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Menopauseis a normal change in a woman's life when her period stops. It is often calledthe "change of life." During menopause, a woman's body slowly makesless of the hormones estrogen and progesterone. This often happens between theages of 45 and 55 years old. A woman has reached menopause when she has not hada 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 ismaking. Many women wonder if these changes are normal, and many are confusedabout how to treat their symptoms. You can feel better by learning all you canabout menopause, and talking with your doctor about your health and yoursymptoms. If you want to treat your symptoms, your doctor can tell you moreabout your options and help you make the best treatment choices.
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Everywoman's period will stop at menopause. Some women may not have any othersymptoms. But as you near menopause, you may have these symptoms:
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.
Hot flashes ("hot flushes"). You get warm in the face, neck and chest.
Night sweats and sleeping problems. These may lead to feeling tired, stressed, or tense.
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).
Mood changes. May include mood swings, depression, and irritability.
Urinary problems. You may have leaking, burning or pain when urinating, or leaking when sneezing, coughing, or laughing.
Lack of concentration. You may become forgetful.
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.
Depression. Some researchers believe that the decrease in estrogen triggers changes in your brain, causing depression.
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Asyou near menopause, you may have symptoms from the changes your body is making.Here are some ways to relieve those symptoms.
Hot Flashes. A hot environment, eating or drinking hot or spicy foods, alcohol, or caffeine, and stress can bring on hot flashes. Try to avoid these triggers. Dress in layers and keep a fan in your home or workplace. Regular exercise might also bring relief from hot flashes and other symptoms. Ask your doctor about taking an antidepressant medicine. There is proof that this can be helpful for some women.
Vaginal Dryness. Use an over-the-counter vaginal lubricant. There are also prescription estrogen replacement creams that your doctor might give you. 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 a lot of exercise 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. Try to keep your bedroom at a comfortable temperature. Avoid napping during the day and try to go to bed and get up at the same times every day.
Memory problems. Ask your doctor about mental exercises you can do to improve your memory. Try to get enough sleep and be physically active.
Mood swings. Try to get enough sleep and be physically active. Ask your doctor about relaxation exercises you can do. Ask your doctor about taking an antidepressant medicine. There is proof that this can be helpful. 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.
Twoother common health problems can start to happen at menopause, and you might noteven notice.
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, that put you at greater risk for heart disease.
Youcan use this chart to keep track of menopausal symptoms that bother you. Take itwith you when you visit your doctor, so you both can figure out the best way tohandle them.
Menopauseis only one of several stages in the reproductive life of a women. The wholemenopause transition is divided into four main stages known as:
Premature Menopause — menopause that happens before the age of 40, whether it is natural or induced.
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 women'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.
PrematureMenopause
PrematureMenopause — menopause that happens before the age of 40, whether it isnatural or induced.
Prematuremenopause is menopause that happens before the age of 40 — whether it isnatural or induced. Women who enter menopause early get symptoms similar tothose of natural menopause, like hot flashes, emotional problems, vaginaldryness, and decreased sex drive. For some women with early menopause, thesesymptoms are severe. Also, women who have early menopause tend to get weakerbones faster than women who enter menopause later in life. This raises theirchances of getting osteoporosis and breaking a bone. Premature menopause canhappen for these reasons.
Chromosome defects. Defects in the chromosomes can cause premature menopause. For example, women with Turner's syndrome are born without a second X chromosome or born without part of the chromosome. The ovaries don't form normally, and early menopause results.
Genetics. Women with a family history of premature menopause are more likely to have early menopause themselves.
Autoimmune diseases. The body's immune system, which normally fights off diseases, mistakenly attacks a part of its own reproductive system. This hurts the ovaries and prevents them from making female hormones. Thyroid disease and rheumatoid arthritis are two diseases in which this can happen.
Surgery to Remove the Ovaries. Surgical removal of both ovaries, also called a bilateral oophorectomy, puts a woman into menopause right away. She will no longer have periods, and hormones decline rapidly. She may have menopausal symptoms right away, like hot flashes and diminished sexual desire. Women who have a hysterectomy, but have their ovaries left in place, will not have induced menopause because their ovaries will continue to make hormones. But because their uterus is removed, they no longer have their periods and cannot get pregnant. They might have hot flashes since the surgery can sometimes disturb the blood supply to the ovaries. Later on, they might have natural menopause a year or two earlier than expected.
Chemotherapy or Pelvic Radiation Treatments for Cancer. Cancer chemotherapy or pelvic radiation therapy for reproductive system cancers can cause ovarian damage. Women may stop getting their periods, have fertility problems, or lose their fertility. This can happen right away or take several months. With cancer treatment, the chances of going into menopause depend on the type of chemotherapy used, how much was used, and the age of the woman when she gets treatment. The younger a woman is, the less likely she will go into menopause.
