What is menopause?
Women naturally go through menopause as they age, usually between the ages of 45 and 55. When a woman goes 12 months without having a menstrual period, her menstrual cycle ends. It is considered a normal part of the aging process.
During menopause, there is a decrease in estrogen and progesterone hormone production, which can lead to a variety of physical and emotional symptoms, including hot flashes, night sweats, mood swings, vaginal dryness, and sleep disturbances. While menopause is a normal part of aging, it can significantly affect a woman’s quality of life, and many women seek medical care to manage their symptoms.
When a woman has her uterus and/or ovaries surgically removed due to an illness or other reasons, she may experience induced or surgical menopause instead of natural menopause. Surgical menopause can cause more severe and sudden symptoms compared to natural menopause, as the body experiences an abrupt decrease in hormone levels.
What are the stages of menopause?
Menopause is typically divided into three stages:
Perimenopause or menopause transition: Perimenopause typically begins 8 to 10 years before menopause, when a woman’s ovaries gradually produce less estrogen. This stage usually begins in a woman’s 40s and continues until menopause, when the ovaries stop releasing eggs. There is a faster decline in estrogen levels in the final 1 to 2 years of perimenopause. Many women may experience menopausal symptoms such as night sweats, hot flashes, mood changes, vaginal dryness, and a lack of interest in sex. Despite experiencing symptoms, women may still have menstrual cycles during this stage and can become pregnant.
Menopause: Menopause is defined as the absence of a menstrual period for 12 consecutive months. During this stage, the ovaries stop producing eggs and making most of their estrogen, leading to symptoms such as hot flashes, night sweats, and mood changes.
Postmenopause: Postmenopause refers to the time after menopause. During this stage, hormone levels stabilize at a low level, and symptoms such as hot flashes and mood swings may improve. However, some women may experience menopausal symptoms for a decade or longer after the menopause transition. Due to the low estrogen level, postmenopausal women are at increased risk for certain health conditions, such as osteoporosis and heart disease.
Menopause is typically divided into three stages:
Perimenopause or menopause transition: Perimenopause typically begins 8 to 10 years before menopause, when a woman’s ovaries gradually produce less estrogen. This stage usually begins in a woman’s 40s and continues until menopause, when the ovaries stop releasing eggs. There is a faster decline in estrogen levels in the final 1 to 2 years of perimenopause. Many women may experience menopausal symptoms such as night sweats, hot flashes, mood changes, vaginal dryness, and a lack of interest in sex. Despite experiencing symptoms, women may still have menstrual cycles during this stage and can become pregnant.
Menopause: Menopause is defined as the absence of a menstrual period for 12 consecutive months. During this stage, the ovaries stop producing eggs and making most of their estrogen, leading to symptoms such as hot flashes, night sweats, and mood changes.
Postmenopause: Postmenopause refers to the time after menopause. During this stage, hormone levels stabilize at a low level, and symptoms such as hot flashes and mood swings may improve. However, some women may experience menopausal symptoms for a decade or longer after the menopause transition. Due to the low estrogen level, postmenopausal women are at increased risk for certain health conditions, such as osteoporosis and heart disease.
Menopause is considered a natural part of aging when it occurs between ages 45 and 55. Menopause that occurs before the age of 45 is referred to as early menopause; if it happens at the age of 40 or younger, it is considered premature menopause. If there is no medical or surgical reason for premature menopause, it is known as primary ovarian insufficiency.
What are the signs and symptoms of menopause?
The impact of menopause varies from woman to woman. While some may experience no symptoms at all, others may experience brief and minor symptoms, and for some, the symptoms can be severe and distressing.
Common symptoms include:
- Hot flashes (a sudden feeling of warmth that spreads all over your body)
- Night sweats and/or cold flashes
- Mood swings, irritability, and anger
- Tender breasts
- Vaginal dryness
- Itchy skin
- Weight gain
- Fatigue
- Difficulty sleeping (insomnia)
- Urinary urgency (sudden urge to pass urine)
- Irregular periods
Some may also experience:
- Forgetfulness
- Headache
- Decrease in sexual desire
- Joint and muscle pains
- Hair loss or thinning
- Palpitations
Irregular periods are common during perimenopause, and periods are expected to become less regular before they stop altogether. Women may experience skipped periods, with a month or several months passing before monthly cycles resume. Periods may also occur more frequently, with shorter cycles.
