Menopause
Common Questions & Answers
Perimenopause, menopause, and postmenopause are the three stages of menopause. Perimenopause begins when your ovaries gradually stop working, lasting up to 10 years until menopause, the end of your menstrual cycle, occurs. Postmenopause is the remainder of life following menopause.
During the menopausal transition, the body significantly reduces its production of the hormones estrogen and progesterone. This change can lead to hot flashes, mood swings, and disrupted sleep. Eventually, your menstrual cycle will end.
If you're tracking your menstrual cycle, you'll know you've experienced menopause if you haven't had a menstrual period for 12 consecutive months. Your physician can also perform a blood test measuring hormone levels that indicate menopause.
While neither universal nor uniform, the mental side effects of menopause can include depression, anxiety, mood swings, brain fog, memory issues, and trouble concentrating, often as a result of the body's diminishing estrogen production.
Menopause increases a woman's risk of heart disease, as the body's loss of estrogen negatively affects the flexibility of blood vessels. Reduced estrogen also leads to bone loss, making osteoporosis a significant concern as well.
Kara Smythe, MD
Medical Reviewer
Kara Smythe, MD, has been working in sexual and reproductive health for over 10 years. Dr. Smythe is a board-certified fellow of the American College of Obstetricians and Gynecologists, and her interests include improving maternal health, ensuring access to contraception, and promoting sexual health.
She graduated magna cum laude from Florida International University with a bachelor's degree in biology and earned her medical degree from St. George’s University in Grenada. She completed her residency in obstetrics and gynecology at the SUNY Downstate Medical Center in Brooklyn, New York. She worked in Maine for six years, where she had the privilege of caring for an underserved population.
Smythe is also passionate about the ways that public health policies shape individual health outcomes. She has a master’s degree in population health from University College London and recently completed a social science research methods master's degree at Cardiff University. She is currently working on her PhD in medical sociology. Her research examines people's experiences of accessing, using, and discontinuing long-acting reversible contraception.
When she’s not working, Smythe enjoys dancing, photography, and spending time with her family and her cat, Finnegan.
Anurag Sahu, MD
Medical Reviewer
Anurag Sahu, MD, is the director of the adult congenital heart program at Inova Health System in Fairfax, Virginia. Previously, he was an associate professor of medicine as well as an associate professor of radiology at Emory University in Atlanta, where he also served as director of cardiac intensive care.
He attended medical school at the University of Missouri in Kansas City in its combined six-year BA/MD program. He then completed his internal medicine residency at Washington Hospital Center in Washington, DC; fellowship training at Rush University in Chicago; and advanced training in cardiac imaging and adult congenital heart disease at The Ohio State University in Columbus.
Dr. Sahu has published book chapters on cardiovascular imaging as well as a variety of journal articles in publications including The Journal of Heart and Lung Transplant, JACC: Cardiovascular Interventions, and the Journal of Thoracic Imaging.
Among the places that his career has taken him, his favorite was Kauai, Hawaii, where he was the only cardiologist on the island.
Justin Laube, MD
Medical Reviewer
Justin Laube, MD, is a board-certified integrative and internal medicine physician, a teacher, and a consultant with extensive expertise in integrative health, medical education, and trauma healing.
He graduated with a bachelor's in biology from the University of Wisconsin and a medical degree from the University of Minnesota Medical School. During medical school, he completed a graduate certificate in integrative therapies and healing practices through the Earl E. Bakken Center for Spirituality & Healing. He completed his three-year residency training in internal medicine at the University of California in Los Angeles on the primary care track and a two-year fellowship in integrative East-West primary care at the UCLA Health Center for East-West Medicine.
He is currently taking a multiyear personal and professional sabbatical to explore the relationship between childhood trauma, disease, and the processes of healing. He is developing a clinical practice for patients with complex trauma, as well as for others going through significant life transitions. He is working on a book distilling the insights from his sabbatical, teaching, and leading retreats on trauma, integrative health, mindfulness, and well-being for health professionals, students, and the community.
Previously, Dr. Laube was an assistant clinical professor at the UCLA Health Center for East-West Medicine and the David Geffen School of Medicine at UCLA, where he provided primary care and integrative East-West medical consultations. As part of the faculty, he completed a medical education fellowship and received a certificate in innovation in curriculum design and evaluation. He was the fellowship director at the Center for East-West Medicine and led courses for physician fellows, residents, and medical students.
Kacy Church, MD
Medical Reviewer
Dr. Church always knew that she wanted to pursue endocrinology because the specialty allows for healthy change through patient empowerment. She completed her fellowship in endocrinology, diabetes, and metabolism in 2017 at Stanford University in California.
She loves running, dancing, and watching her sons play sports.
