Menopause

Menopause is a normal change in a woman's life when her period stops. It is often called the "change of life." During perimenopause, a woman's body slowly makes less of the hormones estrogen and progesterone. This often happens between the ages of 45 and 55 years old. A woman has reached menopause when she has not had a period for 12 months in a row, and there are no other causes for this change.

As you near menopause, you may have symptoms from the changes your body is making. Many women wonder if these changes are normal, and many are confused about how to treat their symptoms. You can feel better by learning all you can about menopause, and talking with your doctor about your health and your symptoms. If you want to treat your symptoms, your doctor can tell you more about your options and help you make the best treatment choices.

Menopause is only one of several stages in the reproductive life of a woman. The whole menopause transition is divided into four main stages known as:

  • Premenopause - refers to the entirety of a woman's life from her first to her last regular menstrual period. It is best defined as a time of "normal" reproductive function in a woman.
  • Perimenopause - means "around menopause" and is a transitional stage of two to ten years before complete cessation of the menstrual period and is usually experienced by women from 35 to 50 years of age. This stage of menopause is characterized by hormone fluctuations, which cause the typical menopause symptoms, such as hot flashes.
  • Menopause - represents the end stage of a natural transition in a woman's reproductive life. Menopause is the point at which estrogen and progesterone production decreases permanently to very low levels. The ovaries stop producing eggs and a woman is no longer able to get pregnant naturally.
  • Postmenopause - refers to a woman's time of life after menopause has occurred. It is generally believed that the postmenopausal phase begins when 12 full months have passed since the last menstrual period. From here a woman will be postmenopausal for the rest of her life.

Symptoms of Menopause:

Every woman's period will stop at menopause. Some women have no other symptoms. But many women notice changes in body, mind, and mood at this stage of life. We don't always know if these changes are related to menopause, aging, or both. Some changes you might notice include:

  • Changes in your period. The time between periods and the flow from month to month may be different.
  • Abnormal bleeding or "spotting." This is common as you near menopause. But if your periods have stopped for 12 months in a row, and you still have "spotting," you should talk to your doctor to rule out serious causes, like cancer.
  • Night sweats. Hot flashes that occur while a woman is sleeping and cause her to perspire. They can make it hard to get a good night's sleep.
  • Sleeping problems. Lack of sleep can affect your mood, health, and ability to cope with everyday stress.
  • Vaginal changes. The vagina may become dry and thin, and sex and vaginal exams may be painful. You also might get more vaginal infections.
  • Thinning of your bones. This may lead to loss of height and bone breaks (osteoporosis).
  • Emotional changes. May include mood swings, sadness, tearfulness, and irritability. Although menopause does not cause depression, women are at a higher risk of depression in the years leading up to menopause. Some researchers think that the decrease in estrogen levels plays a role in the onset of depression in some women. Also, lack of sleep can strain a woman's emotional health.
  • Urinary problems. You may have leaking, burning or pain when urinating, or leaking when sneezing, coughing, or laughing.
  • Problems with memory and staying focused. You may notice you are more forgetful or have trouble concentrating.
  • Sex drive decreases. You may have less interest in sex and changes in sexual response.
  • Weight fluctuation. Weight gain or increase in body fat around your waist.
  • Hair loss or thinning. Hair thinning or loss is a problem for some women.

Symptom Relief

Many women are able to cope with minor discomforts of menopause. Try these tips:

  • Hot flashes. Keep track of when hot flashes happen. You might be able to identify a pattern or triggers, which you can avoid. Dress in layers and keep a fan in your home or workplace. If lifestyle changes don't seem to help, ask your doctor about menopausal hormone therapy or nonhormonal prescription drugs. Research has found that nonhormonal prescription drugs, such as antidepressants, help hot flashes in some women.
  • Vaginal dryness. Try an over-the-counter water-based vaginal lubricant. Prescription estrogen replacement creams and tablets also can help restore moisture and tissue health. If you have spotting or bleeding while using estrogen creams, you should see your doctor.
  • Problems sleeping. One of the best ways to get a good night's sleep is to get at least 30 minutes of physical activity on most days of the week. But avoid physical activity close to bedtime. Also avoid alcohol, caffeine, large meals, and working right before bedtime. You might want to drink something warm, such as herb tea or warm milk, before bedtime. Keeping your bedroom cool and dark also can help. Avoid napping during the day and try to go to bed and get up at the same times every day.
  • Memory problems. Some women complain about problems with memory and concentration. But there is no proof that menopause causes memory problems. Try to get enough sleep and engage in physical and social activity. If forgetfulness or other mental problems worry you or are affecting your everyday functioning, talk to your doctor.
  • Mood swings. Try to get enough sleep and be physically active. Set limits for yourself, and look for positive ways to ease daily stress. Think about going to a support group for women who are going through the same thing as you, or getting counseling to talk through your problems and fears. Talk to your doctor if mood swings are causing you distress. Medicines might help. For instance, menopausal hormone therapy might help if mood swings are related to disrupted sleep caused by night sweats. Also, your doctor can look out for signs of depression, which is a serious illness that needs treatment.
  • Osteoporosis. Day in and day out your body is busy breaking down old bone and replacing it with new healthy bone. Estrogen helps control bone loss. So losing estrogen around the time of menopause causes women to begin to lose more bone than is replaced. In time, bones can become weak and break easily. This condition is called osteoporosis.
  • Heart disease. After menopause, women are more likely to have heart disease. Changes in estrogen levels may be part of the cause. But, so is getting older. As you age, you may develop other problems, like high blood pressure or weight gain, which put you at greater risk for heart disease.