Confirmed after 12 months without a period. As estrogen levels drop, our cycles become irregular and the duration and intensity of bleeding begins to vary. Some women skip periods, even for months at a time, then start again. Any pattern is possible. A cold chill often follows.
Some women never have a hot flash.
Those who do can experience them over a period of three to five years. In rare cases, hot flashes continue into the ninth decade of life. These are changes in the vagina or genital area as well as the urinary tract. Urogenital changes are among the most embarrassing and often are ignored for that reason. Treatment options do exist.