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What Is Menopause?


Menopause is a normal part of reproductive aging. For most women this process begins between ages 30 and 50 when periods become irregular. Declining levels of estrogen and progesterone can cause changes in your menstrual cycles, sleep patterns, and may also lead to mood swings. These hormones keep the vagina, uterus, bones, and heart healthy.

Some surgical procedures may start menopause. A hysterectomy will cause your periods to stop. When both ovaries are removed (Oophorectomy), menopause will begin and hormone replacement therapy (HRT) maybe necessary.


Hormones and Change

A woman’s body changes throughout her lifetime. Many of those changes are due to varying hormone levels that happen at different stages in life.

Puberty often begins between 11 and 13 years of age. The body changes, breasts and pubic hair develop, and monthly menstrual periods begin.

Menopausal transition, commonly calledperimenopause, is the time when a woman’s body is closer to menopause. At this time, a woman’s periods may become irregular, menopause symptoms such as hot flashes and night sweats may occur, sleep patterns may change, and mood swings may develop. Perimenopause may last between 2 and 8 years.

Menopause is a natural part of aging. Menopause is the point when a woman has not had a menstrual period for 1 year or when the hormones are no longer being produced. Pregnancy is no longer possible. Hormone Replacement Therapy (HRT) is not necessary unless your symptoms become intolerable. It is important to consult with your physician about menopause. Knowing what to expect can help improve your quality of life and to stay healthy during this new phase of life.


Menopausal Symptoms



Irregular menstrual cycles

Many women experience irregular menstrual periods including a lighter flow, a heavier flow, more frequent menstrual cycles, or bleeding for extended periods. There may also be spotting between periods. It is important to contact your physician if you are having continuous heavy bleeding


Hot Flashes

Hot flashes are the most common symptom of menopause. A hot flash is a sudden sensation of intense body heat affecting the upper body as well as the entire body. The face and neck may become flushed along with profuse sweating and chills. Hot flashes can be as mild as a light blush or severe enough to wake you from a sound sleep (called night sweats). They often strike unexpectedly, often at night, and usually last several seconds to minutes. These symptoms may be accompanied by mild to severe heart palpitations, anxiety, irritability and, in rare cases, panic. It is important to contact your physician if these symptoms disrupt your daily life


Vaginal Dryness

As a result of lower estrogen levels, the blood supply to the vagina is decreased, affecting vaginal lubrication. The genital area becomes drier and thinner causing sexual intercourse to be painful. Vaginal infections may also become more common.




During menopause, women may experience urinary incontinence and increased urinary tract infections. The lack of estrogen can cause the pelvic muscles responsible for bladder control to weaken. There are two types of urinary incontinence: urge incontinence and stress incontinence. Urge incontinence occurs when it is hard to hold urine long enough to get to the bathroom. Stress incontinence occurs when urine leaks during exercise, sneezing, coughing, laughing, or running.




The lack of estrogen during menopause can decrease a woman's sex drive. Sexual intercourse may be uncomfortable due to vaginal dryness. Some menopausal women may notice that they are not as easily aroused while others feel freer and sexier.



Sleep problems

During menopause many women have difficulty getting a good night’s sleep due to insomnia. Some have difficulty falling asleep while others may wake too early. This is usually caused by hot flashes and the urge to urinate making it difficult to fall back to sleep. It is important to notify your physician if these symptoms disrupt your daily life.



Mood changes

During menopause many women experience mood swings making them feel as if they are in a constant state of PMS (premenstrual syndrome). There may be a relationship between the lower levels of estrogen and a woman’s mood swings. Shifts in mood may also be caused by stress, changes in family dynamics, or tiredness from lack of sleep. Symptoms of depression may occur during menopause, however depression is NOT a symptom of menopause. If you are experiencing any of these symptoms, it is important to notify your physician.




