Menopause

Menopause

When a woman reaches middle age, usually in her 40s or 50s, her periods begin to change. When they stop completely, it is called menopause. It is a normal condition that all women experience as they age. Though it naturally occurs with age, menopause may also come on suddenly as a result of a surgical procedure, treatment of a disease, or illness. In these cases it is referred to as induced menopause. Remember, it is still possible to become pregnant until you reach menopause. To prevent an unwanted pregnancy, keep using birth control until you have not had a period for 1 full year.

What Is Menopause?

Menopause is the end of a woman’s menstrual cycle and fertility. It occurs when the ovaries no longer produce estrogen and progesterone, two necessary hormones for a woman’s reproductive cycle to function. Menopause is the point in a woman’s life when she has not had a menstrual period for 1 year. Menopause marks the end of the childbearing years. It is sometimes called “the change of life.” For most women, menopause happens around age 50, but every woman’s body has its own timeline. Some women stop having periods in their mid-40s. Others continue well into their 50s.

What Is Perimenopause?

The period of gradual change before menopause is called perimenopause. During perimenopause, a woman may experience many hormonal changes and symptoms. As your egg supply ages, your body begins to ovulate less often. During this time, your hormone levels go up and down unevenly (fluctuate), causing changes in your periods and other symptoms. In time, estrogen and progesterone levels drop enough that the menstrual cycle stops. Some medical treatments can cause your periods to stop before age 40. Having your ovaries removed, radiation therapy, or chemotherapy can trigger early menopause.

What Are Menopause Symptoms?

  • Irregular periods. Some women have light periods. Others have heavy bleeding. Your menstrual cycle may be longer or shorter, or you may skip periods.
  • Hot flashes.
  • Trouble sleeping (insomnia).
  • Emotional changes. Some women have mood swings or feel grouchy, depressed, or worried.
  • Headaches.
  • Feeling that your heart is beating too fast or unevenly (palpitations).
  • Problems with remembering or thinking clearly.
  • Vaginal dryness.

Some women have mild symptoms. Others have severe symptoms that disrupt their sleep and daily lives. Symptoms tend to last or get worse the first year or more after menopause. Over time, hormones even out at low levels, and many symptoms improve or go away. Then you can enjoy being free from periods and birth control concerns.

Why Do I Have Hot Flashes and Night Sweats?

A hot flash is a sudden sensation of intense body heat, often with profuse sweating and reddening of the head, neck, and chest. These symptoms can be accompanied by mild to severe heart palpitations, anxiety and, in rare cases, panic. Hot flashes are the most common symptom of a woman’s changing estrogen levels around the time of menopause. They strike unexpectedly, often at night, and usually last several seconds to minutes. Hot flashes affect some women during perimenopause, when estrogen levels are changing. Women who become menopausal from chemotherapy, surgical removal of the ovaries during hysterectomy or from antiestrogen treatment for breast cancer are especially likely to have severe hot flashes. Hot flashes continue to affect some women for 5 years or more after menopause. Several medicines are available to treat hot flashes.

What are Treatments for Menopause Symptoms?

Menopause is a natural part of growing older. You don’t need treatment for it unless your symptoms bother you. There are treatments that can help. The first step is to have a healthy lifestyle. This can help reduce symptoms and also lower your risk of heart disease and other long-term problems related to aging.

  • Make a special effort to eat well. Choose a heart-healthy diet that is low in saturated fat and includes plenty of fish, fruits, vegetables, beans, and high-fiber grains and breads.
  • Include plenty of calcium in your diet to help your bones stay strong. Get 1,200 mg a day after age 50 (plus 800 to 1,000 IU of vitamin D to help your body use the calcium). Low-fat or nonfat dairy products are a great source of calcium.
  • Get regular exercise. Exercise can help you manage your weight, keep your heart and bones strong, and lift your mood.
  • Limit caffeine, alcohol, and stress. These things can make symptoms worse. Limiting them may help you sleep better.
  • If you smoke, try to stop. Quitting smoking can reduce hot flashes and long-term health risks.

If lifestyle changes are not enough to relieve your symptoms, you can try other measures, such as:

  • Meditative breathing exercise (called paced respiration). Breathing exercises may help reduce hot flashes and emotional symptoms.
  • Black cohosh. This herb may prevent or relieve symptoms. But experts don’t know about its long-term safety. You should not take it if there is a chance you could be pregnant. If you plan to try black cohosh, talk to your doctor about how to take it safely.
  • Soy (isoflavones). Some women feel that eating lots of soy helps even out their menopause symptoms. It may also help keep your bones strong after menopause.
  • Yoga or biofeedback to help reduce stress. High stress is likely to make your symptoms worse.

If you have severe symptoms, you may want to ask your doctor about prescription medicines. Choices include:

  • Low-dose birth control pills before menopause.
  • Low-dose hormone replacement therapy (HRT) after menopause.
  • Antidepressants.
  • A medicine called clonidine (Catapres) that is usually used to treat high blood pressure.

All medicines for menopause symptoms have possible risks or side effects. A very small number of women develop serious health problems when taking hormone therapy. Be sure to talk to your doctor about your possible health risks before you start a treatment for menopause symptoms.