Menopause is the transition out of your reproductive years.
It is usually determined to have started when it has been 12 months since your last menstrual cycle.
When you go through menopause, you will experience many changes to your body over several years.
Due to fluctuating hormones, bodily changes, and other symptoms, menopause can be a stressful or distressing time.
Knowing what to expect, and how to manage your symptoms, can help you cope with this stage of life more easily.
In this article, I’ll explain more about what menopause is and what causes it to start.
I’ll outline some of the symptoms of menopause, and complications it can cause.
I’ll describe how it’s diagnosed, treatments for some of its symptoms, and list some questions to ask your doctor or healthcare provider about menopause.
What is Menopause?
Menopause is the time when people with ovaries stop producing the hormones estrogen and progesterone.
During menopause, the ovaries no longer release an egg every month and your period stops.
Not having your period for a year and being at the typical age of menopause (usually occurring between 40-50 years old) are all signs that you may be going through this phase.
Menopause is a natural biological process for people with female reproductive organs.
In some cases, it can be brought on prematurely by certain health conditions and treatments.
Naturally declining reproductive hormones
As you near the age of menopause, your body will first enter a stage of perimenopause.
This is usually one to two years before menopause starts.
Your ovaries slowly make less estrogen until your body enters menopause, the time when your ovaries stop releasing eggs.
Chemotherapy and radiation therapy
Chemotherapy and radiation therapy can damage your ovaries and bring on menopause.
This is more likely to happen in people who have this therapy later in life, closer to the age of menopause.
It can also cause your period to stop for a while, or in some cases, permanently. If this occurs, you may find it difficult to get pregnant or you may not be able to get pregnant at all.
Surgery that removes the ovaries
Bilateral oophorectomy is the surgical removal of the ovaries.
This procedure can bring on menopause symptoms right away.
The surgery will cause your hormone levels to drop and your period to stop.
You may experience hot flashes and a decreased libido.
Primary ovarian insufficiency
Primary ovarian insufficiency is when a woman’s ovaries stop working normally before the age of 40.
About 1% of women experience menopause before age 40.
This is considered premature menopause and may result in your ovaries no longer producing normal levels of reproductive hormones.
You may have primary ovarian insufficiency from genetic factors or autoimmune disease, but in most cases, the reasons for premature menopause are unknown.
Hormone therapy is typically suggested until the natural age of menopause to protect the brain, heart, and bones.
Some people may not struggle with this transition at all, while others may be burdened with many symptoms that come and go for a long time as their body adjusts to new hormonal changes.
Common symptoms include:
- A change in period duration and flow
- Missing periods for several months
- Abdominal pain
- Hot flashes
- Night sweats
- Trouble sleeping
- Difficulty concentrating
- Mood swings
- Increases hair on your face
- Vaginal dryness
Menopause is not a disease or disorder.
It is a natural process in all people with female reproductive parts.
Going through menopause causes hormonal changes to the body that put a person at greater risk of other health concerns.
Menopause can put you at greater risk of cardiovascular disease (CVD).
This is due to declining levels of estrogen, which affect cardiovascular function and metabolism.
Menopause can exacerbate CVD risk factors such as increased blood pressure, vascular inflammation, body fat distribution from a gynoid to an android pattern, reduced glucose tolerance, abnormal plasma lipids, and endothelial dysfunction.
The decrease in estrogen caused by menopause can put you at a greater risk of osteoporosis.
Estrogen supports osteoblasts, which are bone-producing cells.
When your estrogen levels decline, osteoblasts can’t produce enough new bone.
This can cause significant bone weakness.
After going through menopause, it is common in aging women to develop urinary incontinence (sporadic and involuntary releases of urine).
Estrogen helps keep your bladder and urethra healthy, and the declining levels can cause your pelvic floor muscles to become weak.
This can cause uncontrollable urine leakage, often as a result of sudden movements such as laughing or coughing.
Changes in sexual function
Less estrogen and testosterone in the body can cause changes in sexual function.
During and after menopause, you may find you’re not as easily aroused or have less interest in sex, as you are less sensitive to touching and stroking.
You may gain weight around your abdomen during and after menopause due to hormonal changes.
This could also be attributed to aging, lifestyle changes, and genetic factors.
The increase in weight around your abdomen can out you at a greater risk of heart disease.
In most cases, menopause can be determined by signs and symptoms such as changes to your menstrual cycle and hot flashes at the common age of menopause.
Your doctor can also administer blood tests to check your levels of follicle-stimulating hormone (FSH) and estrogen (estradiol).
When menopause occurs, the FSH levels increase and estradiol levels decrease.
You can also get over-the-counter home tests to check the FSH levels in your urine.
These tend to be a little less reliable, as FSH levels rise and fall during the course of your menstrual cycle, so the results won’t be as definitive as a blood test.
Treatment of Menopause Symptoms
Talk with your healthcare provider about your medical history, family history, and symptoms, and they will be able to determine the best treatment plan for you.
Hormone therapy can help treat hot flashes and can be effective in relieving the symptoms of menopause.
It can also reduce the risk of osteoporosis caused by declining estrogen levels.
If you still have your uterus, you’ll need progestin in addition to estrogen.
Long-term use of hormone therapy may have some cardiovascular and breast cancer risks.
Your doctor will be able to inform you of the benefits and risks.
Vaginal creams, tablets, or rings can be administered directly to the vagina to improve vaginal dryness.
These treatments release small amounts of estrogen into your vaginal tissues, which can relieve dryness, discomfort during sexual intercourse, and some urinary issues.
In some cases, low-dose antidepressants such as selective serotonin reuptake inhibitors (SSRIs) can help manage menopausal symptoms.
They may decrease menopausal hot flashes or help your mood if you’re suffering a mood disorder from hormonal changes.
Gabapentin is typically prescribed to treat seizures, but you can also take it to reduce nighttime hot flashes.
Clonidine is another medication that can relieve hot flashes.
It is typically in pill or patch form, and is used to treat high blood pressure.
Since menopause can put you at a greater risk of osteoporosis, your doctor may recommend medication to prevent or treat it.
There are several medications available that help reduce bone loss and the risk of fractures.
Your doctor may suggest you take these in conjunction with calcium and vitamin D supplements to help strengthen bones.
Questions to Ask Your Doctor About Menopause
If you suspect you may be going through menopause or have started perimenopause, visit your doctor to ask them some questions on what to expect.
Consider the following to help navigate this important transition period:
- Am I experiencing symptoms of perimenopause or menopause?
- How long should I expect my symptoms to last?
- Are my symptoms a sign of menopause or something else?
- Should I visit a gynecologist?
- What natural remedies, including supplements, should I take?
- Do my symptoms need medical treatment?
- Do I still need to use birth control? If so, for how long?
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