Menopause, which is considered a normal part of the aging process, typically occurs in women between the ages of 40 and 50 – after they’ve not had a menstrual period for 12 consecutive months. There is also something known as perimenopause (or menopause transition), in which a woman may develop symptoms leading up to menopause – including hormones that fluctuate – such as changes in their monthly cycle, a decrease in the number of stored eggs in their ovaries, as well as unpredictable production of progesterone, and a drop in estrogen production too. Perimenopause usually starts when a woman is in her 40s but can begin as early as her 30s – and, in some cases, even earlier.

As mentioned, menopause often doesn’t hit until a woman is in her 40s – with 95% of women who experience menopause developing it around the age of 45. If you develop menopause before the age of 40, however, this is known as premature menopause. Premature menopause can occur as a result of a number of different reasons including genetics, autoimmune disorders, and even having certain medical procedures (for example, having the ovaries removed for medical reasons, like endometriosis, which can then lead to induced menopause.) Premature ovarian failure can also cause a woman to go into premature menopause. This is because when the ovaries fail, the levels of estrogen and progesterone that a woman’s body is getting will change. What causes the ovaries to fail, however, is not clear, though it isn’t always permanent.

So how do you know whether or not you are in menopause? It is usually diagnosed based on the symptoms that you experience, which can include the following:

Vasomotor symptoms: Affecting as many as 80% of women diagnosed with menopause, vasomotor symptoms include hot flashes, sweating, and even palpitations. These symptoms can also occur in the perimenopause stage and are some of the earliest warning signs that you could be going into menopause. These symptoms will usually go away over time; however, some women can also experience vasomotor symptoms even during the postmenopausal stage. Using a cool cloth or fan can help to relieve some of these symptoms.

Changes in mood: Another very common symptom that is associated with menopause are mood swings, or other changes in mood such as anxiety, and even bouts of depression and memory loss. If mood-related symptoms are severe, antidepressants or anti-anxiety medication can sometimes be beneficial. Memory loss related to menopause is usually minor, but can still be disruptive, and can include things like having difficulty recalling the names of individuals or finding/remembering certain words. To keep the mind sharp and decrease anxiety, I recommend getting regular physical activity, eating a healthy diet, and maintaining good social connections.

Weight gain: Speaking of having a healthy diet, weight gain is also something that can sometimes occur as a result of menopause. In fact, the average woman going through menopause will gain approximately 4 and a half to 5 pounds. You can control your weight by exercising regularly, watching your caloric intake, and reducing carbohydrates and sugar. You can find more of my healthy eating tips here.

Sleep disturbances: Another classic symptom that is associated with menopause, which can include difficulty falling asleep as well as waking up repeatedly in the middle of the night, and a general feeling of fatigue. To improve sleep, there are certain lifestyle habits that I recommend trying. For example, if you’re a coffee drinker, cut back on your caffeine intake – especially at night. You should also avoid eating heavy meals at late hours as well as snacking on unhealthy foods. Certain things like electronics (such as computers, smartphones and televisions) can also make it harder to fall or stay asleep at night, so limit the time you spend on these devices in the evenings as well. You should also make sure your bedroom is dark enough, and you may even need to replace your mattress. Medication can also be helpful. If, after making these changes, you’re still having trouble with your sleep or you find that you are severely fatigued, it may be a good idea to book an appointment you’re your family doctor to make sure something else isn’t going on medically, such as sleep apnea.

Vision changes: Due to changes in hormonal balance, it’s not uncommon for a woman that is going through menopause to also develop changes in their vision. For example, dry eye, which can cause the eyes to have a grit-like sensation as well as feel sore, but can even cause blurred vision. Artificial tears are the most common treatment recommended for dry eye, though it’s always a good idea to see your optometrist for regular check-ups to ensure you don’t have any other vision problems going on, such as cataracts, glaucoma, or macular degeneration.