Lynn Grieger, RDN, CDCES
Medical Reviewer
Lynn Grieger is a registered dietitian-nutritionist, certified diabetes care and education specialist, certified personal trainer, and certified health and wellness coach. She completed requirements to become a registered dietitian at Valparaiso University in 1987 and completed a dietetic internship at Ingalls Memorial Hospital in Harvey, Illinois, in 1988.
Lynn brings her expertise in nutrition, exercise, and behavior change to her work in helping people reach their individual health and fitness goals. In addition to writing for Everyday Health, she has also written for websites and publications like Food and Health Communications, Today's Dietitian, iVillage.com, and Rodale Press. She has a passion for healthy, nutrient-dense, great-tasting food and for being outdoors as much as possible — she can often be found running or hiking, and has completed a marathon in every state.
Juliana (Jewel) Kling, MD, MPH
Medical Reviewer
Jewel Kling, MD, MPH, is the chair of the division of women's health internal medicine and the assistant director of the women's health center at the Mayo Clinic in Scottsdale, Arizona. She is the dean of the Mayo Clinic Alix School of Medicine's Arizona campus. Her clinical and research interests are in menopause, sexual health, and LGBTQ+ care.
She completed medical school and a master's in public health at the University of Arizona and an internal medicine residency at the Mayo Clinic in Arizona, followed by an internal medicine fellowship.
She is a North American Menopause Society–certified menopause practitioner and serves on the boards of the International Society for the Study of Women's Sexual Health and the American Medical Women's Association Sex and Gender Health Collaborative. She is part of the transgender steering committee at the Mayo Clinic in Arizona and was co-chair of the LGBTI Mayo Employee Resource Group. She is also active with the internal medicine residency program, as well as efforts to expand the discipline of sex- and gender-specific medicine.
Jacquelyn Dosal, MD
Medical Reviewer
Jacquelyn Dosal, MD, is a board-certified dermatologist at Skin Associates of South Florida in Coral Gables. She practices general, medical, cosmetic, and surgical dermatology.
Dr. Dosal provides compassionate care to all her patients, listening to their concerns and creating a treatment plan with each patient's priorities and real life in mind.
She is a member of the voluntary faculty at the University of Miami.
Elise M. Brett, MD
Medical Reviewer
Dr. Brett practices general endocrinology and diabetes and has additional certification in neck ultrasound and fine-needle aspiration biopsy, which she performs regularly in the office. She is voluntary faculty and associate clinical professor at the Icahn School of Medicine at Mount Sinai. She is a former member of the board of directors of the American Association of Clinical Endocrinology. She has lectured nationally and published book chapters and peer reviewed articles on various topics, including thyroid cancer, neck ultrasound, parathyroid disease, obesity, diabetes, and nutrition support.
John Paul McHugh, MD
Medical Reviewer
John Paul McHugh, MD, is an obstetrician-gynecologist and lifestyle medicine specialist in southern California. He has always placed wellness at the center of his work, in both delivering babies and improving practice standards. Dr. McHugh believes that bringing lifestyle medicine to the center of health and wellness empowers patients to make the change they seek and enjoy the benefits of true wellness.
He is a graduate of Harvard Medical School and the Massachusetts Institute of Technology and a fellow of the American College of Lifestyle Medicine. He served as a department chair at Scripps Mercy Hospital in San Diego and is now the chair-elect for the American College of Obstetricians and Gynecologists for California.
He has published several articles in the American Journal of Lifestyle Medicine and served as a peer reviewer for many articles. He contributed to the first textbook of lifestyle medicine in women's health: Improving Women's Health Across the Lifespan.
Chung Yoon, MD
Medical Reviewer
Ross Radusky, MD
Medical Reviewer
Ross Radusky, MD, is a practicing board-certified dermatologist at the Dermatology Treatment and Research Center in Dallas. Originally from New York City, he graduated summa cum laude from the City University of New York and then received his MD from the New York University School of Medicine. There, he was inducted into the Alpha Omega Alpha Honor Medical Society and served as chapter president for two years. He completed his residency in dermatology at NewYork-Presbyterian Hospital and Weill Cornell Medical Center, and at Memorial Sloan Kettering Cancer Center.
Dr. Radusky practices general and cosmetic dermatology with a focus on the early detection of skin cancer, and provides patients with a personalized approach to looking their best at any age. He has authored articles and textbook chapters on the clues that our finger- and toenails may provide us about internal disease, as well as on comprehensive therapies for cosmetic dermatology and reversing the signs of skin aging.
Complementing his medical practice, Radusky has a strong passion for the cultural arts, particularly in expanding access to youths and seniors. He previously served as an artist instructor for the Rockaway Artists Alliance, a New York City nonprofit arts and education organization, and then served as both a board director and treasurer of the organization throughout his medical school training.
