Menopause is a natural biological occurrence signaling the end of a woman's ability to reproduce. This happens with the end of her last menstrual period. Medically, menopause is said to happen 12 months after a woman menstruates for the final time.
Menopause is a normal part of a woman's life, just like puberty. Even though a woman may experience many symptoms as she goes through menopause, it is not a disease or condition. Every woman experiences menopause differently, although there are many common symptoms.
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When does menopause start?
Hot flashes are a common symptom of menopause and occur mainly in a woman's upper body.
Though menopause is defined as starting one year after the end of her last period, a woman may begin experiencing symptoms earlier.
According to the Mayo Clinic, the average age for a woman to reach menopause in the United States is 51 years. However, this age range varies.
Menopause may happen early, when a woman is in her 40s, or later, when she is in her 50s.
Symptoms of menopause often last for many years. They can begin years before the menopause, and they often continue for years afterward.
Symptoms of menopause
Symptoms of menopause generally start when a woman's estrogen levels begin to drop. This generally happens in the 3-5 years before menopause begins. This is known as perimenopause.
- Irregular menstruation: As estrogen levels drop, a woman's menstrual cycle may change. She may miss periods or experience longer lengths of time between periods. Menstruation may also be heavier or lighter than previously.
- Vaginal dryness: Decreases in estrogen levels can cause vaginal lubrication to change and decrease. As lubrication decreases, the vaginal tissues also become thinner. This can lead to pain during intercourse, and a woman may also experience vaginal inflammation.
- Decreased fertility: As estrogen levels drop in perimenopause, it becomes harder for a woman to become pregnant. When a woman reaches menopause, her body no longer releases eggs. This means she can no longer get pregnant.
- Weight gain: A woman's metabolism tends to slow during menopause, and she may suddenly gain weight, especially around the midsection. This weight gain can happen without the woman changing her diet or exercise routine.
- Hot flashes: Fluctuations in hormone levels might lead to hot flashes or an abrupt feeling of heat and flushing. These flashes may be mild, occurring primarily in a woman's upper body, or they may spread throughout her body. Hot flashes can last anywhere from a few seconds to many minutes.
- Night sweats: Night sweats are caused by hot flashes that happen during sleep and may cause such intense sweating that they wake a woman up.
- Low mood: Some women may experience mood changes during menopause. This may be due to hormonal changes, but it might also be made worse by common life circumstances that tend to occur around the time menopause occurs. Low mood may also be linked to feeling tired as a result of sleep trouble, or mourning the loss of fertility.
- Trouble sleeping: Menopause often makes it harder to sleep. Many women find sleep disturbances occur more often around the time of menopause. The disturbances may or may not be related to night sweats.
- Attention problems: Many women find they have problems concentrating, and it may be harder to remember things during menopause. Scientists are not sure if this is due to falling estrogen levels or aging.
- Thinning skin and hair: Extreme fluctuations in hormone levels can cause skin to thin. Some women may experience hair loss.
- Urinary frequency and incontinence: Around menopause, women may experience urinary changes due to weakened muscles that control the pelvic floor.
Hormone replacement therapy can relieve some menopause symptoms and reduce the risk of bone loss.
Menopause itself does not require any medical treatment, but many women seek relief from their symptoms. They may want to prevent some of the health effects of aging that often appear around the time menopause begins.
Many women find estrogen therapy the most effective option for relieving menopause-related hot flashes. Doctors often prescribe the lowest dose of estrogen possible to relieve symptoms. Sometimes, progestin is also needed.
There are many other treatments available that alleviate symptoms and prevent aging-related issues. Options include:
- Medications to treat hot flashes: Low-dose antidepressants and some anti-seizure medications may decrease hot flashes. A low-dose antidepressant may not only help to manage hot flashes, but may help women to cope with mood-related changes that occur during menopause as well.
- Vaginal estrogen: Vaginal estrogen helps to relieve uncomfortable vaginal dryness caused by the plummet in estrogen levels come menopause. Estrogen can be applied directly to the vagina via a cream, tablet, or inserted ring. The vaginal tissues absorb just enough estrogen to relieve dryness and discomfort during intercourse. It may also help with urinary issues that occur during this time.
- Medications to prevent osteoporosis: Because bone density starts to decrease more rapidly during menopause, some doctors prescribe medications to prevent this loss of bone density.
When to see a doctor
Menopause is not a cause for immediate medical attention, but a woman should schedule regular doctor visits for preventive healthcare starting at perimenopause.
Around perimenopause, most doctors recommend certain health screenings like a colonoscopy, mammogram, and certain blood tests.
A woman should not hesitate to seek a doctor's care and advice to deal with disruptive menopausal symptoms. If vaginal bleeding occurs after menopause, a woman should seek medical attention.
What happens after menopause?
The risk of ovarian cancer rises after menopause.
After menopause, the risk of some medical conditions increases.
- Cardiovascular disease: As estrogen levels decline, the risk of heart disease rises.
- Osteoporosis: Osteoporosis is a condition that causes bones to weaken, making them subject to an increased risk of fracture. For the first years after menopause, women lose bone density very rapidly. This increases the risk of osteoporosis and related fractures.
- Certain cancers: The risk of breast and ovarian cancer rises after menopause. The reasons vary but this could be due to aging, hormonal changes related to menopause, and HRT, if used.
Apart from these risks, most women continue to enjoy a healthy life as long as they maintain their health by eating healthily, exercising, maintaining a healthy weight, and checking in with a doctor regularly.
Symptoms of ovarian cancer
Ovarian cancer has several signs and symptoms that resemble the symptoms of menopause.
These symptoms tend to appear only when the cancer has spread, and the most common ones overlap with menopausal symptoms.
- Urgent or frequent urination
- Pain during intercourse
- Menstrual changes
If a woman experiences any of these symptoms, in addition to bloating, back pain, upset stomach, and abdominal swelling with weight loss, she should consult a doctor. These symptoms do not necessarily indicate ovarian cancer, as they can stem from other conditions.