Menopause is a natural biological process, and although it ends fertility, women can stay healthy, vital, and sexual. Even so, the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt your sleep, lower your energy or—for some women–trigger anxiety or feelings of sadness and loss.

Symptoms of Menopause include:

• Absence of period for 12 months
• Hot flashes
• Night sweats
• Mood swings and irritability
• Difficulty sleeping
• Cognitive changes (difficulty remembering names, directions, losing focus/train of thought)
• Vaginal dryness
• Vaginal/vulvar itching
• Generalized itching
• Bone loss

Once your period has officially stopped, the estrogen levels in your body will gradually decline; also, you will no longer produce another female hormone called progesterone. Such hormonal changes may intensify the hot flashes, mood swings, or other symptoms you may have been experiencing throughout perimenopause, or they may trigger symptoms you have yet to experience. Another physical sign of menopause is bone loss (approximately 20 percent of bone mass can be lost in the first five years of menopause). And although hot flashes usually subside, some women experience hot flashes for the rest of their life.

If you experience these symptoms, the first thing you should do is make an appointment with your provider. As Estrogen therapy can help with the cardiovascular issues that come with menopause, it is recommended that estrogen therapy begin within five years of the last period.

Is Hormone Replacement Therapy Safe?

A common question is if hormone therapy is safe and whether it can cause it cancer. Hormone Replacement Therapy can increase the risk of Estrogen-dependent Cancer. It’s important to see your provider so they can take a thorough history and help determine your risk and whether estrogen is safe for you. There are alternatives such as hormone creams, etc. There’s a lot more options on the market now than there used to be. Everyone is different and your provider can help guide you through this process.

RELATED: Are Bio-Identical Hormones for Menopause Safe to Use?

Can I Remain Sexually Active After Menopause?

It can be difficult to remain sexual during and after menopause because of vaginal dryness and decrease in libido. Using lubricants and continuing to be sexually active helps promote natural lubrication. The saying “use it or lose it” is definitely applicable in this case.