Menopause

Menopause is the normal time of life when menstrual periods stop completely. Menopause is complete when you have missed 12 consecutive menstrual periods. It usually occurs between the ages of 48 years and 55 years. Very rarely does a woman develop menopause before the age of 40 years. At menopause, your ovaries stop producing the female hormones estrogen and progesterone. This can cause undesirable symptoms and also affect your health. Sometimes the symptoms may occur 4–5 years before the menopause begins. There is no relationship between menopause and:

  • Oral contraceptives.

  • Number of children you had.

  • Race.

  • The age your menstrual periods started (menarche).

Heavy smokers and very thin women may develop menopause earlier in life.

CAUSES

  • The ovaries stop producing the female hormones estrogen and progesterone.

  • Other causes include:

  • Surgery to remove both ovaries.

  • The ovaries stop functioning for no known reason.

  • Tumors of the pituitary gland in the brain.

  • Medical disease that affects the ovaries and hormone production.

  • Radiation treatment to the abdomen or pelvis.

  • Chemotherapy that affects the ovaries.

SYMPTOMS

  • Hot flashes.

  • Night sweats.

  • Decrease in sex drive.

  • Vaginal dryness and thinning of the vagina causing painful intercourse.

  • Dryness of the skin and developing wrinkles.

  • Headaches.

  • Tiredness.

  • Irritability.

  • Memory problems.

  • Weight gain.

  • Bladder infections.

  • Hair growth of the face and chest.

  • Infertility.

More serious symptoms include:

  • Loss of bone (osteoporosis) causing breaks (fractures).

  • Depression.

  • Hardening and narrowing of the arteries (atherosclerosis) causing heart attacks and strokes.

DIAGNOSIS

  • When the menstrual periods have stopped for 12 straight months.

  • Physical exam.

  • Hormone studies of the blood.

TREATMENT

There are many treatment choices and nearly as many questions about them. The decisions to treat or not to treat menopausal changes is an individual choice made with your health care provider. Your health care provider can discuss the treatments with you. Together, you can decide which treatment will work best for you. Your treatment choices may include:

  • Hormone therapy (estrogen and progesterone).

  • Non-hormonal medicines.

  • Treating the individual symptoms with medicine (for example antidepressants for depression).

  • Herbal medicines that may help specific symptoms.

  • Counseling by a psychiatrist or psychologist.

  • Group therapy.

  • Lifestyle changes including:

  • Eating healthy.

  • Regular exercise.

  • Limiting caffeine and alcohol.

  • Stress management and meditation.

  • No treatment.

HOME CARE INSTRUCTIONS

  • Take the medicine your health care provider gives you as directed.

  • Get plenty of sleep and rest.

  • Exercise regularly.

  • Eat a diet that contains calcium (good for the bones) and soy products (acts like estrogen hormone).

  • Avoid alcoholic beverages.

  • Do not smoke.

  • If you have hot flashes, dress in layers.

  • Take supplements, calcium, and vitamin D to strengthen bones.

  • You can use over-the-counter lubricants or moisturizers for vaginal dryness.

  • Group therapy is sometimes very helpful.

  • Acupuncture may be helpful in some cases.

SEEK MEDICAL CARE IF:

  • You are not sure you are in menopause.

  • You are having menopausal symptoms and need advice and treatment.

  • You are still having menstrual periods after age 55 years.

  • You have pain with intercourse.

  • Menopause is complete (no menstrual period for 12 months) and you develop vaginal bleeding.

  • You need a referral to a specialist (gynecologist, psychiatrist, or psychologist) for treatment.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have severe depression.

  • You have excessive vaginal bleeding.

  • You fell and think you have a broken bone.

  • You have pain when you urinate.

  • You develop leg or chest pain.

  • You have a fast pounding heart beat (palpitations).

  • You have severe headaches.

  • You develop vision problems.

  • You feel a lump in your breast.

  • You have abdominal pain or severe indigestion.