 and older need 800 IU of vitamin D each day.  Women past menopause who are still having vaginal bleeding because they are using menopausal hormone therapy might need extra iron.

Other things you can do are:

·         Be active: Exercise can help your bones, heart, mood, and more. At least 2 hours and 30 minutes a week of moderate aerobic physical activity or 1 hour and 15 minutes of vigorous aerobic activity or some combination of the two.  Exercises that build muscle strength on two days each week

• Quit smoking
• Take care of your gynecological health: You will still need certain tests like a pelvic exam after menopause.
• You should discuss blood pressure, bone density, and other tests with your doctor.