Menopause occurs when a woman has not menstruated for 12 straight months and can naturally no longer become pregnant. It typically starts between the ages of 45 and 55, but in the United States, it can grow before or after this age period, but the average age is 51.
Menopause can cause painful symptoms, physical symptoms such as irregular periods, hot flashes, weight gain, and the emotional symptoms of menopause can interrupt your sleep, decrease your energy, or affect emotional health.
Menopause is a natural biological process. From lifestyle changes to hormone therapy, there are many successful therapies available. Medical care for menopause is not appropriate for most women. Read on to see what you need to learn.
When does menopause begin, and how long does it last?
Around four years before their last date, most women first begin to experience menopause symptoms. Symptoms sometimes go on for around four years after the last cycle of a woman.
For up to a decade before menopause fully happens, a small percentage of people experience menopause symptoms, and 1 in 10 women experience menopausal symptoms for 12 years after their last cycle.
The median age for menopause is 51, although it may occur on average up to two years sooner for black and Latina women. To understand the initiation of menopause for women of color, further studies are needed.
Several factors, including genetics and ovary health, help decide when you will begin menopause. Prior to menopause, perimenopause happens.
Perimenopause is when your hormones begin to change in preparation for menopause. One can still get pregnant during perimenopause, the change to menopause, even if you miss your menstrual period for a month or a few months.
The European Menopause and Andropause Society has released guidelines for the assessment of the endometrium, which is usually the main source of spotting or bleeding.
From a few months to several years, it can last anywhere. Any time after their mid-40s, several females begin perimenopause. Other females miss perimenopause and immediately reach menopause. According to the North American Menopause Society, these changes can last for four to eight years.
Perimenopause vs. menopause vs. postmenopause
During perimenopause, you can experience irregular periods. Your periods may be late, or you can entirely skip one or more periods. Menstrual flow can also become heavier or lighter. Menopause is defined as a lack of menstruation for one full year. Postmenopause refers to the years after menopause has occurred.
What are the symptoms of menopause?
The menopause experience of every woman can be different. When menopause comes unexpectedly or during a shorter period of time, symptoms are typically more intense.
Conditions that affect ovarian health, such as cancer or hysterectomy, or certain lifestyle decisions, such as smoking, tend to increase symptom severity and length. The symptoms of perimenopause, menopause, and postmenopause are usually the same, aside from menstruation changes.
Early signs of perimenopause are the most common:
- Irregular periods
- Periods that are heavier or lighter than you usually encounter
- Symptoms of vasomotor use, such as hot flashes, night sweats, and flushing. An estimated 75 percent of females experience menopausal hot flashes.
Other common symptoms of menopause include:
- Difficulty concentrating
- Memory problems
- Dry skin, mouth, and eyes
- Increased urination
- Hair thinning or loss
- increased hair growth on other areas of the body, such as the face, neck, chest, and upper back
- Reduced libido, or sex drive
- Weight gain
- Racing heart
- Sore or tender breasts
- Vaginal dryness
- Urinary tract infections (UTIs)
- Reduced muscle mass
- Painful or stiff joints
- Reduced bone mass
- Less full breasts
Menopause can result from:
- Naturally declining reproductive hormones: Your ovaries begin to generate fewer estrogen and progesterone, the hormones that control menstruation, as you reach your late 30s, and your fertility declines. Your menstrual periods become longer or shorter in your 40s, heavier or lighter, and more or less regular, until your ovaries stop releasing eggs, on average, by age 51, and you have no more periods.
- Surgery that removes the ovaries (oophorectomy): Your ovaries produce hormones that control the menstrual cycle, including estrogen and progesterone. Immediate menopause causes surgery to remove the ovaries. Your period ends, and you are likely to get hot flashes and have other signs and symptoms of menopause. Signs and symptoms can be severe, as hormonal shifts over many years arise suddenly rather than gradually. Typically, a surgery that removes your uterus but not your ovaries (hysterectomy) does not induce instant menopause. Your ovaries still release eggs and contain estrogen and progesterone, while you no longer have cycles.
- Chemotherapy and radiation therapy: Menopause may be caused by these cancer treatments, causing symptoms such as hot flashes during or shortly after treatment. After chemotherapy, the halt to menstruation (and fertility) is not always irreversible, so birth control measures may still be needed. If radiation is aimed at the ovaries, radiation therapy can affect ovarian function. Radiation treatment for other body parts such as breast tissue or the head and neck won’t affect menopause.
