Overview and Facts
Menopause is the term for the permanent end of menstruation and fertility for a woman. Usually occurring 12 months after menstrual periods have been missed consecutively, menopause is a normal biological process for women to experience. It is associated with the reduced functioning of ovaries as related to aging, which results in lower levels of hormones such as estrogen.
On average, menopause occurs at or around age 51. Though this is a natural process, there are still physical and emotional symptoms that can affect your daily routine and the way you think and feel. This menopausal transition occurs over many months and years and thus can be divided into different stages:
- Premenopause. This time period is between puberty when periods first begin and menopause, when they stop.
- Perimenopause. In this time period, a woman is still menstruating but beginning to experience menopausal symptoms such as hot flashes. This period can last four to five years, but for some women it can last even longer.
- Postmenopause. When 12 months have passed since a woman’s last menstrual period, menopause has been reached. The years that follow are postmenopause. Ovaries will still produce estrogen, but at a much lower rate. No progesterone is produced and eggs are not released.
Signs and Symptoms
Many menopause symptoms begin long before actual menopause has been reached. Having these symptoms is an indication of being in the perimenopausal stage, which precedes menopause. Not all women experience these menopausal symptoms as they may vary from woman to woman. Symptoms of menopause include:
- Hot flashes
- Loss of breast fullness
- Night sweats
- Decreased fertility
- Irregular periods
- Increased anxiety
- Mood swings
- Sleep disturbances
- Thinning hair
- Pain during intercourse
- Vaginal dryness
Causes and Diagnosis
For the most part, menopause is caused by the body’s natural decline of producing reproductive hormones. As a woman approaches her late 30s, ovaries already start making less progesterone and estrogen. These two hormones are those that regulate menstruation. Ovulation becomes less predictable at this point and fertility begins to decline. Throughout the 40s, this decline continues up until the ovaries stop producing eggs completely and menstruation stops.
However, there are other things that have may cause menopause before it happens naturally through the decline of reproductive hormones:
- Total hysterectomy. A hysterectomy that removes both the uterus and ovaries causes menopause to occur immediately. There is no slow decline or transition phase – periods stop and thus early menopause symptoms such as hot flashes may start to occur.
- Chemotherapy. Cancer therapies such as chemotherapy and other radiation therapies have been known to bring about menopause earlier than normal. During the course of treatment menopause symptoms such as hot flashes may occur, or begin to occur within three to six months.
- Primary ovarian insufficiency. About 1 percent of women experience menopause before they reach 40. This early menopause may be a result of primary ovarian insufficiency, which is when ovaries fail to produce normal levels of reproductive hormones, usually as a result of genetics or an autoimmune disease.
Usually the signs and symptoms of menopause give a clear diagnosis that a woman has begun going through the menopausal transition. If a woman has had no menstrual periods for 12 months, she is in menopause. Usually woman will get evaluated by a doctor to ensure that the consecutive missed periods are not a result of another underlying medical condition.
Tests and Treatment Options
Since the diagnosis of menopause is based on the observation of missed periods in a 12-month period, there are no tests that doctors usually perform to test for menopause.
Doctors can prescribe medications that can provide menopause relief. Nothing will stop menopause from occurring, but women can find relief from symptoms with the following treatments:
- Hormone therapy. A doctor may recommend taking estrogen in a low dose to provide menopause relief.
- Antidepressants. These taken in a low dose have been shown to reduce menopausal hot flashes.
- Vaginal estrogen. Estrogen can be administered using a tablet, cream or ring and can relieve vaginal dryness and urinary symptoms.
- Biphosphonates. These non-hormonal medications help reduce bone loss and osteoporosis. As a woman loses estrogen, the risk of fractures goes up and this medication can replace estrogen as the main treatment for osteoporosis in women.
Helpful Tips and Home Remedies
Most symptoms associated with menopause can be prevented or reduced by making some modifications to everyday life. Here are some tips in making menopausal symptoms more bearable:
- Decrease vaginal discomfort. Stay sexually active and use water-based lubricants during intercourse.
- Cool hot flashes. Try and figure out what triggers hot flashes – for some, it may be alcohol, certain beverages or foods and hot weather. Get regular exercise and dress in layers.
- Quit smoking. This increases risk of heart disease, cancer and other health issues. It can onset menopause earlier and increase hot flashes, too.
- Exercise. Get at least 30 minutes of physical activity on most days. This can protect against health conditions associate with aging and help you lose weight and reduce stress.
- Get good sleep. Don’t drink caffeine before bed and practice relaxation techniques before going to bed.
- Do yoga. Studies show that yoga can reduce the number and frequency of hot flashes in perimenopausal women.
- Eat a balanced diet. Try and get at least 1,200 mg of calcium each day and eat a diet rich in fruits, vegetables and whole grains.