Menopause

Menopause is a normal and expected time in a woman's life when her monthly menstrual cycle ceases. The average age of a woman's last period is 51 but can range from her 40s to late 50s. After one entire year without menstruation, a woman can say she has been through menopause.

Symptoms of menopause can vary from woman to woman. Early menopause usually starts with shorter and less dense menstrual periods. Other common symptoms of menopause include hot flashes, an increase in vaginal dryness and or urinary tract infections, urine leaks, trouble sleeping, increased or decreased interest in sex, mood changes and weight gain.

Menopause is caused by naturally reduced levels of estrogen. Surgery to remove the uterus will cause periods to stop, the definition of menopause. However, because the ovaries are untouched, symptoms such as hot flashes may not begin to occur immediately. Over time, as the ovaries produce fewer hormones, symptoms and signs of menopause could begin. An oophorectomy along with the removal of the uterus could trigger instant menopause symptoms regardless of the woman's age.

Menopause is not an illness that requires a cure. However, there are treatments to help manage symptoms of menopause, such as  oral birth control pills may be used to help with very heavy, frequent or unpredictable menstrual periods. They may also help with hot flashes. Hormone replacement therapy can help manage menopause symptoms and prevent bone loss. Medications for high blood pressure, high cholesterol and osteoporosis are important to consider, as menopause increases the risks for these conditions.

Just as pre-menstrual and menstrual sytmpoms vary among women, symptoms of menopause can vary from woman to woman. Estrogen is used by many parts of the body, so if a woman has less estrogen, she could have different symptoms than someone whose body produces more estrogen.

A change in your monthly period is normally the first sign of menopause. Your periods may lose their regularity and may be shorter or longer than usual. Your periods might become less dense as well. While these are normal symptoms, consult your doctor if:

• Your periods begin to arrive very close together.
• You have heavy bleeding.
• You have spotting.
• Periods last more than one week.

Hot flashes are also typical of menopause, as they are related to changing levels of estrogen. A hot flash is a sudden feeling of warmth in the upper part or all of your body. Feeling flushed, red blotches on the skin, heavy sweating and cold shivering are all symptoms. Hot flashes can be mild or strong enough to wake you from sleep lasting between 30 seconds and 10 minutes. Hot flashes may last for a few years following menopause. 

Other common symptoms of menopause include drier and thinner genital areas, an increase in vaginal or urinary infections, urine leaks, trouble sleeping, increased or decreased interest in sex, mood changes and weight gain.

Menopause and the overall decrease in estrogen production can trigger two health issues: osteoporosis and heart disease. These conditions may go unnoticed, as they can develop during the onset of menopausal symptoms. Osteoporosis is the weakening and breakage of bone due to the loss of estrogen, which aids in controlling bone loss in women. Without that continual source of estrogen, the body loses more bone than it is able to replace. Heart disease can be brought on by weight gain, a common characteristic of menopause, and changing estrogen levels may put women at higher risk for heart disease.

See your doctor during the onset of menopause to discuss risk factors for these conditions and to learn about preventive measures and medications to help in lowering your risk.

Menopause is caused by the loss of the hormone estrogen in the female body. Because of the fluctuation in female hormone levels, the body adapts, transitioning to compensate for the lack of estrogen and progesterone being produced.

Other events and conditions in a woman's life can bring about menopause and menopausal symptoms much earlier in life. Surgery to remove the uterus will cause periods to stop, the definition of menopause. However, because the ovaries are untouched, symptoms such as hot flashes may not begin to occur immediately. Over time, as the ovaries produce fewer hormones, symptoms and signs of menopause could begin.

An oophorectomy — a surgery in which both ovaries are removed — along with the removal of the uterus could trigger instant menopause symptoms regardless of the woman's age. This is because the body has just lost its main and immediate supply of estrogen.

As the age of menopause varies among individual women, it can be difficult to predict exactly when onset will begin. While the average age of menopause is 51, it could start in a woman's 40s through her late 50s.

Experiencing symptoms may be the strongest sign of menopause. When you reach middle age, pay close attention to your menstrual cycle and note any irregularities or changes. These could be an early sign of menopausal onset. Slight changes to the body such as weight gain, thinning skin or stiff joints may go unnoticed at first, but these symptoms combined with hot flashes and changing periods may be the symptoms needed to confirm menopause.

Because some complications and additional health conditions — including osteoporosis and heart disease — can develop with the onset of menopause, it is important to watch out for signs of menopause so you can ask your doctor how to prevent these issues.

If you are a smoker, watch your body for signs of menopause even before age 50, as the habit can increase your chances for early menopause. If your periods begin to arrive close together, you are experiencing heavier bleeding, you have spotting or your periods are lasting longer than one week, visit your doctor — these symptoms may be signs of internal complications.

Because menopause is something every woman goes through, a support group may be a great way to get ideas for symptom treatment, trade advice and discuss overall experiences. Older female friends, relatives or family members may be able to provide guidance and remedies that have worked for them.

Living with menopause may be troublesome, but it is something that cannot be avoided. Taking advantage of the opportunity to get healthy and actively taking charge of your symptom management may give you control over the condition. It is important to know your various options when considering treatment for symptoms of menopause. Ask your doctor if pharmaceutical avenues such as oral birth control and HRT would be good choices for you. Look into exercise options around your community that you may enjoy, as staying active is essential to fighting osteoporosis.