- Primary ovarian insufficiency: Around 1% of women undergo menopause before 40 years of age (premature menopause). Premature menopause may be triggered by the lack of normal amounts of reproductive hormones (primary ovarian insufficiency) in your ovaries, which may be caused by genetic factors or autoimmune disorder. Sometimes, however, no cause of premature menopause is found. Hormone therapy is usually prescribed for these women until the natural age of menopause to protect the brain, heart, and bones.
After menopause, your risk of certain medical conditions increases. Examples include:
- Heart and blood vessel (cardiovascular) disease: Your risk of cardiovascular disease increases as your levels of estrogen decrease. The leading cause of death in women as well as in men is heart disease. So it’s important to exercise regularly, eat a balanced diet, and maintain a normal weight. Ask your doctor for advice on how to protect your heart, such as how to lower your cholesterol or, if it’s too high, your blood pressure.
- Osteoporosis: This condition causes bones to become fragile and brittle, resulting in an increased risk of fractures. You may lose bone density at a rapid rate during the first few years after menopause, raising your risk of osteoporosis. Postmenopausal women with osteoporosis are particularly vulnerable to the spine, hip, and wrist fractures.
- Urinary incontinence: You can experience regular, unexpected, strong urges to urinate as the tissues of your vagina and urethra lose elasticity, accompanied by involuntary urine loss (urge incontinence) or urine loss from coughing, laughing, or raising (stress incontinence). More commonly, you can have urinary tract infections.
- Kegel exercises and the use of topical vaginal estrogen may help alleviate the effects of incontinence by strengthening the pelvic floor muscles. Hormone therapy can also be an effective treatment choice for urinary tract menopause, as well as for vaginal change that can lead to urinary incontinence.
- Sexual function: Vaginal dryness from reduced development of moisture and loss of elasticity during sexual intercourse can cause discomfort and minor bleeding. The decreased sensation may also diminish your appetite for sexual activity (libido).
- Vaginal moisturizers and lubricants that are water-based can aid. Many women benefit from the use of local vaginal estrogen therapy, available as a vaginal cream, tablet, or ring if a vaginal lubricant is not enough.
- Breast cancer: Some types of breast cancer are more likely to develop after menopause and one can have an increased risk of breast cancer when receiving combined menopausal hormone therapy with progesterone and estrogen.
- Weight gain: Since metabolism slows, many women gain weight during the menopausal transition and after menopause. To maintain your current weight, you can need to eat less and exercise more.
Why does menopause occur?
Menopause is a natural process that occurs as the ovaries age and produces fewer reproductive hormones. The body begins to undergo several changes in response to lower levels of:
- Follicle-stimulating hormone (FSH)
- Luteinizing hormone (LH)
The loss of active ovarian follicles is one of the most noticeable changes. The structures that create and release eggs from the ovary wall are ovarian follicles, and they enable menstruation and fertility.
As the flow grows heavier and longer, most females first note the frequency of their time being less constant. This typically takes place in the mid-to-late 40s at some point.
Most U.S. women have experienced menopause by the age of 52. In certain cases, menopause is induced or exacerbated by damage to the ovaries and associated pelvic structures or by surgical removal.
Popular induced menopause causes include:
- Bilateral oophorectomy, or removal of ovaries by surgery
- Ovarian ablation or shutdown of ovarian activity, which can be achieved in women with estrogen receptor-positive tumors by hormone therapy, surgery, or radiotherapy techniques
- Pelvic radiation
- Pelvic injuries that severely damage or destroy the ovaries
How is menopause diagnosed?
If you have problematic or debilitating symptoms of menopause, or if you experience symptoms of menopause and are 45 years of age or younger, it is worth talking to your healthcare provider.
The Food and Drug Administration Trusted Source recently approved a new blood test known as the PicoAMH Elisa diagnostic test. This test is used to determine whether a woman has reached menopause or is approaching menopause.
This new test could be beneficial for women who have perimenopausal symptoms, which may also have adverse health effects. A greater risk of osteoporosis and fracture, heart disease, cognitive changes, vaginal changes, and loss of libido, and mood changes are associated with early menopause.
A blood test that tests the number of certain hormones in the blood, normally FSH, and a type of estrogen called estradiol, can also be ordered by your doctor.
Menopause is typically reported by chronically elevated FSH blood levels of 30 mIU/mL or higher, combined with a lack of menstruation for one consecutive year. Also available are saliva tests and over-the-counter (OTC) urine tests, but they are inaccurate and costly.
FSH and estrogen levels fluctuate regularly during perimenopause, but most healthcare providers can diagnose this disorder based on symptoms, medical history, and menstruation knowledge.
Your healthcare provider can also prescribe further blood tests based on your symptoms and health records to help rule out any underlying problems that may be responsible for your symptoms.