During menopause the loss of estrogen may cause bone loss that will lead to osteoporosis. Osteoporosis is when the bones become thin and weak. This may cause an increased risk of bone fracture or breakage. The test used to diagnose bone loss or osteoporosis is called bone densitometry. Lifestyle changes that can reduce your risk for bone loss and osteoporosis include regular weight-bearing exercise and taking adequate calcium and vitamin D. There are several medications that assist with the prevention of bone loss. It is important to talk with your physician about how to protect your bones.


Heart disease

After menopause a woman’s risk of heart disease increases. Heart disease is the major cause of death in women, killing more women than lung or breast cancer. It’s important to check your blood pressure, cholesterol levels, LDL, HDL, triglycerides, and fasting blood glucose regularly. You can lower your risk of heart disease by eating a healthy diet, not smoking, maintaining a healthy weight, and exercising regularly. There are medications that may be necessary to maintain normal levels. It is important to talk to your physician about protecting your heart.


Changes in your body

During menopause many women experience changes in their bodies. Some of these changes include weight gain, decreased muscle mass, increased fatty tissue, thinner skin, and hair loss. Other changes include memory loss, joint and muscle stiffness, and generalized pain. These changes can be improved with regular exercise and a balanced diet.


Tips for a Healthy Menopause

  • Avoid smoking.
  • Eat a healthy diet that is low in fat and cholesterol, high in fiber, and well balanced in vitamins, minerals, and calcium.
  • Maintain a healthy weight.
  • Begin a weight-bearing exercise program, such as walking, jogging, running, or dancing, at least 3 days each week.
  • Take medications prescribed by your physician for blood pressure, cholesterol, glucose, heart disease, or other medical conditions.
  • Water-based vaginal lubricants (no petroleum jelly) or an estrogen cream may be used to treat vaginal dryness.
  • Pelvic muscle exercises, biofeedback, and bladder training can help improve muscle control for urinary urgency.
  • It is important to schedule routine annual exams that include a pelvic and breast exam and Pap test. Mammograms should also be scheduled annually. Contact your physician if you are experiencing pelvic pain, bleeding, or any breast problems.
  • Contact your physician regarding hormone replacement therapy (HRT) if your symptoms are disrupting daily life.


What About Hormone Replacement Therapy (HRT)?

In perimenopause, your doctor may suggest oral contraception or the birth control pill if you are experiencing heavy, frequent or unpredictable menstrual periods. This will help regulate your menstrual cycles. It may also help with other symptoms such as mood swings and hot flashes. Birth control pills may mask the onset of menopause. If you think you have reached menopause, you can discontinue the pill to determine if your menstrual cycles return. If you are using the birth control pill for contraception, it will be necessary to use another method of contraception until you have gone 12 months without a period.

In menopause, your doctor may suggest taking estrogen and progesterone, known as hormone replacement therapy or HRT. Estrogen may be taken alone if a woman has had her uterus removed. Progesterone must be used in combination with Estrogen if a woman has her uterus to prevent the risk of uterine cancer. These hormones can be taken in a variety of forms depending on a woman’s needs. These include injectables, pills, skin patches, creams, or vaginal inserts.

Hormone replacement therapy may relieve menopause-related symptoms and reduce loss of bone, however there are risks involved. It should not be used for long-term prevention of heart disease. Taking hormones may increase the risk for heart disease and stroke. It may also increases the risk of breast cancer and blood clots. It appears to decrease the risk of colon cancer. Scientists are still studying the effects of hormone replacement therapy — the final answers are not yet available. Talk to your doctor about taking estrogen/progestin to ease menopausal symptoms.


What About Phytoestrogens?

Phytoestrogens are estrogen-like substances found in foods such as cereals, vegetables, legumes (beans), and some herbs. They can work in the body like a weak form of estrogen. These may lower cholesterol levels. Soy, wild yams, and herbs such as black cohosh and dong quai, contain phytoestrogens and could relieve some menopausal symptoms. The government does not regulate phytoestrogens. Scientists are studying some plant estrogens to find out if they really work and if they are safe.Be sure to discuss with your physician if you eat any foods high in phytoestrogens. Any food or over-the-counter product that you use to treat menopausal symptoms could interact with other prescribed drugs.

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