What is menopause?
Often called the "change of life", this stage signals the end of a woman's ability to have children. The term menopause frequently is referred as the time when a woman's hormone levels start to change.
The transition phase before menopause is often referred to as perimenopause. During this transition time, the supply of mature eggs in a woman's ovaries diminishes and ovulation becomes irregular. At the same time, the production of estrogen and progesterone decreases. It is the big drop in estrogen levels that causes most of the familiar symptoms of menopause.
What are the symptoms of menopause?
These are the most common symptoms of menopause and each woman may experience symptoms differently. Some have few and less severe symptoms, while others have more frequent and troublesome ones. The signs and symptoms of menopause may include:
- Hot flashes - the common symptom of menopause. It can range from mild to debilitating.
- Vaginal atrophy or vaginal dryness - Another normal side effect of the menopausal transition. Talk to your provider to learn more about treatments.
- Relaxation of pelvic muscles - This can lead to urinary incontinence and increase the risk of prolapse of the uterus, bladder, urethra or rectum. Talk to your care provider about keeping your bladder healthy.
- Cardiac effects - Menopause can affect your heart health, as well. Some symptoms may include dizziness, numbness, heightened sensitivity, fast heart rhythm and palpitations (beats).
- Hair growth - Changing hormones can cause some women to have an increase in facial hair or thinning of the hair on the scalp.
- Mental health - While several studies have suggested that menopause does not negatively affect mental health, menopause can cause emotional symptoms of fatigue, insomnia (sleeplessness) and nervousness which may be related to the lack of estrogen, the stress of aging and a women’s changing roles.
- Osteoporosis - Does menopause cause osteporosis? The hormone estrogen which protects bones, decreases as one reaches menopause. Talk to you provider about osteoporosis and how best to prevent bone loss.
Every woman’s experience with menopause is different. As a woman approaches and transitions into menopause, they should discuss their concerns and symptoms with their healthcare provider, to discuss risks and benefits of treatments for menopause symptoms.
When does menopause take place?
Menopause usually happens naturally, most often after the age of 45. Everyone is different and menopause can happen any time from the 30s to the mid-50s or later. Natural menopause is a normal part of aging.
Menopause can also happen for reasons other than natural reasons. These include:
- Premature menopause. Premature menopause may happen when there is ovarian failure before the age of 40. It may be associated with smoking, radiation exposure, chemotherapeutic drugs, or surgery that impairs the ovarian blood supply. Premature ovarian failure is also called primary ovarian insufficiency.
- Surgical menopause. Surgical menopause may follow the removal of one or both ovaries or radiation of the pelvis, including the ovaries, in premenopausal (before menopause) women. This results in an abrupt menopause. These women often have more severe menopausal symptoms than if they were to have menopause naturally.
Does menopause require treatment?
Depending on the severity of symptoms, some women seek treatment and therapies to help manage menopause symptoms.
Some therapies may include:
- Hormone therapy - Hormone therapy involves the taking a combination of the female hormone estrogen and progesterone during perimenopause and menopause.
- Estrogen therapy - This therapy involves taking estrogen, which is no longer being made by the body. Estrogen therapy is often recommended for women who have had a hysterectomy.
- Non-hormonal treatment - This type of treatment often involves the use of other types of medicines to relieve some of the symptoms associated with menopause.
- Estrogen alternatives - Or also known as “synthetic estrogens”, like ospemifene, can improve vaginal dryness (atrophy) without affecting endometrial cancer risk.
- Alternative therapies - Homeopathy and herbal treatments, often called bioidentical hormones, may offer some relief from some symptoms of menopause. However, there are concerns about potency, safety, purity, and effectiveness.
Everyone's experience with menopause will differ. As you approach and transition into menopause, please discuss your concerns and symptoms with your healthcare provider, to discuss risks and benefits of treatments for menopause symptoms.