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Menopause: What Is It?
Menopause is not a disease, but rather the point in a woman's life at which she is no longer fertile, and menstrual periods have ceased. Menopause can be accompanied by physical symptoms in some women, like hot flashes or night sweats. It can also be seen as a positive beginning of a new phase of life, with opportunities to take preventive action against major health risks.
What Causes Menopause?
Age is the most common cause of menopause. The ovaries gradually lose their ability to function with advancing age. There are other causes of menopause, since some surgeries and medical treatments can induce menopause. These causes include removal of the ovaries, chemotherapy for cancer, and radiation therapy to the pelvis.
When the uterus is removed (hysterectomy) without removing the ovaries in a premenopausal woman, menstrual periods cannot occur, but the hormonal changes characteristic of menopause will not occur.
When Does Menopause Start?
The average age for natural menopause is 51, but it can occur earlier or later. Rarely, women may reach menopause as early as 40 or as late as 60 years of age. Women who smoke cigarettes tend to have earlier menopause than nonsmoking women. There is no way to predict in advance precisely when a particular woman will reach menopause. Menopause is confirmed when a woman has not had menstrual periods for 12 consecutive months.
Before Menopause, Perimenopause
The transition to menopause and the time approaching menopause are referred to as perimenopause. During this time the ovaries are still functioning, but their function has started to decrease. It’s still possible for a woman to become pregnant even if she is showing signs of perimenopause, because she may still ovulate.
Menopause: What to Expect
The experience of menopause is different for every woman. Some women have few complaints, while others have severe symptoms that affect their quality of life. When menopause occurs suddenly (as a result of chemotherapy or surgery), the transition can be difficult. In the following slides, we will discuss some common symptoms of menopause.
Menopause Sign: Period Changes
With approaching menopause, a woman’s menstrual periods may change. They may get shorter or longer, lighter, or heavier. The interval between periods may increase or decrease. If you have concerns about changes in your periods, talk with your doctor. Sometimes, conditions other than menopause can also cause changes in your period.
Menopause Symptom: Hot Flashes
Hot flashes are a common symptom around the time of menopause. A hot flash is a feeling of warmth that tends to be concentrated around the face and neck. It can cause flushing, or reddening of the skin, in these areas as well as the chest, arms, or back. Hot flashes vary in their intensity and can be followed by sweating and/or chills. They last anywhere from 30 seconds to 10 minutes. Women can help reduce the symptoms of hot flashes by dressing in light layers, exercising regularly, using a fan, managing stress, and avoiding spicy foods.
Menopause Symptom: Sleep Issues
Hot flashes can occur at night and result in night sweats. The following tips can help you sleep well if you are having night sweats:
- Use lightweight bedding
- Use a fan in the bedroom
- Wear lightweight, cotton pajamas or gowns
- Use a damp washcloth to cool off your face and keep one handy at bedside
- Don't allow pets in the bed or bedroom (they may give off heat)
Menopause Symptom: Sex Problems
Along with menopause, women experience lower levels of the hormone estrogen. One of the effects of lowered estrogen levels is vaginal dryness, which can result in painful or uncomfortable intercourse. Water-soluble lubricants can help overcome this problem. If lubricants are not effective, contact your doctor. Vaginal creams and suppositories can be prescribed to ease vaginal dryness.
Another effect of hormonal changes is a change in libido, or sex drive. This may improve or worsen, but it is important to remember that other factors besides menopause can affect libido. Stress, sleep disturbances, medications, and anxiety can all affect sex drive. Your doctor can help you find ways to manage the changes in your sex drive if they occur.
Finally, although fertility ends at menopause, women of all ages are still susceptible to STDs, so safe sex is still important.
Managing Severe Symptoms
Hormone therapy can help alleviate many of the troublesome symptoms of menopause, but hormone therapy is not without its own risks. Your doctor can help you weigh the risks and benefits of this treatment. Low-dose oral contraceptive (birth control) pills are one option for perimenopausal women to help manage symptoms. Other potential treatments that can help relieve symptoms include antidepressants, blood pressure medications, and lifestyle modifications.
Hormone Replacement Therapy
Long-term use of hormone therapy has been associated with an increased risk of heart attacks, strokes, and breast cancer, so it is recommended that the lowest dose of hormones that are effective be taken for the shortest time possible. There are a number of different types of prescription hormone therapies, and your doctor can help you find the best solution if you require this treatment.
Bioidentical Hormone Therapy
The term "bioidentical" hormone therapy has been used to refer to hormones derived from plants prepared individually for patients at compounding pharmacies. Some FDA approved prescription products are also "bioidentical" in the true sense of the word. Some doctors feel that compounded "bioidentical" hormone products are safer, but the US FDA does not approve these products.
Alternative Menopause Treatments
Many women try alternative treatments for menopausal symptoms. According to the US National Institutes of Health, there is too little well-designed research to prove the benefits of therapies like red clover, dong quai, soy, or black cohosh. If you decide to try these remedies, or other herbal products, be sure to discuss this with your doctor. Some botanical or herbal supplements can interact with prescription drugs.
Menopause Health Risks
Health risks associated with menopause include a greater risk of heart disease and osteoporosis. Heart disease remains the number one cause of death for women in the US. Declining estrogen levels may be partly to blame, but hormone therapy is not recommended for postmenopausal women to decrease these risks because it is associated with health risks of its own.
Menopause: Staying Healthy
It's never too late to start living a healthy lifestyle. Regular checkups should include a measurement of cholesterol, blood sugar, and blood pressure. And don't skip routine preventive screenings such as mammograms. You can work with your doctor to establish a plan for a healthy lifestyle including a nutritious diet, physical activity, and stress management skills.
Active Menopause Is a Must
Regular physical activity is important at any age, and especially as a woman transitions to menopause. Aerobic exercise strengthens the heart, and weight-bearing exercises to maintain bone strength are two important components of an exercise program. Regular exercise can also help keep weight off and elevate your mood. Even if you weren't active before, you can start to increase your physical activity at any age.
Menopause: A New Era Starts
Many women find that menopause is a time to celebrate a new phase of life rather than grieving for lost youth. Christian Northrup is a physician and writer who recommends that menopause be used as a time to explore sources of pleasure and joy, fill yourself with positive thoughts, love yourself, and revive your sex life.
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