Menopause is time in a woman’s life when her periods (menstruation) eventually stop and the body goes through changes that no longer allow her to get pregnant. It is a natural event that normally occurs in women age 45 – 55.
Menopause is a natural part of a woman’s aging process.The correct answer is true. Before and during menopause, the ovaries make less of the hormones estrogen and progesterone. The ovaries also stop releasing eggs. After menopause, you can no longer become pregnant.What is the average age American women reach menopause?The correct answer is 51. Menopause most often occurs slowly between the ages of 45 and 55, but it can also happen when you’re older or younger. You have reached menopause when you have not had a period for 12 months.Perimenopause happens a few years before menopause.The correct answer is true. Perimenopause is the start of menopause. It usually starts 4 years before your last period. During this time, you may notice changes in your monthly flow and the length of your cycle. It most often starts between the ages of 40 and 48.Early menopause is menopause that happens before age ___.The correct answer is 40. Women who have a family history of early menopause are more likely to have menopause early. You might also have early menopause if you have certain medical conditions, use certain cancer treatments, or have your ovaries removed.Hot flashes are the most common sign that menopause is starting.The correct answer is true. A hot flash feels like an intense build-up of body heat. Most often, it lasts 2 to 4 minutes and is most common at night. You also may feel sweaty or have chills after the hot flash. You can reduce hot flashes by avoiding triggers such as hot drinks, spicy foods, caffeine, and alcohol.Some women take medicine for hot flashes and other menopause symptoms.The correct answer is true. Hormone therapy with estrogen and perhaps another hormone can reduce hot flashes. Many women can use this treatment safely. If hot flashes are severe, talk to your doctor about the risks and benefits.Mood swings during menopause are just a myth.The correct answer is false. Mood changes and feeling irritable are real symptoms of menopause. Getting regular exercise, not smoking, reducing stress, and getting enough sleep may help you feel better. If you’re having severe mood swings, talk to your doctor.Before menopause your periods will get:The correct answer is either A or B. In the years before menopause your periods will change. But how they change depends on your body. Your bleeding may get heavier or lighter and your cycles may get longer or shorter — or you may have a mixture of these. If you have any concerns, talk to your doctor.Many women have trouble sleeping during menopause.The correct answer is true. You may have sleep problems because of hot flashes or changes in hormones. Getting regular exercise, keeping a regular schedule, and avoiding caffeine late in the day may help. See your doctor if sleep problems are affecting your life.Pain during sex is one sign of menopause.The correct answer is true. During menopause your body makes less estrogen. This can make your vaginal walls dry and can cause pain and itching during sex. Using lubricants that dissolve in water such as KY Jelly, Replens, and Astroglide can help reduce dryness and pain.Menopause can make you gain weight.The correct answer is true. Changes in hormone levels can make you more likely to gain weight. Getting more exercise and reducing the amount of calories you eat can help you keep off extra pounds. Staying at a healthy weight may also help reduce hot flashes.You should still use birth control even if you are having symptoms of menopause.The correct answer is true. You can still get pregnant even if you have symptoms of menopause. So you should continue to use birth control until you have not had a period for 12 months. If you have any questions about using birth control while you are going through perimenopause, talk with your doctor.
Causes, incidence, and risk factors
During menopause, a woman’s ovaries stop making eggs and they produce less estrogen and progesterone. Changes in these hormones cause menopause symptoms. Periods occur less often and eventually stop. Sometimes this happens suddenly. But most of the time, periods slowly stop over time.
Menopause is complete when you have not had a period for 1 year. This is called postmenopause. Women who are postmenopausal can no longer get pregnant.
Surgical menopause is when medical treatments cause a drop in estrogen. This can happen if your ovaries are removed or if you receive chemotherapy or hormone therapy for breast cancer.
Symptoms vary from woman to woman. They may last 5 or more years. Some women may have worse symptoms than others. Symptoms of surgical menopause can be more severe and start more suddenly.
The first thing you may notice is that your periods start to change. They might occur more often or less often. Some women might get their period every 3 weeks. This might last for 1 – 3 years before the periods completely stop.
