Everything You Need to Know About Menopause

What is menopause?

Menopause occurs when a woman has not menstruated for 12 consecutive months and is no longer able to become pregnant naturally. It usually begins between the ages of 45 and 55, but can develop before or after this age range.

Menopause can cause uncomfortable symptoms such as hot flashes and weight gain. For most women, no medical treatment is needed for menopause.

Read on to find out what you need to know about menopause.

When does menopause begin and how long does it last?

Most women first start developing symptoms of menopause four years before their last period. Symptoms usually last up to four years from a woman’s last period.

A small number of women experience menopausal symptoms up to ten years before menopause occurs, and 1 in 10 women experience menopausal symptoms for 12 years following their last period.

The median age for menopause is 51, but it can occur on average up to two years earlier in African-American and Latino women. More studies are needed to understand the onset of menopause for non-Caucasian women.

There are many factors that will help you decide when to start menopause, including genetics and ovarian health. Perimenopause occurs before menopause. Perimenopause is a time when your hormones start to change in preparation for entering menopause.

It can last anywhere from a few months to several years. Many women begin perimenopause at some point after their mid-40s. Other women skip perimenopause and suddenly enter menopause.

About 1 percent of women begin menopause before age 40, called premature menopause or primary ovarian failure. About 5 percent of women reach menopause between the ages of 40 and 45. This is called early menopause.

Menopause and postmenopause

In perimenopause, menstrual periods become irregular. Your periods may be late or you may skip one or more periods altogether. Menstrual flow can also be heavy or light.

Menopause is defined as the absence of menstruation for one year.

Indicates the years in which postmenopause occurs.

What are the symptoms of menopause?

Every woman’s menopause experience is unique. Symptoms are usually more severe when menopause comes on suddenly or over a shorter period of time.

Conditions that affect ovarian health, such as cancer or hysterectomy, or certain lifestyle choices, such as smoking, tend to increase the severity and duration of symptoms.

Besides menstrual changes, perimenopause, menopause, and postmenopausal symptoms are often the same. The most common early symptoms of perimenopause are:

  • less frequent menstruation
  • heavier or lighter periods than you normally experience
  • vasomotor symptoms, including hot flashes, night sweats, and flushing

About 75 percent of women experience hot flashes at menopause.

Other menopausal symptoms include:

  • insomnia disease
  • vaginal dryness
  • gaining weight
  • depression
  • anxiety
  • difficulty concentrating
  • memory problems
  • decreased libido or sex drive
  • dry skin, mouth, and eyes
  • increased urination
  • sore or tender breasts
  • headache
  • heart racing
  • urinary tract infections (UTI)
  • reduced muscle mass
  • painful or stiff joints
  • decreased bone mass
  • less full breasts
  • hair thinning or loss
  • Increased hair growth in other parts of the body such as the face, neck, chest, and upper back

Complications

Common complications of menopause:

  • vulvovaginal atrophy
  • dyspareunia or painful intercourse
  • slow metabolic function
  • osteoporosis, or weak bones that reduce mass and strength
  • mood or sudden emotional changes
  • cataract
  • periodontal disease
  • incontinence
  • heart or blood vessel disease

Why does menopause occur?

Menopause is a natural process that occurs as the ovaries age and produce less reproductive hormones.

The body begins to undergo several changes in response to low levels:

  • estrogen
  • progesterone
  • testosterone
  • follicle stimulating hormone (FSH)
  • luteinizing hormone (LH)

One of the most notable changes is the loss of active ovarian follicles. Ovarian follicles are structures that produce and secrete eggs from the ovarian wall, which allows for menstrual cycle and fertility.

Most women find that as the flow gets heavier and longer, the frequency of their periods becomes less consistent. This usually occurs at some point in the mid-40s. By age 52, most U.S. women have reached menopause.

In some cases, menopause results from injury or surgical removal of the ovaries and related pelvic structures.

Common causes of induced menopause include:

  • bilateral oophorectomy or surgical removal of the ovaries
  • ovarian ablation or closure of ovarian function, which can be done with hormone therapy, surgery, or radiotherapy techniques in women with estrogen receptor-positive tumors
  • pelvic radiation
  • pelvic injuries that severely damage or destroy the ovaries

How is menopause diagnosed?

If you have troublesome or disabling menopausal symptoms or are experiencing menopausal symptoms and you’re 45 years old or younger, it’s worth talking to your healthcare provider.

A new blood test known as the PicoAMH Elisa diagnostic test, Food and Drug Administration recently approved by This test is used to determine if a woman is entering or approaching menopause.

This new test may help women who show signs of perimenopause, which can have adverse health effects. Early menopause is associated with osteoporosis and fracture risk, heart disease, cognitive changes, vaginal changes, and loss of libido and mood changes.

Your doctor may also order a blood test to measure the level of certain hormones in the blood, usually FSH and a form of estrogen called estradiol.

FSH blood levels of 30 mIU/mL or higher consistently with a lack of menstruation for a consecutive year are usually confirmation of menopause. Saliva tests and over-the-counter (OTC) urine tests are also available, but they are unreliable and expensive.

