Menopause

Definition

Menopause refers to a natural stop in a woman’s menstrual period and fertility. Menopause happens because the woman’s ovary stops producing the hormones estrogen and progesterone. All women go through menopause, usually between the ages of 40 and 55. A woman has reached menopause when she has gone 12 months without having a period.

A study suggests that women may experience symptoms of menopause for far longer than previously thought — and Hispanic women may suffer for longer than others.

The study, published in JAMA Internal Medicine, reported that more than half of women experience frequent menopausal vasomotor symptoms (VMA), such as hot flashes and night sweats. Researchers determined the median for VMS duration to be about 7.4 years. However, they found that Hispanic women suffer for even longer than that. In fact, 50 percent of African American women reported symptoms that lasted nearly 10 years, and Latinas reported a median VMS duration of nearly nine years. Meanwhile, non-white Hispanic women reported symptoms lasting about six years.

Alternative Names

Perimenopause; Postmenopause

Causes

During menopause, a woman’s ovaries stop making eggs and they produce less estrogen and progesterone. Changes in these hormones cause menopause symptoms. Periods occur less often and eventually stop. Sometimes this happens suddenly. But most of the time, periods slowly stop over time.

Menopause is complete when you have not had a period for 1 year. This is called postmenopause. Women who are post-menopausal can no longer get pregnant.

Surgical menopause is when medical treatments cause a drop in estrogen. This can happen if your ovaries are removed, or if you receive chemotherapy or hormone therapy for breast cancer.

Symptoms

Although menopause itself is the time of a woman’s last period, symptoms can begin several years before that (in a stage called peri-menopause).

Menopause and peri-menopause affect every woman differently. There are some common symptoms, including:
•    Changes in periods (they may be shorter or longer, heavier or lighter, or have more or less time in between)
•    Hot flashes
•    Night sweats
•    Trouble sleeping through the night
•    Vaginal dryness
•    Mood changes
•    Hair loss or thinning on the head, more hair growth on the face

Another health problem that can start during menopause is estrogen loss. This can lead to osteoporosis, a condition where bones become weak and break easily.

Exams and Tests

Blood and urine tests can be used to look for changes in hormone levels. Test results can help your doctor determine if you are close to menopause or if you have already gone through menopause.

Tests that may be done include:
•    Estradiol
•    FSH
•    LH

Your health care provider will perform a pelvic exam. Decreased estrogen can cause changes in the lining of the vagina.
Bone loss increases during the first few years after your last period. Your doctor may order a bone density test to look for bone loss related to osteoporosis.

Treatments

In the past, some women would take hormones to replace the estrogen and progesterone their bodies were losing during menopause. Taking these hormones, known as hormone replacement therapy (HRT), might help with menopause symptoms and with bone loss.
But new research shows that, for some women, taking hormones has risks, including greater risk of heart disease, stroke, blood clots, and breast cancer. Therefore, for post-menopausal women, the U.S. Food and Drug Administration advises that HRT be used for the shortest time and at the lowest doses possible.

Possible Complications

The loss of estrogen associated with menopause has been linked to a number of health problems that become more common as women age.

After menopause, women are more likely to suffer from:
•    Osteoporosis.
•    Heart disease.
•    Poor bladder and bowel function.
•    Poor brain function (increased risk of Alzheimer’s disease).
•    Poor skin elasticity (increased wrinkling).
•    Poor muscle power and tone.
•    Some deterioration in vision, such as from cataracts (clouding of the lens of the eye) and macular degeneration (breakdown of the tiny spot in the center of the retina that is the center of vision).

When to Contact a Medical Professional

Call your health care provider if:
•    You are spotting blood between periods
•    You have had 12 consecutive months with no period and suddenly vaginal bleeding or spotting begins again, even if it is a very small amount

Preventions

Menopause is a natural and expected part of a woman’s development and does not need to be prevented. You can reduce your risk of long-term problems such as osteoporosis and heart disease by lowering risks of complications associated with these diseases.

 

Natural Remedies

Menopause is not a disease—it’s a natural part of life. According to research or other evidence, the following self-care steps may be helpful:

What You Need To Know:

• Control symptoms with isoflavones
Supplements containing at least 80 to 100 mg a day of isoflavones from soy or red clover may help control symptoms

• Cool down with black cohosh
Some people have found 20 mg of a concentrated herbal extract twice a day relieves hot flashes

• Eat soy and flaxseed
Make foods high in phytoestrogens, such as flaxseed, tofu, soy milk, tempeh, and roasted soy nuts, a regular part of your diet

• Find relief with exercise
Even light aerobic activities can help reduce menopausal symptoms

• Quit smoking
Smokers are more likely to experience hot flashes and other menopausal symptoms

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full menopause article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.