In case a female has one year (12 months) without a menstrual period, it is considered that menopause has begun. However, it is a natural part of aging and it means that reproductive years have ended. Women usually experience menopause at age 51 on average.
What is Menopause?
The period before menopause is called perimenopause. It means the transition of a female of people assigned female at birth (AFAB) to menopause. In perimenopause, women may experience some changes in their menstrual periods and symptoms such as hot flashes.
Menopause Stages
- Perimenopause or “menopause transition” – This stage of menopause may start from 8 to 10 years before menopause. Perimenopause starts when your ovaries begin to produce less estrogen. This period commonly occurs in your 40s. Thereafter, in the last two years of perimenopause, the drop in estrogen accelerates and some people may experience menopausal symptoms. In any case, you still have menstrual periods and can get pregnant.
- Menopause – In this stage, your ovaries stop producing estrogen and release eggs. Physicians often diagnose menopause when you have gone for one year without menstrual cycles.
- Postmenopause – In this stage, people may experience menopausal symptoms for decades or get better. Furthermore, due to decreased levels of estrogen, some females may experience some diseases including osteoporosis (brittle bones) and heart disease.
Symptoms
If you experience any of the following symptoms, it may mean that transition into menopause has begun.
- Hot flashes
- Night sweats or cold flashes
- Vaginal dryness
- Urinary urgency
- Sleeping disturbances (insomnia)
- Breast tenderness
- Dry skin, eyes, or mouth
- Emotional changes (such as mood swings, mild depression, or irritability)
- Worsening of premenstrual syndrome (PMS)
- Irregular menstrual periods
Additionally, some women may also experience:
- Headaches
- Concentrating problems
- Weight gain
- Hair thinning or even loss
- Changes in sex drive (libido)
- Joint and muscle pain
- Fast heart rate
The menopausal symptoms are different among women and usually occur due to hormonal changes. In case you are not sure that the symptoms you experience are associated with menopause or other conditions, talk with your healthcare professional.
These symptoms can last up to 10 years however, on average females experience less than 5 years.
Causes
If your menopause starts naturally, it is a normal part of aging and it means that you do not have menstrual periods for one year (12 months). In addition, you may not have menstrual bleeding due to other causes including surgical removal of your ovaries, hormonal birth control, radiation therapy, medical condition, and others.
The reproductive cycle begins to slow with aging and then prepares to stop. Commonly, the menstrual periods start to change when the ovaries produce less hormone (estrogen). Therefore, it can be irregular or even stop.
Additionally, physical changes and symptoms that a person experiences occur because the body adjusts to the three stages of menopause (such as perimenopause, menopause, and postmenopause).
What Hormonal Changes Occur During Menopause?
Ovaries store and help to release eggs. They also produce progesterone and estrogen. These hormones influence how the body uses calcium and keep under control cholesterol levels. However, with aging, ovaries produce less estrogen. That‘s why a female in the menopause stage is at higher risk of developing osteoporosis. In addition, if you have vaginal bleeding in the menopausal and postmenopausal stages, it may be a symptom of a more serious health problem.
Diagnosis
Different diagnosis methods are available to determine if menopause has begun. For example, discussing about your menstrual cycle for the last year. Thus, in case you do not have menstrual periods in the last 12 months, you have entered menopause or even maybe postmenopause.
Treatment
The treatment usually involves therapies and non-hormonal treatments that help to lessen the symptoms that negatively affect your life. For example:
- Hormone Therapy
- Non-hormonal Treatments
Hormone Therapy
These therapies are used to make up for lost hormones because ovaries start to produce less estrogen and progesterone. They help to lessen symptoms such as vaginal dryness and hot flashes and reduce your risk of osteoporosis. Check below two main hormone therapies:
- Estrogen Progesterone and Progestin Hormone Therapy (EPT) – Another name for this therapy is combination therapy. It uses estrogen and progesterone doses. EPT is commonly used in patients who still have their uterus.
- Estrogen Therapy (ET) – This therapy involves estrogen which starts with a lower dose. This hormone comes in different forms including pills, patches, creams, vaginal rings, gels, or sprays. You should not use this therapy in case you have a uterus.
Health Risks Associated with Hormone Therapy
- Blood clots
- Deep vein thrombosis
- Pulmonary embolism
- Stroke
- Gallstones and gallbladder problems
- Endometrial cancer
These therapies work in case you start them within 10 years of menopause. Thereafter, you are at higher risk for developing cardiovascular diseases. In addition, before any hormonal therapy, discuss with your healthcare provider about your past health conditions and family history.
Non-Hormonal Therapy
While hormonal therapies are quite effective in reducing menopause symptoms, these are not good for everyone, especially after breast cancer treatment. That’s why other people use non-hormonal treatments. For example, diet changes, avoiding triggers to hot flashes, regular exercise, prescription medicines, and joining support groups.
Diet
It is advised to change something in your diet that will help to experience less severe hot flashes. For example, avoid spicy foods, quit smoking, and limit alcoholic drinks. Furthermore, you can add in your diet some estrogen-containing plants (isoflavones). However, it is not a replacement for the estrogen that your body produces naturally before menopause. Check below some examples of foods:
- Grains
- Beans
- Fruits
- Vegetables
- Flaxseed
- Lentils
- Chickpeas
- Soybeans
Avoiding Triggers to Hot Flashes
There are some things that it is recommended to do because they can help against hot flashes. Examples include quitting smoking, keeping your bedroom cool at night, weight loss, and others. Consult with your healthcare provider for more details.
Regular Exercise
If you exercise regularly it can help to diminish many menopausal symptoms. For example, if you have insomnia, exercises are recommended. Moreover, yoga is an exercise that is effective against anxiety and fear.
Prescription Medicines
These drugs include antidepressants (such as SSRIs and SNRIs), birth control pills, and estrogen therapy (including creams, gels, or pills). Healthcare professionals prescribe these medicines to lessen symptoms such as vaginal dryness, hot flashes, and mood swings.
Joining Support Groups
For many people may be a relief from many problems, just talking with other persons who experience menopause.
Frequently Asked Questions
What are the health risks associated with menopause?
Osteoporosis and coronary artery disease are two health conditions that could affect you after menopause. Discuss with your doctor for diagnosis and suitable treatment if you suspect you have any of these conditions.
Can menopause affect sleep?
Yes, some people after menopause may experience sleep disturbances. In most cases, it is a symptom of menopause. However, talk with your doctor because it may be also from another health condition.
Can I get pregnant if menopause starts?
Unfortunately or fortunately it is not possible because ovulation is no longer occurring. The only menopausal stage you can get pregnant is perimenopause. Ask your physician if you have any questions.