Additional widely used blood tests to help validate menopause include:
- Thyroid function tests
- Blood lipid profile
- Liver function tests
- KIdney function tests
- Testosterone, progesterone, prolactin, estradiol, and chorionic gonadotropin (hCG) tests
If your symptoms are serious or are impacting your quality of life, you may need care. Hormone therapy can be an appropriate treatment in women under the age of 60 or 10 years after the start of menopause to manage or reduce:
- Hot flashes
- Night sweats
- Vaginal atrophy
More specific symptoms of menopause, such as hair loss and vaginal dryness, can be treated with other drugs. Additional drugs often used for signs of menopause include:
- Topical minoxidil 5 percent, used once daily to treat hair thinning and loss
- Anti-dandruff shampoos, commonly ketoconazole 2 percent and zinc pyrithione 1 percent, used to treat hair loss
- Eflornithine hydrochloride topical cream to treat or unwanted hair growth
- Selective serotonin reuptake inhibitors (SSRIs), commonly paroxetine 7.5 milligrams to treat hot flashes, anxiety, and depression
- Non-hormonal vaginal moisturizers and lubricants
- Low-dose estrogen-based vaginal lubricants in the form of a cream, ring, or tablet
- Ospemifene to treat vaginal dryness and painful intercourse
- Prophylactic antibiotics to treat recurrent UTIs
- Sleep medications for insomnia
- Denosumab, teriparatide, raloxifene, or calcitonin for postmenstrual osteoporosis
Home remedies and lifestyle changes
Using home remedies, lifestyle improvements, and alternative therapies, there are many ways to naturally alleviate mild to moderate menopause symptoms. Here are several strategies at home for treating the effects of menopause:
Keeping cool and staying comfortable
- Dress in loose, layered clothing, particularly at night and when the weather is warm or unpredictable. This will assist you in handling hot flashes.
- Keeping your bedroom cool and avoiding heavy blankets at night will also help reduce your risk of sweating at night. Consider using a waterproof sheet under your bedding to cover your mattress if you frequently have evening sweats.
- If you feel flushed, you can also bring a portable fan to help cool you down.
Exercising and managing your weight
To better control your weight, decrease your daily calorie intake by 400 to 600 calories. It’s also necessary to do 20 to 30 minutes of moderate exercise a day. This will assist:
- Increase energy
- Promote a better night’s sleep
- Improve mood
- Promote your general well-being
Communicating your needs
Discuss any symptoms of depression, anxiety, grief, loneliness, and insomnia with a therapist or counselor. You should also consider talking about feelings of anxiety, mood shifts, or depression with your family members, loved ones, or friends so that they know your needs.
Supplementing your diet
To help reduce the risk of osteoporosis and boost energy levels and sleep, take calcium, vitamin D, and magnesium supplements. Speak to your doctor about supplements that can assist you with your unique health needs.
Practicing relaxation techniques
Practice relaxation and breathing techniques, such as:
Taking care of your skin
To decrease skin dryness, apply moisturizers regularly. Excessive bathing or swimming, which can dry out or irritate the skin, should also be avoided.
Managing sleeping issues
To temporarily treat your insomnia, use OTC sleep drugs, or consider exploring natural sleep aids with your doctor. If you regularly have trouble sleeping, talk to your doctor so they can help you handle it, and get a better night’s rest.
Quitting smoking and limiting alcohol use
Stop smoking to eliminate secondhand smoke exposure. Your symptoms can be made worse by exposure to smoke. To avoid worsening symptoms, you should also restrict your alcohol consumption. Your risk of health problems can increase with heavy drinking during menopause.
Some limited studies have endorsed the use of herbal remedies for estrogen deficiency-induced menopausal symptoms. Natural supplements and nutrients that can help to limit the symptoms of menopause include:
- Vitamin E
There are also reports that certain symptoms, such as hot flashes and night sweats, can improve with black cohosh. But little evidence was discovered to support these arguments in a recent study of studies.
It needs further study. Similarly, no evidence was found in 2015 by Research to support reports that omega-3 fatty acids may enhance menopausal vasomotor symptoms.
Menopause is the natural termination or halt of a woman’s menstrual cycle, which marks the end of fertility. By the age of 52, most women undergo menopause, but pelvic or ovarian damage can cause sudden menopause earlier in life. The early onset of menopause can also result from biology or underlying conditions.
In the few years before menopause, many women experience signs of menopause, most often hot flashes, night sweats, and flushing. After menopause, symptoms may continue for four or five years.
If your symptoms are serious or impact your quality of life, you can benefit from medication, such as hormone therapy. Generally, using natural remedies and lifestyle changes, menopause symptoms may be treated or reduced.
- Menopause; Mayo Clinic