Radusky enjoys spending time outdoors with his wife Robyn, son Oliver, and poodle Lucy, where he can usually be found preventing photoaging and reducing the risk of skin cancer beneath an umbrella in a wide-brimmed hat. He is also the proud inventor of Sunshotz, the world’s only sunscreen measuring cup, designed to help patients of all ages apply the proper amount of sunscreen needed to enjoy all the sun without the burn.
Reyna Franco, RDN
Medical Reviewer
Reyna Franco, RDN, is a New York City–based dietitian-nutritionist, certified specialist in sports dietetics, and certified personal trainer. She is a diplomate of the American College of Lifestyle Medicine and has a master's degree in nutrition and exercise physiology from Columbia University.
In her private practice, she provides medical nutrition therapy for weight management, sports nutrition, diabetes, cardiac disease, renal disease, gastrointestinal disorders, cancer, food allergies, eating disorders, and childhood nutrition. To serve her diverse patients, she demonstrates cultural sensitivity and knowledge of customary food practices. She applies the tenets of lifestyle medicine to reduce the risk of chronic disease and improve health outcomes for her patients.
Franco is also a corporate wellness consultant who conducts wellness counseling and seminars for organizations of every size. She taught sports nutrition to medical students at the Albert Einstein College of Medicine, taught life cycle nutrition and nutrition counseling to undergraduate students at LaGuardia Community College, and precepts nutrition students and interns. She created the sports nutrition rotation for the New York Distance Dietetic Internship program.
She is the chair of the American College of Lifestyle Medicine's Registered Dietitian-Nutritionist Member Interest Group. She is also the treasurer and secretary of the New York State Academy of Nutrition and Dietetics, having previously served in many other leadership roles for the organization, including as past president, awards committee chair, and grant committee chair, among others. She is active in the local Greater New York Dietetic Association and Long Island Academy of Nutrition and Dietetics, too.
Adam Gilden, MD, MSCE
Medical Reviewer
Adam Gilden, MD, MSCE, is an associate director of the Obesity Medicine Fellowship at University of Colorado School of Medicine and associate director of the Colorado University Medicine Weight Management and Wellness Clinic in Aurora. Dr. Gilden works in a multidisciplinary academic center with other physicians, nurse practitioners, registered dietitians, and a psychologist, and collaborates closely with bariatric surgeons.
Gilden is very involved in education in obesity medicine, lecturing in one of the obesity medicine board review courses and serving as the lead author on the Annals of Internal Medicine article "In the Clinic" on obesity.
He lives in Denver, where he enjoys spending time with family, and playing tennis.
Kara Smythe, MD
Medical Reviewer
Kara Smythe, MD, has been working in sexual and reproductive health for over 10 years. Dr. Smythe is a board-certified fellow of the American College of Obstetricians and Gynecologists, and her interests include improving maternal health, ensuring access to contraception, and promoting sexual health.
She graduated magna cum laude from Florida International University with a bachelor's degree in biology and earned her medical degree from St. George’s University in Grenada. She completed her residency in obstetrics and gynecology at the SUNY Downstate Medical Center in Brooklyn, New York. She worked in Maine for six years, where she had the privilege of caring for an underserved population.
Smythe is also passionate about the ways that public health policies shape individual health outcomes. She has a master’s degree in population health from University College London and recently completed a social science research methods master's degree at Cardiff University. She is currently working on her PhD in medical sociology. Her research examines people's experiences of accessing, using, and discontinuing long-acting reversible contraception.
When she’s not working, Smythe enjoys dancing, photography, and spending time with her family and her cat, Finnegan.
Angela D. Harper, MD
Medical Reviewer
Angela D. Harper, MD, is in private practice at Columbia Psychiatric Associates in South Carolina, where she provides evaluations, medication management, and psychotherapy for adults.
A distinguished fellow of the American Psychiatric Association, Dr. Harper has worked as a psychiatrist throughout her career, serving a large number of patients in various settings, including a psychiatric hospital on the inpatient psychiatric and addiction units, a community mental health center, and a 350-bed nursing home and rehab facility. She has provided legal case consultation for a number of attorneys.
Harper graduated magna cum laude from Furman University with a bachelor's degree and cum laude from the University of South Carolina School of Medicine, where she also completed her residency in adult psychiatry. During residency, she won numerous awards, including the Laughlin Fellowship from the American College of Psychiatrists, the Ginsberg Fellowship from the American Association of Directors of Psychiatric Residency Training, and resident of the year and resident medical student teacher of the year. She was also the member-in-training trustee to the American Psychiatric Association board of trustees during her last two years of residency training.
Harper volunteered for a five-year term on her medical school's admission committee, has given numerous presentations, and has taught medical students and residents. She currently supervises a nurse practitioner. She is passionate about volunteering for the state medical board's medical disciplinary commission, on which she has served since 2015.
She and her husband are avid travelers and have been to over 55 countries and territories.
- What Is Menopause? National Institute on Aging. October 16, 2024.