Yourdoctor will ask you if you've had changes typical of menopause, like hotflashes, irregular periods, sleep problems, and vaginal dryness. Normally,menopause is confirmed when a woman hasn't had her period for 12 months in arow.
However,with certain types of premature menopause, these signs may not be enough for adiagnosis. A blood test that measures follicle-stimulating hormone (FSH) can bedone. Your ovaries use this hormone to make estrogen. FSH levels rise when theovaries stop making estrogen. When FSH levels are higher than normal, you'vereached menopause. However, your estrogen levels vary daily, so you may needthis test more than once to know for sure.
Youmay also have a test for levels of estradiol (a type of estrogen) andluetinizing hormone (LH). Estradiol levels fall when the ovaries fail. Levelslower than normal are a sign of menopause. LH is a hormone that triggersovulation. If you test above normal levels, you've gone through menopause.
Premenopause
Premenopause— refers to the entirety of a woman's life from her first to her last regularmenstrual period. It is best defined as a time of "normal"reproductive function in a woman.
Perimenopause
Perimenopause— means "around menopause" and is a transitional stage of two to tenyears before complete cessation of the menstrual period and is usuallyexperienced by women from 35 to 50 years of age. This stage of menopause ischaracterized by hormone fluctuations, which cause the typical menopausesymptoms, such as hot flashes.
Perimenopausemarks the time when your body begins its move into menopause. It includes theyears leading up to menopause — anywhere from two to eight years — plus thefirst year after your final period. There is no way to tell in advance how longit will last OR how long it will take you to go through it. It's a natural partof aging that signals the ending of your reproductive years.
Perimenopausecauses some changes in your body that may not be noticeable. For most women, thediscomforts associated with perimenopause are minimal and manageable. Somethings you might experience include:
Changes in your menstrual cycle (longer or shorter periods, heavier or lighter periods, or missed periods)
Hot flashes (sudden rush of heat from your chest to your head)
Night sweats (hot flashes that happen while you sleep)
Vaginal dryness
Sleep problems
Mood changes (mood swings, depression, irritability)
Pain during sex
More urinary infections
Urinary incontinence
Less interest in sex
Increase in body fat around your waist
Problems with concentration and memory
Bymonitoring your menstrual cycle and recording your signs and symptoms forseveral months, you'll gain a better understanding of the changes occurringduring this time. You will also have valuable information to discuss with yourdoctor.
Oralcontraceptives (birth control pills) are often the treatment of choice torelieve perimenopausal symptoms — even if you don't need them for birthcontrol. Today's low-dose pills regulate periods and eliminate or reduce hotflashes, vaginal dryness, and premenstrual syndrome.
Makinglifestyle changes may help ease the discomfort of your symptoms and keep youhealthy in the long run.
Good nutrition. Because your risk of osteoporosis and heart disease increases at this time, a healthy diet is more important than ever. Adopt a low-fat, high-fiber diet that is rich in fruits, vegetables, and whole grains. Add calcium-rich foods or take a calcium supplement. Avoid alcohol or caffeine, which can trigger hot flashes. If you smoke, try to quit.
Regular exercise. Regular physical activity helps keep your weight down, improves your sleep, strengthens your bones, and elevates your mood. Try to exercise for 30 minutes or more on most days of the week.
Stress reduction. Practiced regularly, stress reduction techniques, such as meditation or yoga — both can help you relax and tolerate your symptoms more easily. The "Stress and Your Health" FAQ can be a good resource as well.
Ifyou're still having periods, even if they are not regular, you can get pregnant.Talk to your doctor about your options for birth control. Keep in mind thatmethods of birth control, like birth control pills, shots, implants, ordiaphragms will not protect you from STDs or HIV. If you use one of thesemethods, be sure to also use a latex condom or dental dam (used for oral sex)correctly every time you have sexual contact. Be aware that condoms don'tprovide complete protection against STDs and HIV — the only sure protection isabstinence (not having sex of any kind). But appropriate and consistent use oflatex condoms and other barrier methods can help protect you from STDs.
Moreabout Menopause for Men
Menopauseis the time in a woman's life when her period stops. It is a normal change in awoman's body. A woman has reached menopause when she has not had a period for 12months in a row (and there are no other causes, such as pregnancy or illness,for this change). Menopause is sometimes called, "the change of life."Leading up to menopause, a woman’s body slowly makes less and less of thehormones estrogen and progesterone. This change often happens between the agesof 45 and 55 years old.
