October is Menopause Awareness Month. This is what is really happening in your body, what you deserve to ask for, and where to find help.
Somewhere in Maricopa or Pinal County at 3:07 this morning, a woman is lying awake, soaked in sweat, with a knee that aches and a mind that cannot find the word she knows she knows. She is forty-eight, or fifty-one, or fifty-six. She has been told it is stress. She has been told it is her age. Some days she has stopped telling anyone at all.
This October, during Menopause Awareness Month, and especially on World Menopause Day, October 18, we want to say to her what no one has said clearly enough: you are not imagining this. What you are living through is real, it has a name, and you deserve to understand it.
Part one
Menopause is not an illness. It is a normal passage in a woman's life, the point when your periods stop for good. You have reached it only after twelve months in a row with no bleeding, including spotting. In the United States, the average age is 52.
The years leading up to that point are called perimenopause, which simply means "around menopause." It usually begins in the mid to late forties and, for most women, lasts about four years, though it can run anywhere from two to eight. During this time your ovaries make estrogen and progesterone in uneven amounts, which is why your body can feel unpredictable. Periods may come closer together, farther apart, heavier, or lighter. You can still become pregnant, so if you do not want to, keep using birth control until a full year after your last period.
Part two
Hot flashes and night sweats. Sleep that breaks into pieces. Mood swings, anxiety, a shorter fuse. Brain fog. Vaginal dryness, painful sex, and less desire. Bladder changes. Aching joints. Headaches. Not every woman has all of these, and some have almost none, but many have more than one at the same time, and almost no one was warned.
Many women are told hot flashes will pass in a year or two. The largest study of women through midlife in the United States, the SWAN study, found that among women who had frequent hot flashes and night sweats, the median length was about seven and a half years. For Black women it was about ten years, the longest of any group in the study.
The brain fog is real too. Research suggests it is usually subtle and temporary, and for most women it is not a sign of early dementia. But memory trouble that keeps getting worse, or that makes everyday tasks hard to manage, deserves a doctor's attention.
Depression is also more likely in this season, especially if you have struggled with it before. That is not weakness. It is common, and it is treatable.
And then there is the part many women never say out loud. Vaginal dryness and painful sex are common after menopause and tend to get worse without treatment. There are safe and effective options. A good clinician will not be embarrassed to talk about it, and you should not be either.
Part three
This year, the International Menopause Society chose chronic pain at midlife as the theme for World Menopause Day, and the numbers explain why. Women are up to 70 percent more likely than men to live with chronic pain. Almost 3 in 4 women have joint or muscle pain during perimenopause. Migraine often gets worse in the years leading up to menopause. Fibromyalgia is about three times more common in women than in men.
Here is what we most want you to hear. This pain is real. It has physical causes, even when scans and blood tests look normal. Falling estrogen affects your nerves, joints, and muscles, and it changes how your brain processes pain signals. Poor sleep and low mood turn the volume up, and pain makes sleep harder, so the cycle feeds itself.
What helps is usually a combination. Movement, especially strength training, is one of the most helpful things for joint and muscle pain over time. Physical therapy can help with joint, muscle, and pelvic pain. Talk therapy, such as cognitive behavioral therapy, can help you live well with pain. That does not mean the pain is in your head. It means you are getting support for something that is very much in your body. Hormone therapy can ease many menopause symptoms, but the evidence does not show it reliably treats joint or muscle pain on its own, so ask your doctor to weigh it with you. And be careful with online "miracle" fixes. Many supplements and detox products are expensive and not well supported by evidence.
Part four
In one large Mayo Clinic survey of women ages 45 to 60, more than 8 in 10 had not sought medical care for their symptoms. Many were too busy. Many did not know effective treatments existed. Part of the reason is that many doctors were never taught. In a 2023 survey, only about 3 in 10 OB-GYN residency program directors said their program had a menopause curriculum.
For women of color, the gap can be wider. Researchers have documented that pain is assessed and treated differently depending on a patient's race and language. In one primary care study of patients with moderate to severe pain, opioid therapy was prescribed three times as often to English-speaking white patients as to minority patients with limited English. If that sounds familiar, it is because it is the same pattern so many of us already know: showing up in pain and having to fight to be believed.