How is menopause diagnosed?
Menopause is usually diagnosed based on a woman’s age, medical history, and symptoms.
In general, if a woman over the age of 45 has not had a menstrual period for 12 consecutive months, she is considered to have gone through menopause.
A healthcare provider may consider FSH testing (blood test) to diagnose menopause in women aged 40-45 years with menopausal symptoms, including a change in their menstrual cycle.
How to manage menopause?
Menopause is a natural process and does not require treatment. However, for some women, the symptoms associated with menopause can be bothersome and affect their quality of life. There are several options available to manage these symptoms, including:
- Hormone replacement therapy (HRT) involves taking estrogen and sometimes progesterone to replace the hormones that the ovaries are no longer producing. HRT can be taken in the form of pills, patches, creams, gels, or vaginal suppositories.
- Non-hormonal medications: Certain medications, such as selective serotonin reuptake inhibitors (SSRIs) and gabapentin, may help relieve hot flashes and other menopausal symptoms.
- Vaginal moisturizers and lubricants: These products can help relieve vaginal dryness and discomfort during sexual activity.
- Lifestyle changes: Regular exercise, a healthy diet, stress management, and avoiding triggers such as caffeine and alcohol can help reduce the severity of menopausal symptoms. Practicing relaxation techniques such as deep breathing and meditation may help with menopausal symptoms.
- Diet: Including foods containing plant estrogen, also known as isoflavones, may help alleviate some menopausal symptoms. Some foods to consider adding to your diet include soybeans, chickpeas, lentils, flaxseed, whole grains, beans, fruits, and vegetables.
- Strengthening your pelvic floor muscles with Kegel exercises may help improve certain types of urinary incontinence.
- Getting enough sleep is also vital for overall health.
- Complementary and alternative therapies: Some women find relief from menopausal symptoms with acupuncture, yoga, and herbal supplements. However, talking to a healthcare provider before starting any new treatment is essential.
It is important to note that the decision to treat menopausal symptoms with any of these options should be made in consultation with a healthcare provider, who can help determine the most appropriate treatment plan based on an individual’s medical history and overall health.
What are long-term health hazards related to menopause?
Menopause is a natural biological process that marks the end of a woman’s reproductive life. A decline in the production of estrogen and progesterone in the ovaries causes it. While menopause itself is not a health hazard, the hormonal changes associated with it can increase a woman’s risk for certain health conditions. Some long-term health hazards related to menopause include:
- Osteoporosis: The decline in estrogen levels during menopause can lead to a loss of bone density, making the bones brittle and weak, leading to an increased risk of fractures. Women who have undergone menopause and osteoporosis are at a greater risk of fractures in their spine, hips, and wrists.
- Heart and blood vessel (cardiovascular) disease: Coronary artery disease occurs when the arteries that supply blood to the heart become narrowed or blocked due to the buildup of fatty plaque, a condition called atherosclerosis. High levels of cholesterol in the blood contribute to this buildup. Women are at an increased risk for coronary artery disease after menopause due to several factors, including
- the loss of the protective effects of estrogen
- increased blood pressure
- decreased physical activity, and
- the long-term impact of certain unhealthy lifestyle habits like smoking or excessive alcohol consumption.
- Urinary incontinence: With decreased estrogen, the tissues of the vagina and urethra can lose elasticity, which may cause you to experience specific urinary symptoms. These can include sudden and intense urges to urinate, which can lead to involuntary loss of urine (referred to as urge incontinence), as well as urine loss when coughing, laughing, or lifting (stress incontinence). Additionally, you may experience an increased frequency of urinary tract infections.
- Weight gain: Many women experience weight gain during menopause, which can increase the risk of other health problems such as type 2 diabetes and high blood pressure.
- Sexual function: Changes in sexual function can occur with age, mainly due to hormonal changes associated with menopause. Reduced moisture production and loss of elasticity in the vaginal tissues can cause discomfort and slight bleeding during sexual intercourse due to vaginal dryness. Additionally, there could be a gradual decline in sexual desire (libido).
Conclusively, menopause is a normal and natural phase of aging. Once you reach menopause, you have gone through 12 months without a menstrual period. It is common to experience symptoms like vaginal dryness, hot flashes, mood swings etc. Be open with your healthcare provider about the symptoms you are experiencing and how they impact your quality of life. They can recommend treatments to manage your symptoms and make you more comfortable.