During perimenopause, FSH and estrogen levels fluctuate daily, so most healthcare providers diagnose this condition based on symptoms, medical history, and menstrual information.

Depending on your symptoms and health history, your healthcare provider may order additional blood tests to rule out other underlying conditions that may be responsible for your symptoms.

Additional blood tests commonly used to help confirm menopause include:

  • thyroid function tests
  • blood lipid profile
  • liver function tests
  • kidney function tests
  • testosterone, progesterone, prolactin, estradiol and chorionic gonadotropin (hCG) tests

Treatments

You may need treatment if your symptoms are severe or affect your quality of life. Hormone therapy can be an effective treatment for women under 60 years of age, or within 10 years of the onset of menopause, for the reduction or management of:

  • hot flashes
  • night sweats
  • washing
  • vaginal atrophy
  • osteoporosis

Other medications may be used to treat more specific menopausal symptoms, such as hair loss and vaginal dryness.

Additional medications sometimes used for menopausal symptoms include:

  • Topical minoxidil 5 percent Used once a day for thinning and loss of hair.
  • anti-dandruff shampoos usually 2 percent ketoconazole and 1 percent zinc pyrithione, used for hair loss
  • for unwanted hair growth eflornithine hydrochloride topical cream
  • selective serotonin reuptake inhibitors (SSRIs) 7.5 milligrams of paroxetine commonly used for hot flashes, anxiety, and depression
  • non-hormonal vaginal moisturizers and lubricants
  • in cream, ring or tablet form low-dose estrogen-based vaginal lubricants
  • for vaginal dryness and painful intercourse ospemifene
  • for recurrent UTIs prophylactic antibiotics
  • for insomnia sleeping pills
  • for postmenstrual osteoporosis denosumab, teriparatide, raloxifene, or calcitonin

Home remedies and lifestyle changes

There are several ways to naturally reduce minor to moderate menopause symptoms using home remedies, lifestyle changes, and alternative treatments.

Here are some at-home tips for managing menopausal symptoms:

keep calm and relax

Dress in loose-fitting clothing, especially at night and in hot or unpredictable weather. This can help you manage hot flashes.

Keeping your bedroom cool and avoiding heavy blankets at night can help reduce your chances of night sweats. If you regularly suffer from night sweats, consider using a waterproof sheet under your mattress to protect your mattress.

You can also carry a portable fan to keep you cool when you feel flushed.

Exercise and manage your weight

Reduce your daily calorie intake by 400 to 600 calories to help reduce your weight. It’s also important to get 20 to 30 minutes of moderate exercise a day. This may help:

  • increase energy
  • promoting a better night’s sleep
  • improve mood
  • promote your general well-being

Communicate your needs

Talk to a therapist or psychologist about any feelings of depression, anxiety, sadness, isolation, insomnia, and identity change.

You should also try talking to family members, loved ones, or friends about feelings of anxiety, mood swings, or depression so they know about your needs.

Complete your diet

Take calcium, vitamin D, and magnesium supplements to help reduce your risk of osteoporosis and improve energy levels and sleep. Talk to your doctor about supplements that can help you with your personal health needs.

Practicing relaxation techniques

Practice relaxation and breathing techniques such as:

  • yoga
  • box breath
  • meditation

take care of your skin

Apply daily moisturizers to reduce skin dryness. You should also avoid excessive bathing or swimming, which can dry or irritate your skin.

Managing sleep problems

Use OTC sleep medications to temporarily manage your insomnia or consider discussing natural sleep aids with your doctor. If you regularly have trouble sleeping, talk to your doctor so they can help you manage it and get a better night’s sleep.

Quitting smoking and limiting alcohol use

Quit smoking and avoid exposure to secondhand smoke. Exposure to smoking can worsen your symptoms.

You should also limit your alcohol intake to reduce worsening symptoms. Excessive alcohol consumption during menopause can increase your risk of health concerns.

other drugs

Some limited studies have supported the use of herbal remedies for menopausal symptoms caused by estrogen deficiency.

Natural supplements and nutrients that can help limit menopausal symptoms include:

  • soy
  • Vitamin E
  • isoflavones
  • melatonin
  • flaxseed

There are also claims that black cohosh can improve some symptoms such as hot flashes and night sweats. But recent studies have found little evidence to support these claims. More research is needed.

Similarly, since 2015 research found no evidence to support claims that omega-3 fatty acids can improve vasomotor symptoms associated with menopause.

Overview

Menopause is the natural cessation or cessation of a woman’s menstrual cycle and indicates the end of fertility. Most women go through menopause at age 52, but pelvic or ovarian damage can cause sudden menopause early in life. Genetic or underlying conditions can also cause menopause to have an early onset.

Many women experience menopausal symptoms in the few years before menopause, the most common being hot flashes, night sweats, and flushing. Symptoms may persist for four or more years after menopause.

If your symptoms are severe or are affecting your quality of life, you may benefit from treatments such as hormone therapy. Often, menopausal symptoms can be managed or reduced using natural remedies and lifestyle adjustments.

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