Asyou 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 howto treat their symptoms. You will feel better by learning all you can aboutmenopause and talking with your doctor about your health and your symptoms. Ifyour symptoms are causing you discomfort or concern, your doctor can teach youabout treatment options and help you to make wise treatment choices.
Menopauseaffects every woman differently. Your only symptom may be your period stopping.You may have other symptoms, too. Many symptoms at this time of life are becauseof you getting older. But some are due to menopause. Common symptoms ofmenopause include:
Change in pattern of periods (can be shorter or longer, lighter or heavier, more or less time between periods)
Hot flashes (sometimes called hot flushes), night sweats (sometimes followed by a chill)
Trouble sleeping through the night (with or without night sweats)
Vaginal dryness
Mood swings, feeling crabby, crying spells (probably because of lack of sleep)
Trouble focusing, feeling mixed-up or confused
Hair loss or thinning on your head, more hair growth on your face
Whena woman is young, estrogen helps to keep bone strong. When estrogen levels fallat menopause, bones weaken. When bones weaken a lot, the condition iscalled osteoporosis. Weak bones can break more easily.
Eatinga healthy diet and exercising at menopause and beyond are important to feelingyour best. Most women do not need any special treatment for menopause. But somewomen may have menopause symptoms that need treatment. Several treatments areavailable. It's a good idea to talk about the treatments with your doctor so youcan choose what’s best for you. There is no one treatment that is good for allwomen. Sometimes menopause symptoms go away over time without treatment, butthere’s no way to know when.
Hormonetherapy (HT) -- If used properly, hormone therapy (once called hormonereplacement therapy or HRT) is one way to deal with the more difficult symptomsof menopause. It's the only therapy that is approved by the government fortreating more difficult hot flashes and vaginal dryness. Hormone therapy shouldNOT be used solely to prevent heart or bone disease, stroke, memory loss, orAlzheimer's disease. There are many kinds of hormone therapies so your doctorcan suggest what's best for you. As with all treatments, HT has both possiblebenefits and possible risks; it is important to talk about these issues withyour doctor. If you decide to use HT, use the lowest dose that helps and for theshortest time needed. Check with your doctor every 6 months to see if you stillneed HT. For more information on the benefits and risks of HT, go to http://www.nhlbi.nih.gov/health/women/index.htm.
HTcan help with menopause by:
Reducing hot flashes
Treating vaginal dryness
Slowing bone loss
Improving sleep (and thus decrease mood swings)
Forsome women, HT may increase their chance of:
Blood clots
Heart attack
Stroke
Breast cancer
Gall bladder disease
Womenwho . . .
Think they are pregnant
Have problems with vaginal bleeding
Have had certain kinds of cancers (such as breast and uterine cancer)
Have had a stroke or heart attack
Have had blood clots
Have liver disease
Have heart disease
HTcan also cause these side effects:
Vaginal bleeding
Bloating
Breast tenderness or swelling
Headaches
Mood changes
Nausea
Besure to see your doctor if you have any of these side effects while using HT.
Somewomen decide to take herbal or other plant-based products to help relieve hotflashes. Some of the most common ones are:
Soy. Soy contains phytoestrogens (chemicals that are like estrogen). But, there is no proof that soy--or other sources of phytoestrogens--really do make hot flashes better. And the risks of taking soy--mainly soy pills and powders--are not known. The best sources of soy are foods such as tofu, tempeh, soymilk, and soy nuts. These soy products are more likely to work on mild hot flashes.
Other sources of phytoestrogens. These include herbs such as black cohosh, wild yam, dong quai, and valerian root. Again, there is no proof that these herbs (or pills or creams containing these herbs) help with hot flashes.
Productsthat come from plants may sound like they are safe, but there is no proof theyreally are. There also is no proof that they are better at helping symptoms ofmenopause. Make sure to discuss these types of products with your doctor beforetaking them. You also should tell your doctor about other medicines you aretaking, since some plant products can be harmful when combined with other drugs.
Thisterm means different things to different people. It’s really hormones that arejust the same as the hormones the body makes. There are several products withhormone like this that are on the market and are well-tested. But some peopleuse this term to mean drugs that are custom-made from a doctor’s order. Thereis no proof that these custom-made products are better or safer than hormonetherapy that’s on the market.
Awoman should first talk to her doctor to see what's best for her. The goal is toexercise regularly so you can lower the risk of serious disease (such as heartdisease or diabetes), and maintain a healthy weight. This usually takes at least30 minutes of exercise (such as brisk walking) on most days of the week.
