(Feature Impact) Menopause is a phase of life every woman knows will come eventually yet few are truly prepared for. Beyond stereotypical symptoms like hot flashes and mood swings, the other realities of menopause can be mysterious, taking women by surprise when their experiences differ from expectations.

Rather than being a single event, menopause involves a gradual transition that happens as estrogen production changes – meaning symptoms can appear and evolve unpredictably. According to a survey commissioned by the National Menopause Foundation, 63% of U.S. women ages 35-54 experienced symptoms they believed may be related to perimenopause or menopause, yet nearly half (49%) said they weren’t prepared for the changes beforehand.

When women and their loved ones understand what they’re facing, they can approach this time with patience and compassion, which can make a real difference to the 71% of women who wished the people in their lives understood more about perimenopause or menopause. Consider these five facts to help fill in the menopause knowledge gap.

Perimenopause Can Start Years Before Menopause

The physiological transition to menopause can happen up to 10 years before a woman’s final menstrual period, although the average length of perimenopause is about four years. Symptoms may quietly begin in a woman’s 30s, 40s or 50s, and what might look like an isolated problem at first – like brain fog, a night of insomnia or an irregular monthly cycle – could be connected to broader hormonal changes.

Menopause Is More Than Just “Hot Flashes”

Since more than half of women surveyed were already aware of menopause symptoms like hot flashes, mood changes, anxiety and fatigue, these may not take them by surprise. Little-known symptoms are a different story – the majority of respondents didn’t anticipate menopausal issues like rage, inner-ear itching or reduced joint mobility. According to the National Menopause Foundation, women may also experience sleep disturbances, sweating, changes in libido, vaginal dryness, incontinence, weight changes and more.

Every woman’s experience is unique, so these symptoms could present in different combinations and intensities during menopausal years or may not appear at all.

Talking About Menopause Can Be Difficult

Even as women go through these physical and emotional shifts, many struggle to open up about their experiences. In fact, women rank menopause symptoms (17%) more difficult to discuss than hot-button topics like political views (13%), weight (13%) and religious beliefs (10%).

However, suffering in silence can lead to feelings of isolation, relationship misunderstandings and hesitation to seek help, which is why 66% of women said the lack of open discussion about menopause makes the experience worse.

Menopause Isn’t All Bad News

Although this season of life comes with challenges, there are joys to embrace as well. Women navigating midlife can come out the other side with more resilience, emotional awareness and a stronger sense of self. In fact, 44% of women surveyed said their outlook on life became more positive since their transition.

What Loved Ones Can Actually Do

Menopause is a highly individual experience, but that doesn’t mean women have to navigate it alone. Support from partners, families and friends can lift women up during difficult moments, and it can be as simple as taking the time to ask questions, listen and learn about how menopause is affecting their lives. With 30% of women in the U.S. labor force – approximately 15-16 million – in the age range corresponding to menopausal transition (ages 45-60), workplaces can also take steps to become more menopause friendly.

For more resources to help understand symptoms and discuss the transition with loved ones, visit nationalmenopausefoundation.org.

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Source: National Menopause Foundation