Menopause oftentimes comes with bothersome symptoms, such as insomnia, mood swings, hot flashes, generalized anxiety, and fears about what menopause is doing to our bodies. We meet to discuss what you are going through. We then teach you a wide range of techniques that aim to change your perspective on menopause and help you appreciate that you are "transitioning into a different phase of your life. A vital part of the session involves teaching you to practice relaxation responses when feeling the effects of menopause. What is menopause? Menopause is the time in a woman's life when her period stops. It usually occurs naturally, most often after age 45. Menopause happens because the woman's ovaries stop producing the hormones estrogen and progesterone. The transition into menopause is called perimenopause, and it can begin several years before your last menstrual period. After a full year without a period, you have been "through menopause." The average age of a woman having her last period is 51, but some women have their last period in their forties, and some have it later in their fifties. Perimenopausal and menopause symptoms include: • A change in periods - shorter or longer, lighter or heavier, with more or less time in between • Hot flashes and/or night sweats • Trouble sleeping • Vaginal dryness • Mood swings • Trouble focusing • Less hair on the head, more hair on the face While these symptoms are not life-threatening, they can be so bothersome that they interfere with the quality of life.

No More Periods Menopause marks the end of the menstrual cycle, which for many women is a cause for celebration in itself. It means no more fussing with tampons or pads, no more worry about leakage, and no more menstrual cramping. And after the perimenopausal years, when periods often become irregular and bleeding may be heavy, it puts an end to the guessing game of when your period is going to start or stop. "Some women are even limited to their homes on days when bleeding is heavy. For them, menopause can be incredibly liberating," Goodbye to PMS In the week or two before your period, premenstrual syndrome (PMS) can cause a host of physical and emotional symptoms, ranging from breast tenderness and headache pain to food cravings and irritability. PMS is very common: According to the American College of Obstetricians and Gynecologists, at least 85 percent of all menstruating women experience one symptom or more each month. In perimenopause, PMS can temporarily worsen as estrogen levels rise and fall. All the better, then, to have PMS disappear after menopause. "Perimenopause involves a number of years of a very rough hormonal ride, so there's no question, particularly for women who have had mood changes around these hormonal fluxes, that menopause can be an 'Ahhhh!' kind of time. Sex Without Pregnancy Worries Women in menopause can enjoy sex without having to think about a possible pregnancy. This makes a big difference, according to the Study of Women's Health Across the Nation, a multisite, longitudinal study of the physical and psychosocial changes women experience in midlife, including menopause. "Among American women of different ethnic groups, sex without thinking about pregnancy was frequently cited as one of the benefits of menopause," says Nanette Santoro, MD, professor and director of Reproductive Endocrinology at Albert Einstein College of Medicine in New York. Some women even find that, because they no longer have to worry about the unanticipated outcome of sex, they can actually enjoy it more once they reach menopause. The End of Hormonal Headaches Women are affected by migraines three times more often than men, according to the National Headache Foundation. About 70 percent of these women have menstrual migraines, headaches that coincide with ovulation and menstruation. Like other migraines, these headaches cause throbbing pain on one side of the head, sometimes accompanied by nausea, vomiting, and light or sound sensitivity. In a normal menstrual cycle, fluctuating levels of the hormones estrogen and progesterone can trigger menstrual migraines. But after menopause, levels of estrogen and progesterone fall, and often the number of hormonal headaches declines too. Headaches can temporarily worsen during the turbulent hormone changes associated with perimenopause, but migraine sufferers can look forward to an improvement once they are through the menopause transition. Uterine Fibroids Shrink Many women approaching their 50s develop fibroids, uterine tumors that are almost always benign. Fibroids grow when estrogen levels in the body are high — during pregnancy, when levels of estrogen and progesterone increase, and in perimenopause when estrogen levels can swing from low to high. If fibroid symptoms, including pain, heavy menstrual bleeding, and pressure on the bladder are severe, doctors may recommend surgery. Fortunately, fibroids often stop growing or shrink when women reach menopause and estrogen levels decline. "For women who have been charting fibroid growth hoping to avoid surgery, or for those who have heavy periods due to fibroids, menopause is welcome," says Marcie Richardson, MD, director of the Harvard Vanguard Menopause Consultation Service in Boston, Massachusetts. "For women who have fibroids sitting on their bladder, menopause gives them a break!" A Chance to Take Stock American anthropologist Margaret Mead called it "menopausal zest" — the rush of energy, both physical and psychological, that some women feel after menopause. This makes menopause a natural time for women to take stock of their lives. Many decide to take a fresh look at their relationships, their professions, the ways they're caring for their own health, and the ways they want to expend their energy. "It's important to take advantage of this wakeup call to say, 'Let's put our best foot forward as we move along,' " says Dr. Stuenkel. She advises menopausal women to ask themselves if they're headed in the direction they want to go, both professionally and personally, and whether the way they're spending their time is meaningful to them. Greater Self-Assurance It's not uncommon for postmenopausal women to report feeling empowered, partly because of the biological changes that take place in menopause and partly because of the point in life at which menopause occurs. "Women are often relieved not to have monthly periods with the accompanying risk of pregnancy, mood swings, and other PMS symptoms,At the same time, your children are growing older and you are freed to pursue your professional and personal ambitions." After 50-plus years of life experience, including the ups and downs of relationships, child-rearing, and careers, women are more likely to go after what they want with a greater sense of confidence that they can handle whatever comes their way. A Time to Take Risks "We used to say, after menopause, you have a third of your life to live," says Dr. Stuenkel. "But now I tell women, 'You have half of your life to live. Stop holding back because the party starts now.' " This is a message that women in menopause are primed to hear, because midlife is the time when women are inclined to take more chances. If there's something you've been putting on hold, there's no time like the present to taste what life has to offer. Focus on Caring for Yourself With children grown or on their way to independence and a career that's well established, women in menopause have more time to take care of themselves. Many women in menopause are receptive to making changes that will maintain or improve their health." These changes can start with getting regular health checkups and routine health screenings, such as mammograms and Pap tests. You can also put your best foot forward by eating a healthy diet that's low in fat and high in fruits and vegetables, and by getting regular physical activity — anything from walking and biking to gardening and housework counts. And finally, it's important to take time out and reduce stress; techniques such as meditation, relaxation techniques, or tai chi can help. Bonding With Other Menopausal Women When hot flashes have you peeling off layers of clothing or when you can't remember what that one thing was that you came to the supermarket for, you're likely to feel a kinship with any woman as sweaty or forgetful as yourself. Talking — and often joking — with other women about the menopausal symptoms you're experiencing can be very helpful by reassuring you that you're not alone. "Not only do women exchange coping strategies and sympathy and empathy, but sharing their stories gives women the courage to face the world, knowing that they're in good company and those unwelcome symptoms will not last forever.