What is menopause? — Menopause is the time in a woman’s life when she stops having monthly periods. At this time, her ovaries stop releasing eggs and stop making the hormones estrogen and progesterone. Menopause usually occurs between the ages of 45 and 55. The average age is 51.
How do I know if I am going through menopause? — Most women start to wonder about menopause when their periods start to change. If you are going through menopause, you might:
●Have periods more or less often than usual (for example, every 5 to 6 weeks instead of every 4)
●Have bleeding that lasts for fewer days than before
●Skip 1 or more periods
●Have symptoms of menopause, such as hot flashes (described below)
If your uterus has been removed, but you still have your ovaries, it might be tough to tell when you are going through menopause. Still, women who do not have a uterus can have menopause symptoms. If your ovaries were removed before the usual age of menopause, you had what doctors call “surgical menopause.” That just means that you went through it early, because your ovaries were removed.
What are the symptoms of menopause? — Some women go through menopause without symptoms. But most have 1 or more of these symptoms:
●Hot flashes – Hot flashes feel like a wave of heat that starts in your chest and face and then moves through your body. Hot flashes usually start happening before you stop having periods.
●Night sweats – When hot flashes happen during sleep, they are called “night sweats.” They can make it hard to get a good night’s sleep.
●Sleep problems – During the transition to menopause, some women have trouble falling or staying asleep. This can happen even if night sweats are not a problem.
●Vaginal dryness – Menopause can cause the vagina and tissues near the vagina to become dry and thin. This can be uncomfortable or make sex painful.
●Depression – During the transition to menopause, some women start having symptoms of depression. That’s especially true for women who have been depressed before. Depression symptoms include:
•Losing interest in doing things
•Sleeping too much or too little
●Trouble concentrating or remembering things – This might be caused by lack of sleep that often happens at menopause, or by the lack of estrogen. Some experts suspect that estrogen is important for good brain function.
Should I see a doctor or nurse? — If your periods start changing and you are 45 or older, you do not need to see your doctor or nurse. But you should see your doctor or nurse if you have symptoms that really bother you. For instance, you should see your doctor if you cannot sleep because of night sweats, or if you start to feel sad or blue and don’t seem to enjoy things anymore.
You should also see your doctor or nurse if you:
●Have your period more often than every 3 weeks
●Have very heavy bleeding during your period
●Have spotting between your periods
●Have been through menopause (have gone 12 months without a period) and start bleeding again, even if it's just a spot of blood
Is there a test for menopause? — There is a test that can point to menopause. But doctors usually use that test only in women who are too young to be in menopause or who have special circumstances.
Can I still get pregnant? — As long as you are still having periods, even if they do not happen often, you could get pregnant. If you have sex and do not want to get pregnant, use some form of birth control. If you have not had a period for a full year, it is probably safe to say you have been through menopause and can no longer get pregnant.
How are the symptoms of menopause treated? — Treatments include:
●Hormones (estrogen) – The hormone estrogen is the most effective treatment for menopause symptoms. Women who no longer have a uterus can take estrogen by itself. Women with a uterus must take estrogen with another hormone, called progesterone. Experts think these hormones are effective and safe for many women in their 40s and 50s with symptoms of menopause. If you want to take hormones, ask your doctor or nurse if it is an option. You should not take hormones if you have had breast cancer, a heart attack, a stroke, or a blood clot.
Women who have vaginal dryness without other symptoms of menopause can try “vaginal estrogen.” Vaginal estrogen is any form of estrogen that goes directly into the vagina. It comes in creams, tablets, or a flexible ring. Vaginal estrogen comes in small doses that don’t increase the levels of estrogen in other parts of the body very much.
●Ospemifene (brand name: Osphena) – This medicine helps relieve vaginal dryness caused by menopause, but it can also cause hot flashes. It is similar to estrogen but is not estrogen. It comes in a pill and is for women who prefer not to use a vaginal medicine.
●Antidepressants – Antidepressants can ease hot flashes and depression. Even women who are not depressed can take them to help with hot flashes.
●Anti-seizure medicine – One of the medicines used to prevent seizures seems to help some women with hot flashes – even if they do not have seizures.
Can I do anything on my own to reduce the symptoms of menopause? — Yes. There are some steps you can try. But ask your doctor before you take any “natural remedies.” Some natural remedies might not be safe, especially for women who have a history of breast cancer.
What can I do to protect my bones? — You can:
●Take calcium and vitamin D supplements
●Be active (exercise helps keep bones strong)
●Ask your doctor when you should start having bone density tests
If needed, your doctor can prescribe medicines to help keep your bones strong.
Tips on how to treat symptoms of menopause:
Hot flashes and night sweats:
Dress in layers so you can take off clothes if you get hot.
Keep the thermostat down and avoid hot drinks, such as coffee or tea.
Put a cold, wet washcloth against your neck during hot flashes.
Quit smoking, if you smoke. (Smoking makes hot flashes worse.)
Use lubricants before sex.
Use a vaginal moisturizer, such as Replens or Lubrin
Go to sleep and get up at the same time every day, even when you don't sleep well. (Taking naps can make the problem worse.)
Avoid caffeine in the afternoon and don't drink much alcohol.
Try to stay active.
Exercise helps ward off depression.
Seek social support from women like you.
Content adapted from UpToDate Patient Information.