Menopause refers to a natural stop in a woman’s menstrual period and fertility.
Menopause occurs when a woman hasn’t menstruated in 12 consecutive months and can no longer become pregnant naturally. It usually begins between the ages of 45 and 55, but can develop before or after this age range.
Menopause can cause uncomfortable symptoms, such as hot flashes and weight gain. For most women, medical treatment isn’t needed for menopause.
When does menopause begin and how long does it last?
Most women first begin developing menopause symptoms about four years before their last period. Symptoms often continue until about four years after a woman’s last period.
A small number of women experience menopause symptoms for up to a decade before menopause actually occurs, and 1 in 10 women experience menopausal symptoms for 12 years following their last period.
The median age for menopause is 51, though it may occur on average up to two years earlier.
There are many factors that help determine when you’ll begin menopause, including genetics and ovary health. Perimenopause occurs before menopause. Perimenopause is a time when your hormones begin to change in preparation for menopause.
It can last anywhere from a few months to several years. Many women begin perimenopause some point after their mid-40s. Other women skip perimenopause and enter menopause suddenly.
During perimenopause, menstrual periods become irregular. Your periods may be late, or you may completely skip one or more periods. Menstrual flow may also become heavier or lighter.
Menopause is defined as a lack of menstruation for one full year.
Post menopause refers to the years after menopause has occurred.
What are the symptoms of menopause?
Every woman’s menopause experience is unique. Symptoms are usually more severe when menopause occurs suddenly or over a shorter period of time.
Conditions that impact the health of the ovary, like cancer or hysterectomy, or certain lifestyle choices, like smoking, tend to increase the severity and duration of symptoms.
Aside from menstruation changes, the symptoms of perimenopause, menopause, and postmenopause are generally the same. The most common early signs of perimenopause are:
less frequent menstruation
heavier or lighter periods than you normally experience
vasomotor symptoms (VMS), including hot flashes, night sweats, and flushing
An estimated 75 percent of women experience hot flashes with menopause.
Other common symptoms of menopause include: Insomnia, vaginal dryness, weight gain, depression, anxiety, difficulty concentrating, memory problems, low sex drive, increased urine, sore or tender breast, headaches, urinary tract infections( UTIs), dry skin.
Complications
Common complications of menopause include:
vulvovaginal atrophy
dyspareunia, or painful intercourse
slower metabolic function
osteoporosis, or weaker bones with reduced mass and strength
mood or sudden emotional changes
cataracts
periodontal disease
urinary incontinence
heart or blood vessel disease
Why does menopause occur?
Menopause is a natural process that occurs as the ovaries age and produce less reproductive hormones.
The body begins to undergo several changes in response to lower levels of:
estrogen
progesterone
testosterone
follicle-stimulating hormone (FSH)
luteinizing hormone (LH)
One of the most notable changes is the loss of active ovarian follicles. Ovarian follicles are the structures that produce and release eggs from the ovary wall, allowing menstruation and fertility.
Most women first notice the frequency of their period becoming less consistent, as the flow becomes heavier and longer. This usually occurs at some point in the mid-to-late 40s. By the age of 52, most U.S. women have undergone menopause.
In some cases, menopause is induced, or caused by injury or surgical removal of the ovaries and related pelvic structures.
Common causes of induced menopause include:
bilateral oophorectomy, or surgical removal of the ovaries
ovarian ablation, or the shutdown of ovary function, which may be done by hormone therapy, surgery, or radiotherapy techniques in women with estrogen receptor-positive tumors
pelvic radiation
pelvic injuries that severely damage or destroy the ovaries
Treatments
You may need treatment if your symptoms are severe or affecting your quality of life. Hormone therapy may be an effective treatment in women under the age of 60, or within 10 years of menopause onset, for the reduction or management of:
hot flashes
night sweats
flushing
vaginal atrophy
osteoporosis
Other medications may be used to treat more specific menopause symptoms, like hair loss and vaginal dryness.
Additional medications sometimes used for menopause symptoms include:
topical minoxidil 5 percent, used once daily for hair thinning and loss
antidandruff shampoos, commonly ketoconazole 2 percent and zinc pyritinol 1 percent, used for hair loss
eflornithine hydrochloride topical cream for unwanted hair growth
selective serotonin reuptake inhibitors (SSRIs), commonly paroxetine 7.5 milligrams for hot flashes, anxiety, and depression
nonhormonal vaginal moisturizers and lubricants
low-dose estrogen-based vaginal lubricants in the form of a cream, ring, or tablet
ospemifene for vaginal dryness and painful intercourse
prophylactic antibiotics for recurrent UTIs
sleep medications for insomnia
denosumab, teriparatide, raloxifene, or calcitonin for postmenstrual osteoporosis.
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