Menopause

Menopause occurs when menstrual periods have stopped for one whole year. It is also called “the change of life.” In general, this occurs between the ages of 45 and 55. It can, though, occur as early as age 35 or as late as age 65. It can also result when both ovaries are removed by surgery.

Reasons for a Hysterectomy

Signs & Symptoms

Signs and symptoms usually span 1 to 2 or more years. This is called peri-menopause. Symptoms vary from woman to woman. They result from hormone changes, the aging process itself, fatigue, and stress.

Ovarian Cysts & Cancer

Menstrual Cramps

Physical Signs and Symptoms

• Hot flashes. These are sudden waves of heat that can start in the waist or chest and work their way to the neck and face and sometimes the rest of the body. They can occur as often as every 90 minutes. Each one can last from 15 seconds to 30 minutes; 5 minutes is average. Seventy-five to 80% of women going through menopause have hot flashes. Some women are more bothered by them than others. Sometimes heart palpitations come with hot flashes.

• Vaginal dryness. The vaginal wall also becomes thinner. These problems can make sex painful or uncomfortable. Irritation can increase the risk for infection.

• Loss of bladder tone. This can result in stress incontinence (leaking urine when you cough, sneeze, laugh, or exercise).

• Headaches.

• Dizziness.

• The skin is more likely to wrinkle.

• Hair grows on the face, but thins at the temples.

• Muscles lose some strength and tone.

• Bones become more brittle. This increases the risk for osteoporosis.

• Irregular periods:

– Bleeding can occur between periods. This is the most common bleeding pattern in peri-menopause.

– Periods get shorter and lighter for 2 or more years.

– Periods can stop for a few months and then start up again and are more widely spaced.

– Periods occur with heavy bleeding and/or the passage of many small or large blood clots.

Hormone Therapy (HT)

Cervical Cancer

SEE ALL ARTICLES ON WOMEN'S HEALTH

Resources

National Women’s Health Information Center

www.womenshealth.gov

North American Menopause Society (NAMS)

www.menopause.org

Emotional Signs and Symptoms

• Irritability.

• Mood changes.

• Lack of concentration. Memory problems.

• Tension, anxiety, depression.

• Insomnia. Hot flashes can interrupt sleep.

Causes

Hormone changes that come with aging cause menopause. The body makes less estrogen and progesterone.

Treatment

Self-care may be all that is needed. Just estrogen can be prescribed. This is estrogen therapy (ET). Estrogen plus progestogen can be prescribed. This is called EPT. The term hormone therapy (HT) is used for both ET and EPT. Hormone therapy helps protect against osteoporosis, but has health risks. Each women should discuss the benefits and risks of HT and non-estrogen treatments with her doctor.

Questions to Ask

Question 1

Do you have any of these problems?

• Extreme pain during sex.

• Pain or burning when you pass urine.

• Thick vaginal discharge.

• Fever and/or chills.

You should be seen by your doctor for medical advice. Contact your doctor or health care provider to find out how soon you should be seen.

Question 2

During peri-menopause, are you pale and fatigued because you bleed a lot or pass many small or large blood clots with your periods?

You should be seen by your doctor for medical advice. Contact your doctor or health care provider to find out how soon you should be seen.

Question 3

Have you started having menstrual periods again after not having any for 6 months?

You should be seen by your doctor for medical advice. Contact your doctor or health care provider to find out how soon you should be seen.

Question 4

Do hot flashes interfere with normal activities?

You should be seen by your doctor for medical advice. Contact your doctor or health care provider to find out how soon you should be seen.

Question 5

Do you have risk factors for osteoporosis?

• Family history of osteoporosis. Small bone frame. Thinness. Fair skin (Caucasian or Asian race).

• Surgery to remove the ovaries before normal menopause. Menopause before 48 years of age.

• Lack of calcium. Lack of weight-bearing exercise. Alcohol abuse.

• Hyperthyroidism. Use of corticosteroid medicine.

You should be seen by your doctor for medical advice. Contact your doctor or health care provider to find out how soon you should be seen.

Question 6

Are you having any of these problems from hormone therapy?

• Symptoms of menopause return.

• Vaginal bleeding.

• Abnormal breast exam.

• Leg pain or swelling.

You should be seen by your doctor for medical advice. Contact your doctor or health care provider to find out how soon you should be seen.

Use Self-Care / Prevention:

You can probably take care of the problem yourself if you answered NO to all the questions. Use the “Self-Care” measures that are listed. Call your doctor if you don’t feel better soon, though. You may have some other problem.

Self-Care / Prevention

For Hot Flashes

• Wear lightweight clothes made of natural fibers, such as cotton.

• Limit or avoid alcohol. Limit caffeine.

• Have cool drinks, especially water, when you feel a hot flash coming on and before and after you exercise. Avoid hot drinks.

• Keep cool. Open a window. Lower the thermostat when the heat is on. Use air conditioning and/or fans. Carry a small fan with you.

• Try to relax when you get a hot flash. Getting stressed out over one only makes it worse.

• Use relaxation techniques, such as meditation, biofeedback or yoga.

• Follow your doctor’s advice for taking herbal products, such as black cohosh; vitamin supplements; over-the-counter menopause aids; and soy products.

• If you suffer from night sweats (hot flashes that occur as you sleep):

– Wear loose fitting cotton nightwear. Have changes of nightwear ready.

– Sleep with only a top sheet, not blankets.

– Keep the room cool.

For Vaginal Dryness and Painful Sex

• Don’t use deodorant soaps or scented products in the vaginal area.

• Use a water soluble lubricant, such as K-Y Liquid®, Replens®, etc. These make penetration easier during sex. Avoid oils or petroleum-based products. These promote infection.

• Ask your doctor about the benefits and risks of using estrogen (pills, patches, vaginal cream, or rings).

• Stay sexually active. Having sex often may lessen the chance of having the vagina constrict. It also helps to maintain natural lubrication and pelvic muscle tone. Reaching orgasm with a partner or alone gives these benefits.

• If you can, avoid using antihistamines. They dry mucus membranes in the body.

For Emotional Symptoms

• Exercise regularly. This helps maintain hormonal balance.

• Talk to other women who have gone through or are going through menopause.

• Avoid stress as much as you can.

• To deal with stress, use relaxation techniques. Examples are meditation, yoga, listening to soft music, and massages.

• Eat healthy. Take vitamins and minerals, as advised.

This website is not meant to substitute for expert medical advice or treatment. Follow your doctor’s or health care provider’s advice if it differs from what is given in this guide.

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