When does menopause typically begin. What are the common symptoms of menopause. How long does the menopausal transition last. What hormonal changes occur during menopause. How can women manage menopausal symptoms. What health risks increase after menopause. How does menopause affect a woman’s daily life.

The Menopausal Transition: A Natural Part of Aging

Menopause is a significant milestone in a woman’s life, marking the end of her reproductive years. It’s not a disease or disorder, but rather a natural biological process that every woman experiences. The menopausal transition, also known as perimenopause, is the period leading up to menopause and can bring about various physical and emotional changes.

The average age for the onset of menopause is between 45 and 55 years old. However, it’s important to note that every woman’s experience is unique, and the timing can vary significantly. Some women may enter menopause earlier or later than this range.

Duration of the Menopausal Transition

How long does the menopausal transition typically last? The duration of perimenopause can vary widely among women. On average, it lasts about seven years, but it can extend up to 14 years in some cases. Factors that can influence the length of this transition include:

• Smoking habits
• Age at onset
• Race and ethnicity
• Lifestyle factors

Hormonal Changes During Menopause

The menopausal transition is characterized by significant fluctuations in hormone levels, particularly estrogen and progesterone. These hormonal changes are responsible for many of the symptoms women experience during this time.

What happens to hormone levels during menopause? The ovaries gradually produce less estrogen and progesterone, leading to irregular menstrual cycles and eventually the cessation of menstruation. This hormonal shift can affect various bodily functions and lead to a range of symptoms.

Key Hormonal Changes:

1. Decreased estrogen production
2. Fluctuating progesterone levels
3. Increased follicle-stimulating hormone (FSH) levels

Common Symptoms of Menopause

The symptoms of menopause can vary greatly from woman to woman. While some may experience minimal discomfort, others may find the transition more challenging. Understanding these symptoms can help women better prepare for and manage this phase of life.

Changes in Menstrual Cycle

One of the earliest signs of the menopausal transition is changes in the menstrual cycle. Women may notice:

• Irregular periods
• Shorter or longer cycles
• Heavier or lighter bleeding
• Spotting between periods

It’s important to note that while these changes are often normal, certain patterns may warrant medical attention. Women should consult their healthcare provider if they experience very close periods, heavy bleeding, spotting, periods lasting more than a week, or resumption of bleeding after a year without menstruation.

Hot Flashes and Night Sweats

Hot flashes are one of the most common and well-known symptoms of menopause. These sudden feelings of heat can affect the upper body, face, and neck, often accompanied by flushing and sweating. Night sweats are essentially hot flashes that occur during sleep, potentially disrupting rest.

How long do hot flashes typically last? Most hot flashes last between 30 seconds and 10 minutes. Their frequency can vary widely, from several times an hour to just once or twice a week. For many women, hot flashes can persist for several years after menopause.

Physical and Emotional Changes During Menopause

The menopausal transition can bring about a variety of physical and emotional changes that extend beyond reproductive function. These changes can affect a woman’s overall well-being and quality of life.

Physical Changes

• Changes in body composition and weight gain
• Skin changes, including dryness and reduced elasticity
• Thinning hair and dry skin
• Increased risk of osteoporosis
• Changes in breast tissue

Emotional and Cognitive Changes

• Mood swings and irritability
• Increased risk of depression and anxiety
• Memory lapses and difficulty concentrating
• Changes in libido and sexual function

Managing Menopausal Symptoms

While the menopausal transition is a natural process, many women seek ways to alleviate its symptoms and improve their quality of life during this time. There are various approaches to managing menopausal symptoms, ranging from lifestyle modifications to medical interventions.

Lifestyle Changes

Simple lifestyle adjustments can often help manage mild to moderate menopausal symptoms:

• Regular exercise to improve mood, sleep, and overall health
• Maintaining a healthy diet rich in fruits, vegetables, and whole grains
• Practicing stress-reduction techniques like meditation or yoga
• Avoiding triggers for hot flashes, such as spicy foods, alcohol, and caffeine
• Dressing in layers to manage temperature fluctuations

Medical Treatments

For more severe symptoms, medical treatments may be recommended:

• Hormone replacement therapy (HRT)
• Non-hormonal medications for specific symptoms
• Vaginal estrogen for urogenital symptoms
• Antidepressants for mood-related issues

It’s crucial for women to discuss their symptoms and treatment options with their healthcare provider to determine the most appropriate approach for their individual needs.

Health Considerations After Menopause

The postmenopausal period brings new health considerations for women. The decrease in estrogen levels can affect various bodily systems, potentially increasing the risk of certain health conditions.

Cardiovascular Health

Why does the risk of heart disease increase after menopause? The decline in estrogen levels can affect the health of blood vessels and increase the risk of cardiovascular disease. Postmenopausal women should pay particular attention to heart health through regular check-ups, a heart-healthy diet, and regular exercise.