Quit smoking and begin learning how to incorporate high amounts of fiber and low-fat foods into your regular diet. Learning how to adapt your lifestyle is key to managing menopause. Do not force another person's preferences for symptom management onto yourself, as you may find it difficult to adapt in the long haul. Do what fits your individual lifestyle, as menopause affects every woman differently.

Even though each woman reacts in differently to the onset of menopause, all women need to understand that with menopause come risks that are out of their control. Take preventive measures and discuss the need for cancer screening, pelvic and breast exams and PAP tests with your doctor. Know your family’s medical history so that you know what to ask your doctor.

My mother entered menopause much earlier than my own age. I still have a regular menstrual cycle and have therefore not started menopause. Is there something wrong?

• Menopause occurs at different times for every woman. While there may be similarities about the age at which some women start menopause, it is not exactly the same and does not apply to everyone. The average age for the onset of menopause is 51. However, various factors can affect that statistic. Some women start menopause in their 40s, while others don’t experience it until their late 50s. If you or your mother is a smoker, it may help to explain the difference, as smoking can cause menopause at an earlier stage in life. Additionally, if one of you has had surgery to remove your ovaries and/or uterus, that could affect the production of estrogen and could either jumpstart menopause or delay it.

My feelings about sex are changing as I’m experiencing menopause. Is this normal?

• Yes, it is completely normal. Menopause and the changing levels of female hormones in the body can change how women feel about sex. You may become more interested in sex or less interested — both are normal reactions. After one full year without a period, it is no longer physically possible to become pregnant. But the risk of STDs and HIV are still possible, so it is still important to use protection even without the risk of pregnancy.

Heart disease runs in my family and I’m worried about my risk as I enter menopause. What can I do to stay healthy?

• Your risk for both osteoporosis and heart disease rises greatly during menopause. Those who have a family history of either are at greater risk. Check your blood pressure regularly as well as your levels of triglycerides, fasting blood sugar and LDL, HDL and total cholesterol. Talk to your doctor about additional measures you can take to protect your heart. Exercise at least three times a week, and make fiber and low fat foods a part of your regular diet. Stop smoking, and ask your doctor if you should take calcium and vitamin D supplements to improve your health.

Menopause is not an illness. It is an inevitable period in a woman's life during which the body begins to stop production of the hormones estrogen and progesterone. However, menopause does mean a woman’s body is more susceptible to aging and particular conditions without the protection these hormones can provide. Therefore, it is important to stay healthy during and after menopause.

Quitting smoking and eating a healthy diet that is low in fat and high in fiber with a variety of fruits, vegetables and whole grains is essential to women’s health. Make sure you are getting enough calcium and vitamin D. Your doctor may recommend that you take these minerals as supplements even if you also include them in your diet. Osteoporosis is common with menopause, and increased calcium intake can prevent and slow the condition’s progression.

Maintaing a healthy weight is also important as you age and go through menopause. And since menopause can affect bone health, you might consider exercises like walking, jogging or even dancing not only to maintain a healthy weight but also to promote strong bones. Talk to your doctor or health care provider to determine a healthy weight and appropriate exercise plan for you.

You can also get help managing symptoms of menopause by talking to a doctor or health care professional. While menopause cannot be stopped or avoided, a doctor can help alleviate bothersome aspects of this transitional period. A specialty care provider, such as a gynecologist, geriatrician or internist, may be able to provide specific answers and remedies to suit your needs.

If you are experiencing more severe symptoms of menopause or related conditions, visit your doctor to discuss if medications are right for you. Medications for high blood pressure, high cholesterol and osteoporosis are important to consider, as menopause increases the risks for these conditions.

Make sure to tell your doctor about your medical history and your family’s medical history, as these can be vital factors in determining if you are at high risk for breast cancer, heart disease and osteoporosis.

The following are some medication options women may wish to consider:

• Birth control. During menopause, certain oral birth control pills may be used to help with very heavy, frequent or unpredictable menstrual periods. They may also help with hot flashes.
• Menopausal hormone therapy (MHT), or hormone replacement therapy (HRT). This type of treatment can help manage menopause symptoms and prevent bone loss that occurs with menopause. There are risks associated with HRT that may be more prominent for some women. It is important to remember that while HRT has been shown to increase the risks of certain diseases, the benefits of HRT for some women may outweigh the risks. Talk to your gynecologist about whether these medications will be helpful for treating your menopausal symtpoms.

Water-based vaginal lubricants (not petroleum jelly) or a vaginal estrogen cream or tablet can be used to relieve vaginal discomfort or dryness.

Phytoestrogens are estrogen-like substances that work in the body like estrogen but are weaker. Regular ingestion of phytoestrogens may relieve some symptoms of menopause. They can be found in some cereals, vegetables, legumes (including soy) and various herbs. Overindulgence in phytoestrogens may carry risks and women should talk to their doctor when considering using them.

Menopause also indicates the need for regular pelvic and breast exams, PAP tests and mammograms. It is also smart to be checked for colon, rectal and skin cancer. Contact your doctor immediately if you notice a lump in your breast or a mole that has changed.