Hot Flashes. Some women report that eating or drinking hot or spicy foods, alcohol, or caffeine, feeling stressed, or being in a hot place can bring on hot flashes. Try to avoid any triggers that bring on your hot flashes. Dress in layers, and keep a fan in your home or workplace. Regular exercise might also ease hot flashes, but sometimes exercise can cause a hot flash. If hot flashes continue and HT is not an option, ask your doctor about taking an antidepressant or epilepsy medicine. There is proof that these can relieve hot flashes for some women.
Vaginal Dryness. A water-based, over-the-counter vaginal lubricant (like KY® Jelly) can be helpful if sex is painful. A vaginal moisturizer (also over-the-counter) can provide lubrication and help keep needed moisture in vaginal tissues. Really bad vaginal dryness may need HT. If vaginal dryness is the only reason for considering HT, an estrogen product for the vagina is the best choice. Vaginal estrogen products (creams, tablet, ring) treat only the vagina.
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, don’t exercise close to bedtime. Also avoid large meals, smoking, and working right before bedtime. Caffeine and alcohol should be avoided after noon. Drinking something warm before bedtime, such as herbal tea (no caffeine) or warm milk, might help you to feel sleepy. Keep your bedroom dark, quiet, and cool, and use your bedroom only for sleeping and sex. Avoid napping during the day, and try to go to bed and get up at the same times every day. If you wake during the night and can't get back to sleep, get up and read until you’re sleepy. Don't just lie there. If hot flashes are the cause of sleep problems, treating the hot flashes will usually improve sleep.
Mood swings. Some women report mood swings or "feeling blue" as they reach menopause. Women who had mood swings (PMS) before their periods or post-partum depression after giving birth may have more mood swings around menopause. These are women who are sensitive to hormone changes. Often the mood swings will go away with time. If a woman is using HT for hot flashes or another menopause symptom, sometimes her mood swings will get better, too. Also, getting enough sleep and staying physically active will help you to feel your best. Mood swings are not the same as depression.
Memory problems. As people age, their memory is not as good as it once was. Some women say they have "fuzzy thinking" as they reach menopause. This may be caused by changing hormones and can improve over time. Getting enough sleep and keeping physically active can help. If memory problems are really bad, talk to your doctor right away. This is not caused by menopause.
Sometimes,younger women need a hysterectomy to treat health problems such as endometriosisor cancer. A hysterectomy is an operation to remove a woman's uterus (womb).Often one or both ovaries (the female organs that produce eggs and hormones) areremoved at the same time the hysterectomy is done. If you haven’t reachedmenopause, a hysterectomy will stop your period. But, you will reach menopauseonly if both ovaries are removed, called surgical menopause. Because surgicalmenopause is instant menopause, it can cause more severe symptoms than naturalmenopause (menopause that occurs as part of the natural aging process). Youshould talk with your doctor about how to best manage these symptoms.
Womenwho have a hysterectomy but have their ovaries left in place will not reachmenopause at the time of surgery because their ovaries will continue to makehormones. But, because the uterus is removed, they will no longer have theirperiods and they cannot become pregnant. Later on, they might reach naturalmenopause a year or two earlier than expected.
Sometimes,younger women need a hysterectomy to treat health problems such as endometriosisor cancer. A hysterectomy is an operation to remove a woman’s uterus (womb).Often one or both ovaries (the female organs that produce eggs and hormones) areremoved at the same time the hysterectomy is done. If you haven’t reachedmenopause, a hysterectomy will stop your period. But, you will reach menopauseonly if both ovaries are removed, called surgical menopause. Because surgicalmenopause is instant menopause, it can cause more severe symptoms than naturalmenopause (menopause that occurs as part of the natural aging process). Youshould talk with your doctor about how to best manage these symptoms.
Womenwho have a hysterectomy but have their ovaries left in place will not reachmenopause at the time of surgery because their ovaries will continue to makehormones. But, because the uterus is removed, they will no longer have theirperiods and they cannot become pregnant. Later on, they might reach naturalmenopause a year or two earlier than expected.
Menopauseis called "premature" if it happens at or before the age of40--whether it is natural or brought on by medical means (induced). Some womenhave premature menopause because of:
Family history (genes)
Medical treatments, such as surgery to remove the ovaries
Cancer treatments, such as chemotherapy or radiation to the pelvic area that damage the ovaries-- although menopause does not always occur
Havingpremature menopause puts a woman at more risk for osteoporosis later in herlife. For women who want to have children, premature menopause can be a sourceof great distress. Women who still want to become pregnant can talk with theirdoctors about other ways of having children, such as donor egg programs oradoption.
Postmenopauseis the term for all the years beyond menopause. It begins after you have not hada period for 12 months in a row--whether your menopause was natural or medicallyinduced.
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