Bone Health

Osteoporosis becomes a significant concern after menopause due to the accelerated loss of bone density. Women should ensure adequate calcium and vitamin D intake, engage in weight-bearing exercises, and discuss bone density screening with their healthcare provider.

Urogenital Health

The decrease in estrogen can lead to changes in the urogenital system, including:

• Vaginal dryness and atrophy
• Increased risk of urinary tract infections
• Changes in sexual function

These changes can be managed through various treatments, including topical estrogen and lifestyle modifications.

Navigating Life Transitions During Menopause

The menopausal transition often coincides with other significant life changes, adding complexity to this period. Many women find themselves balancing multiple roles and responsibilities during this time.

Caring for Aging Parents

How does caregiving impact women during menopause? Many women in their 40s and 50s find themselves caring for aging parents or relatives. This added responsibility can increase stress levels and potentially exacerbate menopausal symptoms. It’s crucial for women to prioritize self-care and seek support when needed.

Supporting Adult Children

As children transition into adulthood, the parent-child relationship evolves. Women may find themselves providing emotional or financial support to their adult children while also navigating their own life changes.

Career Changes and Challenges

The menopausal years often coincide with significant career milestones or changes. Some women may take on new responsibilities or leadership roles, while others might consider career changes or retirement planning.

Balancing these life transitions with the physical and emotional changes of menopause can be challenging. It’s important for women to:

• Prioritize self-care and stress management
• Communicate openly with family members about their needs
• Seek support from friends, support groups, or professional counselors
• Be proactive about their health and well-being

Embracing a New Chapter: Life After Menopause

While menopause marks the end of a woman’s reproductive years, it also heralds the beginning of a new life stage. Many women find this period to be one of personal growth, self-discovery, and empowerment.

Positive Aspects of Postmenopause

What are some benefits of life after menopause? Despite the challenges, many women report positive experiences in their postmenopausal years:

• Freedom from menstrual cycles and concerns about pregnancy
• Increased confidence and self-assurance
• More time for personal interests and pursuits
• Deeper relationships and connections
• A sense of wisdom and perspective gained from life experiences

Continuing Health and Wellness

Maintaining good health remains important in the postmenopausal years. Women should:

• Continue regular health check-ups and screenings
• Maintain a balanced diet and regular exercise routine
• Stay socially active and engaged in their communities
• Pursue new interests or hobbies
• Prioritize mental health and emotional well-being

By understanding the changes that occur during menopause and taking proactive steps to manage their health, women can navigate this transition with confidence and embrace the opportunities that come with this new stage of life.

The menopausal transition is a complex and individual experience, influenced by a variety of factors including genetics, lifestyle, and overall health. While it can present challenges, it’s also an opportunity for women to reassess their health, prioritize self-care, and embrace new possibilities. With the right information, support, and healthcare, women can navigate this transition successfully and look forward to the years ahead with optimism and vitality.

What Is Menopause? | National Institute on Aging

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Larissa is experiencing the menopausal transition, a normal part of aging for women. Menopause is not a disease or disorder. This time in a woman’s life is often full of other transitions in addition to physical ones: Women may be caring for aging parents or relatives, supporting their children as they move into adulthood, or taking on new responsibilities at work.

Some women don’t have any trouble with menopausal symptoms and may even feel relieved when they no longer need to worry about painful periods or getting pregnant. For other women, the menopausal transition can bring hot flashes, trouble sleeping, pain during sex, moodiness and irritability, depression, or a combination of these symptoms. Some may decide to talk with their doctor about lifestyle changes or medications to treat their symptoms.

Understanding the menopausal transition

Menopause is a point in time 12 months after a woman’s last period. The years leading up to that point, when women may have changes in their monthly cycles, hot flashes, or other symptoms, are called the menopausal transition or perimenopause.

The menopausal transition most often begins between ages 45 and 55. It usually lasts about seven years but can be as long as 14 years. The duration can depend on lifestyle factors such as smoking, age it begins, and race and ethnicity. During perimenopause, the body’s production of estrogen and progesterone, two hormones made by the ovaries, varies greatly.

The menopausal transition affects each woman uniquely and in various ways. The body begins to use energy differently, fat cells change, and women may gain weight more easily. You may experience changes in your bone or heart health, your body shape and composition, or your physical function.

Is it menopause?

If you are having symptoms that are common during menopause, your doctor may ask questions about your age, symptoms, and family history to determine if it really is the menopausal transition causing your problems. In some cases, your doctor may suggest a blood test to check your follicle-stimulating hormone (FSH) and estradiol (E2) levels to rule out any other causes for the changes you’re experiencing.

Read and share this infographic about staying healthy during and after menopause.

While the menopausal transition may commonly be referred to as “menopause,” true menopause doesn’t happen until one year after a woman’s final menstrual period. For that reason, a woman who does not want to get pregnant should continue to use birth control for at least a full 12 months after her last period.

