Menopause is a natural part of aging for women. Some women experience few problems while others find symptoms such as hot flashes very uncomfortable. Often called the change of life, menopause signals the time when a woman’s hormone levels start to change and ultimately ends a woman’s ability to have children. Menopause is said to be complete when menstrual periods have ceased for one continuous year.
The transition phase before menopause is often referred to as perimenopause. During time the supply of mature eggs in a woman’s ovaries diminishes and ovulation and menstruation become irregular. The production of estrogen and progesterone decreases with the big drop in estrogen levels that causes most menopause symptoms.
When does menopause occur?
Although the average age is 51, it can actually happen any time from the 30s to the mid-50s or later. Women who smoke and are underweight tend to have an earlier menopause, while women who are overweight often have a later menopause. Generally, a woman tends to have menopause at about the same age as her mother did. Menopause also can happen for other reasons. Premature menopause usually is associated with smoking, radiation exposure or chemotherapy. Surgical menopause happens abruptly with the removal of one or both ovaries or pelvis radiation that includes the ovaries.
What are the symptoms of menopause?
Symptoms vary and each woman may experience symptoms differently. Some women have few symptoms while others have more frequent and stressful ones. The signs and symptoms of menopause may include:
- Hot flashes or flushes are, by far, the most common symptom and are a result of a decrease in estrogen levels
- Vaginal atrophy is the drying and thinning of the tissues of the vagina and urethra. This can lead to pain during sex, as well as vaginitis, cystitis, and urinary tract infections.
- Relaxation of the pelvic muscles can lead to urinary incontinence and also increase the risk of the uterus, bladder, urethra, or rectum protruding into the vagina.
- Intermittent dizziness, an abnormal sensation, such as numbness, prickling, tingling, and/or heightened sensitivity, cardiac palpitations, and fast heart rhythm may occur as symptoms of menopause.
- Psychological and emotional symptoms of fatigue, irritability, insomnia, and nervousness may be related to both the lack of estrogen, the stress of aging, and a woman’s changing roles.
- “Brain fog”. Although not necessarily reported in studies, some women find their ability to concentrate diminishes as their estrogen levels begin to drop with normal concentration returning after their body has readjusted to the new hormonal balance.
Should I continue using birth control while in menopause?
Yes. Please talk to us about when you can discontinue birth control.
Should I take hormone therapy?
Hormone therapy has been shown to relieve some of the discomfort of hot flashes and vulvar/vaginal atrophy for many women. However, the decision to start using these hormones should be made only after you have met with us so we can evaluate and discuss with you your risk versus benefit ratio.
Are there other alternatives to help manage menopause symptoms?
There are several options we can discuss for you to consider that include:
- Non-hormonal treatment often involves the use of other types of medicines to relieve some of the symptoms associated with menopause.
- Estrogen alternatives are the so-called “synthetic estrogens,” like ospemifene, improve symptoms of vaginal atrophy without affecting endometrial cancer risk.
- Homeopathy and herbal treatments, often called bioidentical hormones, may offer some relief from some symptoms of menopause. However, there are concerns about potency, safety, purity, and effectiveness.
You may want to talk to your friends who are undergoing or have undergone menopause as they may have some suggestions. Please remember to talk to us about any recommendations they may give you.