The Biggest Hormonal Change That Happens to Women Over 50—and How To Manage It

When you reach 50, you might start to notice that you’re not feeling like yourself. Falling asleep may be a struggle, you're moody, and your libido isn’t what it used to be. These can be signs of hormonal changes.

Menopause (and the period of time leading up to it, known as perimenopause) is the biggest hormonal shift that happens to women (or people assigned female at birth) over 50. Menopause refers to when you’ve gone 12 consecutive months without a period, according to the Cleveland Clinic.

It’s a natural part of aging. Menopause typically starts at age 51, on average. However, hormonal changes can begin sooner, in your 30s or 40s.

“The time leading to menopause—the time leading to the cessation of your period—is the biggest hormonal conundrum in our bodies and minds,” says Anna Cabeca, MD, a FACOG, a board-certified OB/GYN, menopause and sexual health expert, and author of The Hormone Fix.

How these hormonal changes affect you can vary, though. Some people experience hot flashes, trouble sleeping, vaginal dryness, night sweats, mood fluctuations, irregular periods and a lack of interest in sex. The symptoms can be more or less severe, depending on the person, Dr. Cabeca says.

“Menopause is natural and mandatory; suffering is optional,” she adds. “You don't have to power through.”

Here’s an overview of the biggest hormonal changes that happen to women over 50—due to menopause—and how to manage them.

What’s the Difference Between Perimenopause and Menopause?

Perimenopause is the transition phase before menopause. Your ovaries start producing less of the hormones estrogen and progesterone, according to the Cleveland Clinic. This causes your menstrual cycle to become irregular or erratic and signals that your body is preparing to stop releasing eggs altogether and move toward the end of your reproductive cycle.

Related: Dealing With Low Estrogen? Consider Loading Up On These 15 Estrogen-Rich Foods

Perimenopause starts at different times for different people, says Monte Swarup, MD, FACOG, founder of Vaginal Health Hub. “Some start in their 30s, while for most women, it begins in their 40s.”

All women experience perimenopause, which can last several years, but not all women have symptoms, he adds. Signs of perimenopause can include:

  • Skipping periods

  • Heavier or lighter periods

  • Shorter or longer periods

  • Hot flashes

  • Vaginal dryness

  • Urinating more frequently

  • Sleep problems

  • Mood changes, like irritability or depression

  • Pain during sex

You might keep having these symptoms as you transition into menopause and even for years afterward.

Keep in mind that you can still get pregnant during perimenopause since you don’t always know when you’ll ovulate. It’s recommended that you keep up your birth control methods until it’s been a full year since your last period, according to the Office on Women’s Health.

Once you’ve gone 12 months straight without a period, you’ve officially reached menopause. Your ovaries have stopped releasing eggs and producing hormones. The average age of menopause is 51, but women can experience it between 40 and 58.

Related: Here's What a Hot Flash Actually Feels Like, According to OB/GYNs

Why do menopause symptoms vary?

Some women experience mild symptoms of perimenopause and menopause, while others have more severe symptoms. Dr. Swarup says the medical community isn’t entirely sure why.

It could be genetic factors or having more inflammation in the body, Dr. Cabeca adds. People with diabetes and insulin resistance might have more severe symptoms. Dr. Swarup says people who smoke, have a higher body mass index (BMI), or who generally aren’t in good health might also struggle more with symptoms.

“As soon as someone recognizes that they’re not feeling themselves, it’s worth getting a lab check to rule out if it could be something else,” Dr. Cabeca explains.

How to manage hormonal changes after 50

Menopause is a natural process, but Dr. Cabeca says you don’t have to suffer through any symptoms caused by hormonal changes. So, it’s crucial to talk to your doctor whenever you notice changes in how you’re feeling.

Related: If You’re Over 50, These Are the Most Important Foods and Drinks To Avoid, According to Registered Dietitians

“Talk with your OB/GYN and find the best treatment for your individual situation,” Dr. Swarup says.

Many lifestyle changes can help. “The first thing I do is a cleanse: drink well, move well, eat well, sleep well to be well,” Dr. Cabeca explains. She counsels patients on changing their diet to ensure they’re eating plenty of green vegetables, low-glycemic fruits like berries, and high-quality proteins and fats.

Exercising more and reducing stress is also recommended, Dr. Swarup says.

Labs to test hormone levels are also important. Some women may need estrogen therapy or estrogen-progesterone/progestin hormone therapy, also known as combination therapy.

Birth control pills, antidepressants and vaginal creams can help you manage symptoms of menopause, like mood swings, hot flashes and vaginal dryness.

“You don’t have to suffer,” Dr. Cabeca says. “I want women to know that there’s a solution and to really focus on their power and what they should do to heal their bodies.”

Next, read about what it means to have a hormone imbalance.


  • Anna Cabeca, MD, a FACOG, a board-certified OB/GYN, menopause and sexual health expert, and author of The Hormone Fix

  • Monte Swarup, MD, FACOG, and founder of Vaginal Health Hub