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What is Menopause?

Menopause marks the end of the reproductive years, when a woman’s menstrual periods cease. Menopause happens when the ovaries stop producing estrogen, which is a hormone that helps control the menstrual cycle. The average age that women experience menopause is 51 years.

Perimenopause describes the years leading up to menopause, typically beginning in a woman’s 30’s and 40’s. During this time, the amount of estrogen produced by the ovaries begins to fluctuate, commonly signaled by a change in menstrual cycle. Cycles may become longer or shorter than usual, depending on the patient. Some women may even begin to skip periods or the flow will become lighter or heavier. These changes are perfectly normal, but it’s still a good idea to keep your gynecologist informed as certain abnormal bleeding could indicate a health problem.

Other Signs and Symptoms

There are other changes a woman may experience during perimenopause besides changes in menstrual cycles. These can include:

  • Hot flashes: A sudden rush of heat to the upper body and face. A hot flash can last from a few seconds to several minutes or longer. Some women have hot flashes a few times a month. Others have them several times a day. Hot flashes that happen at night may wake you up and cause you to feel tired and sluggish the following day.
  • Sleep problems: Some women experience insomnia (trouble falling asleep), or they wake up long before their usual time.
  • Vaginal dryness: Due to decreased estrogen levels, the lining of the vagina may become thinner, dryer, and less elastic. Vaginal dryness may cause pain during sex and infections could occur more often. The urethra also can become dry, inflamed, or irritated. This can simulate an urge for more frequent urination and increase the risk of urinary tract infections.

Associated health risks

During the first four to eight years after menopause, women lose bone tissue more rapidly because of the decreased levels of estrogen. If too much bone is lost, it can increase a woman’s risk of osteoporosis. Spinal, hip, and wrist bones are typically affected the most.

Estrogen also protects against heart attacks and stroke. Risk factors of heart disease such as high cholesterol and high blood pressure are also more common during midlife, increasing the risk of heart attack and stroke in menopausal women.

Hormone Therapy

Hormone therapy is one method of relieving symptoms of menopause and perimenopause. If a woman has never had a hysterectomy and still has a uterus, this therapy consists of a combined hormone therapy of estrogen and progestin.

Estrogen helps guard against the health risks and symptoms listed above and progestin reduces the risk of cancer of the uterus that occurs when estrogen is taken on its own. Women who have had a hysterectomy receive a different kind of hormone therapy simply referred to as “estrogen therapy.”

Hormone therapy can be administered in the form of pills, patches and topical gels and sprays. With systemic therapy, the hormones are released into the bloodstream where they travel to the necessary organs and tissues. Women experiencing only vaginal dryness may be prescribed a local therapy in the form of a ring, tablet or cream.

Other Treatments

If you are not a good candidate for hormone therapy, there are other methods of easing the symptoms of menopause. Certain antidepressants are available for the treatment of hot flashes, as well as antiseizure and blood pressure medications to ease sleep problems associated with menopause.

Some women seek relief using various plant and herbal therapies. It’s important to remember, however, that only a few of these substances have been studied for safety and effectiveness and their regulation is not guaranteed. If you choose to use herbal remedies to supplement or replace your menopause treatments, be sure to let your health care provider know.

Over the counter products such as vaginal moisturizers and lubricants can be used to help with the vaginal dryness and painful sexual intercourse that may occur during menopause. Moisturizers restore the natural acidity of the vagina and can be used every two to three days as needed.

Life After Menopause

Maintaining a healthy lifestyle post-menopause will help you enjoy that time to the fullest. Eat a balanced diet that includes plenty of calcium and vitamin D. Regular exercise slows bone loss. Walking and strength-training improves the health of your bones and muscles as well. Consider balance-focused exercise such as yoga or tai chi to reduce risk of falls and improve circulation. And of course, visit your health care provider regularly for necessary exams and tests. This will give doctors the opportunity to detect any problems early and allow you to share any questions that have come up.