There is real movement, though. In 2026 the FDA began approving updated labels that remove most boxed warnings from several hormone therapy products, and two newer non-hormonal medicines for hot flashes have been approved. None of this means any one treatment is right for everyone. Hormone therapy suits some women and not others, and the newer medicines come with their own safety checks. It means there are more options on the table than most women were ever told about.
Part five
Before your appointment, track your symptoms and your periods for a couple of months. Write down how much each one gets in the way of work, sleep, intimacy, and joy. Then bring your questions:
Some things should not wait. Any vaginal bleeding after menopause needs to be checked as soon as possible. So does very heavy bleeding. Chest pain, trouble breathing, or signs of a stroke are emergencies, so call 911. And if you ever find yourself thinking about harming yourself, call or text 988.
Free tools
Two free, fillable PDFs to help you track what is happening and walk into your appointment prepared. Fill them in on your computer or phone, or print them.
A daily log for symptoms and periods, plus a monthly check-in on how much it gets in the way of work, sleep, intimacy, and joy.
Download PDF ↓Your concerns, your history, your medications, and the questions to ask, with space to write down the answers.
Download PDF ↓Part six
If any part of this is your story, here is where to start. These are real organizations doing real work, not us.
National
The Menopause Society offers free, evidence-based patient education on hot flashes, perimenopause, mental health, sexual health, and more, written by menopause experts.
Visit The Menopause Society →Find a Menopause Practitioner is The Menopause Society's directory for finding a clinician with menopause training.
Visit the practitioner directory →Office on Women's Health (U.S. Department of Health and Human Services) explains perimenopause, menopause, symptoms, and treatment in plain language. Its helpline, 1-800-994-9662 (9 a.m. to 6 p.m. Eastern, Monday through Friday), is a resource line. It does not give medical advice or see patients.
Visit the Office on Women's Health →World Menopause Day is the International Menopause Society's global awareness day. Its 2026 factsheet, "Chronic Pain at Midlife," is a good one to share with a friend.
Visit World Menopause Day →International Society for the Study of Vulvovaginal Disease (ISSVD) publishes patient handouts on vulvar and vaginal conditions, including painful sex.
Visit the ISSVD patient handouts →988 Suicide and Crisis Lifeline is free, confidential, and available 24 hours a day by call, text, or chat at 988.
Visit the 988 Lifeline →Here in Arizona
Mayo Clinic Women's Health Internal Medicine in Scottsdale offers consultative care for menopause and perimenopause, including hot flashes, sleep and mood changes, hormone therapy, and sexual health concerns. It works alongside your own primary care provider and gynecologist, and you can schedule without a referral. 13737 North 92nd Street, Scottsdale, AZ 85260. Phone: 480-614-6001, Monday through Friday, 8 a.m. to 5 p.m. Mountain Time.
Visit Mayo Clinic Women's Health Internal Medicine →Your own primary care provider or gynecologist is a good first call. Bring your symptom log, and ask whether they treat menopause or can refer you to someone who does. You can also search The Menopause Society's directory above using your Arizona ZIP code.
We are not able to vouch for outcomes at any organization or provider listed here. We are pointing you toward people who specialize in this, because you deserve support from those trained to give it.
"But those who trust in the LORD will find new strength. They will soar high on wings like eagles. They will run and not grow weary. They will walk and not faint." (Isaiah 40:31, NLT)
At Kingdom Mission, we do not believe midlife is a decline. We believe it is a season that deserves honest information, skilled care, and a community that never makes you whisper. The problem was never that women are fading. It is that too many of us have been left to figure out a major change in our bodies alone, without the facts, and without anyone who believed us.
We are not medical professionals, and this is not medical advice. But we are a place where you can be encouraged, informed, and pointed toward your next step. Please bring your care team alongside you, and do not stop asking to be heard until you are. Your symptoms are real. Your story matters. And you were never meant to carry this alone.
Sources
Pain at midlife
Symptoms, mood, and the transition
The care gap and treatment
Kingdom Mission is not a medical provider. This content is educational and does not replace medical advice. Please consult a healthcare provider for personal medical guidance.
Kingdom Mission is a 501(c)(3) nonprofit serving Maricopa and Pinal counties, Arizona, with a focus on women's health, wellness, and community. Learn more at kd-mission.org.