Menopause

Menopause is the normal time of a woman's life when menstrual periods stop completely. It marks the natural end to a woman's ability to become pregnant. It can be defined as the absence of a menstrual period for 12 months without another medical cause. The transition to menopause (perimenopause) most often happens between the ages of 45 and 55, and can last for many years. During perimenopause, hormone levels change in your body, which can cause symptoms and affect your health. Menopause may increase your risk for:

Weakened bones (osteoporosis), which causes fractures.
Depression.
Hardening and narrowing of the arteries (atherosclerosis), which can cause heart attacks and strokes.

What are the causes?

This condition is usually caused by a natural change in hormone levels that happens as you get older. The condition may also be caused by changes that are not natural, including:

Surgery to remove both ovaries (surgical menopause).
Side effects from some medicines, such as chemotherapy used to treat cancer (chemical menopause).

What increases the risk?

This condition is more likely to start at an earlier age if you have certain medical conditions or have undergone treatments, including:

A tumor of the pituitary gland in the brain.
A disease that affects the ovaries and hormones.
Certain cancer treatments, such as chemotherapy or hormone therapy, or radiation therapy on the pelvis.
Heavy smoking and excessive alcohol use.
Family history of early menopause.

This condition is also more likely to develop earlier in women who are very thin.

What are the signs or symptoms?

Symptoms of this condition include:

Hot flashes.
Irregular menstrual periods.
Night sweats.
Changes in feelings about sex. This could be a decrease in sex drive or an increased discomfort around your sexuality.
Vaginal dryness and thinning of the vaginal walls. This may cause painful sex.
Dryness of the skin and development of wrinkles.
Headaches.
Problems sleeping (insomnia).
Mood swings or irritability.
Memory problems.
Weight gain.
Hair growth on the face and chest.
Bladder infections or problems with urinating.

How is this diagnosed?

This condition is diagnosed based on your medical history, a physical exam, your age, your menstrual history, and your symptoms. Hormone tests may also be done.

How is this treated?

In some cases, no treatment is needed. You and your health care provider should make a decision together about whether treatment is necessary. Treatment will be based on your individual condition and preferences. Treatment for this condition focuses on managing symptoms. Treatment may include:

Menopausal hormone therapy (MHT).
Medicines to treat specific symptoms or complications.
Acupuncture.
Vitamin or herbal supplements.

Before starting treatment, make sure to let your health care provider know if you have a personal or family history of these conditions:

Heart disease.
Breast cancer.
Blood clots.
Diabetes.
Osteoporosis.

Follow these instructions at home:

Lifestyle

Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health care provider.
Get at least 30 minutes of physical activity on 5 or more days each week.
Avoid alcoholic and caffeinated beverages, as well as spicy foods. This may help prevent hot flashes.
Get 7–8 hours of sleep each night.
If you have hot flashes, try:
- Dressing in layers.
- Avoiding things that may trigger hot flashes, such as spicy food, warm places, or stress.
- Taking slow, deep breaths when a hot flash starts.
- Keeping a fan in your home and office.
Find ways to manage stress, such as deep breathing, meditation, or journaling.
Consider going to group therapy with other women who are having menopause symptoms. Ask your health care provider about recommended group therapy meetings.

Eating and drinking

Eat a healthy, balanced diet that contains whole grains, lean protein, low-fat dairy, and plenty of fruits and vegetables.
Your health care provider may recommend adding more soy to your diet. Foods that contain soy include tofu, tempeh, and soy milk.
Eat plenty of foods that contain calcium and vitamin D for bone health. Items that are rich in calcium include low-fat milk, yogurt, beans, almonds, sardines, broccoli, and kale.

Medicines

Take over-the-counter and prescription medicines only as told by your health care provider.
Talk with your health care provider before starting any herbal supplements. If prescribed, take vitamins and supplements as told by your health care provider.

General instructions

Keep track of your menstrual periods, including:
- When they occur.
- How heavy they are and how long they last.
- How much time passes between periods.
Keep track of your symptoms, noting when they start, how often you have them, and how long they last.
Use vaginal lubricants or moisturizers to help with vaginal dryness and improve comfort during sex.
Keep all follow-up visits. This is important. This includes any group therapy or counseling.

Contact a health care provider if:

You are still having menstrual periods after age 55.
You have pain during sex.
You have not had a period for 12 months and you develop vaginal bleeding.

Get help right away if you have:

Severe depression.
Excessive vaginal bleeding.
Pain when you urinate.
A fast or irregular heartbeat (palpitations).
Severe headaches.
Abdominal pain or severe indigestion.

Summary

Menopause is a normal time of life when menstrual periods stop completely. It is usually defined as the absence of a menstrual period for 12 months without another medical cause.
The transition to menopause (perimenopause) most often happens between the ages of 45 and 55 and can last for several years.
Symptoms can be managed through medicines, lifestyle changes, and complementary therapies such as acupuncture.
Eat a balanced diet that is rich in nutrients to promote bone health and heart health and to manage symptoms during menopause.