Common symptoms of menopause include:
- Menstrual periods that occur less often and eventually stop
- Heart pounding or racing
- Hot flashes, usually worst during the first 1 – 2 years
- Night sweats
- Skin flushing
- Sleeping problems (insomnia)
Other symptoms of menopause may include:
- Decreased interest in sex, possibly decreased response to sexual stimulation
- Forgetfulness (in some women)
- Mood swings including irritability, depression, and anxiety
- Urine leakage
- Vaginal dryness and painful sexual intercourse
- Vaginal infections
- Joint aches and pains
- Irregular heartbeat (palpitations)
Signs and tests
Blood and urine tests can be used to look for changes in hormone levels. Test results can help your doctor determine if you are close to menopause or if you have already gone through menopause.
Tests that may be done include:
Your healthcare provider will perform a pelvic exam. Decreased estrogen can cause changes in the lining of the vagina.
Bone loss increases during the first few years after your last period. Your doctor may order a bone density test to look for bone loss related to osteoporosis.
Treatment for menopause depends on many things, including how bad your symptoms are, your overall health, and your preference. It may include lifestyle changes or hormone therapy.
Hormone therapy may help if you have severe hot flashes, night sweats, mood issues, or vaginal dryness. Hormone therapy is treatment with estrogen and, sometimes, progesterone.
Talk to your doctor about the benefits and risks of hormone therapy. Your doctor should be aware of your entire medical history before prescribing hormone therapy (HT). Learn about options that do not involve taking hormones.
Several major studies have questioned the health benefits and risks of hormone therapy, including the risk of developing breast cancer, heart attacks, strokes, and blood clots.
Current guidelines support the use of HT for the treatment of hot flashes. Specific recommendations:
HT may be started in women who have recently entered menopause.
HT should not be used in women who started menopause many years ago, except for estrogen vaginal creams.
The medicine should not be used for longer than 5 years.
Women taking HT have a low risk for stroke, heart disease, blood clots, or breast cancer.
To reduce the risks of estrogen therapy, your doctor may recommend:
- A lower dose of estrogen or a different estrogen preparation (for instance, a vaginal cream or skin patch rather than a pill)
- Frequent and regular pelvic exams and Pap smears to detect problems as early as possible
- Frequent and regular physical exams, including breast exams and mammograms
If you have a uterus and decide to take estrogen, you should also take progesterone to prevent cancer of the lining of the uterus (endometrial cancer). If you do not have a uterus, you do not need progesterone.
See also: Hormone therapy
ALTERNATIVES TO HORMONE THERAPY
There are other medicines available to help with mood swings, hot flashes, and other symptoms. These include:
Antidepressants, including paroxetine (Paxil), venlafaxine (Effexor), bupropion (Wellbutrin), and fluoxetine (Prozac)
A blood pressure medicine called clonidine
Gabapentin, a seizure drug that also helps reduce hot flashes
DIET AND LIFESTYLE CHANGES
Hormones are not always needed to reduce symptoms of menopause. There are many steps you can take to reduce symptoms.
- Avoid caffeine, alcohol, and spicy foods.
- Eat soy foods. Soy contains estrogen.
- Get plenty of calcium and vitamin D in food or supplements.
Exercise and relaxation techniques:
- Get plenty of exercise.
- Do Kegel exercises every day. They strengthen the muscles of your vagina and pelvis.
- Practice slow, deep breathing whenever a hot flash starts to come on. Try taking six breaths a minute.
- Try yoga, tai chi, or meditation.
- Dress lightly and in layers.
- Keep having sex.
- Use water-based lubricants or a vaginal moisturizer during sex.
- See an acupuncture specialist.
See also: Managing menopause at home
Some women have vaginal bleeding after menopause. This is often nothing to worry about. However, you should tell your healthcare provider if this occurs. It may be an early sign of other health problems, including cancer.
Decreased estrogen levels have been linked with some long-term effects, including:
Bone loss and osteoporosis in some women
Changes in cholesterol levels and greater risk of heart disease
Calling your healthcare provider
Call your healthcare provider if:
- You are spotting blood between periods
- You have had 12 consecutive months with no period and suddenly vaginal bleeding or spotting begins again, even if it is a very small amount
Menopause is a natural and expected part of a woman’s development and does not need to be prevented. You can reduce your risk of long-term problems such as osteoporosis and heart disease by taking the following steps:
Control your blood pressure, cholesterol, and other risk factors for heart disease.
Do NOT smoke. Cigarette use can cause early menopause.
Eat a low-fat diet.
Get regular exercise. Resistance exercises help strengthen your bones and improve your balance.
If you show early signs of bone loss or have a strong family history of osteoporosis, talk to your doctor about medications that can help stop further weakening.
Take calcium and vitamin D.