Menopause can also be triggered by a hysterectomy or surgical removal of the ovaries, which produce hormones. If you have surgery to remove your uterus or ovaries and are not taking hormones, you will experience symptoms of menopause immediately.

After menopause, women enter postmenopause. Postmenopausal women are more vulnerable to heart disease and osteoporosis. During this time, it is important to continue to eat a healthy diet, be active, and make sure you get enough calcium for optimal bone health.

What are the signs and symptoms of menopause?

Estrogen is used by many parts of a woman’s body. As levels of estrogen decrease, you could have various symptoms. Many women experience mild symptoms that can be treated by lifestyle changes such as avoiding caffeine or carrying a portable fan. Some women don’t require any treatment at all, but for others, symptoms can be more severe. The severity of symptoms varies greatly around the world and by race and ethnicity.

Here are the most common changes you might notice at midlife. Some may be part of aging rather than directly related to menopause.

Change in your period. This might be what you notice first. Your periods may no longer be regular. They may be shorter or last longer. You might bleed more or less than usual. These are all normal changes, but to make sure there isn’t a problem, see your doctor if:

• Your periods happen very close together.
• You have heavy bleeding.
• You have spotting.
• Your periods last more than a week.
• Your periods resume after no bleeding for more than a year.

Hot flashes. Many women have hot flashes, which can last for many years after menopause. They may be related to changing estrogen levels. A hot flash is a sudden feeling of heat in the upper part or all of your body. Your face and neck may become flushed. Red blotches may appear on your chest, back, and arms. Heavy sweating and cold shivering can follow. Hot flashes can be very mild or strong enough to wake you up (called night sweats). Most hot flashes last between 30 seconds and 10 minutes. They can happen several times an hour, a few times a day, or just once or twice a week. Find information on managing hot flashes in Hot Flashes: What Can I Do?

Bladder control. A loss of bladder control is called incontinence. You may have a sudden urge to urinate, or urine may leak during exercise, sneezing, or laughing. The first step in treating incontinence is to see a doctor. Bladder infections also can occur in midlife.

Sleep. Around midlife, some women start having trouble getting a good night’s sleep. Maybe you can’t fall asleep easily, or you wake too early. Night sweats might wake you up. And if you wake up during the night, you might have trouble falling back to sleep. Learn how to improve your sleep during the menopausal transition and beyond in Sleep Problems and Menopause: What Can I Do?

Vaginal health and sexuality. After menopause, the vagina may become drier, which can make sexual intercourse uncomfortable. Read about options for addressing vaginal pain during sex in Sex and Menopause: Treatment for Symptoms. You may also find that your feelings about sex are changing. You could be less interested, or you could feel freer and sexier because after one full year without a period, you can no longer become pregnant. However, you could still be at risk for sexually transmitted diseases (STDs), such as gonorrhea or HIV/AIDS. Your risk for an STD increases if you have sex with more than one person or with someone who has sex with others. If so, make sure your partner uses a condom each time you have sex.

Mood changes. You might feel moodier or more irritable around the time of menopause. Scientists don’t know why this happens. It’s possible that stress, family changes such as growing children or aging parents, a history of depression, or feeling tired could be causing these mood changes. Talk with your primary care provider or a mental health professional about what you’re experiencing. There are treatments available to help.

Your body seems different. Your waist could get larger. You could lose muscle and gain fat. Your skin could become thinner. You might have memory problems, and your joints and muscles could feel stiff and achy. Researchers are exploring such changes and how they relate to hormones and growing older.

In addition, for some women, symptoms may include aches and pains, headaches, and heart palpitations. Follow up with a doctor. Because menopausal symptoms may be caused by changing hormone levels, it is unpredictable how often women will experience symptoms and how severe they will be.

• My Menoplan Tool

  My Menoplan is an evidence-based online resource developed by NIA-funded researchers to help people learn about the symptoms and treatments of menopause and create a personalized plan. Learn more on the My Menoplan website.

Treating menopause symptoms: What’s right for me?

Deciding whether and how to treat the symptoms of menopausal transition can be complicated and personal. Discuss your symptoms, family and medical history, and preferences with your doctor. No matter what you decide, see your doctor every year to talk about your treatment plan and discuss any changes you want to make.

Learn about options to help you manage hot flashes, sleep problems, and sex problems during the menopausal transition.

For more information on menopause

Office on Women’s Health                                             
Department of Health and Human Services
800-994-9662
www. womenshealth.gov

American College of Obstetricians and Gynecologists
800-673-8444 
[email protected]
www.acog.org

North American Menopause Society
440-442-7550
[email protected]
www.menopause.org

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Content reviewed:
September 30, 2021

When does menopause start? Signs, stages and what to expect

Menopause is a normal part of aging. As normal as it may be, menopause can feel anything but. Changes to your body and mood may have you flashing back to memories of puberty: Is this normal? What comes next? Do I need to do something?

Your experience with menopause will be unique to you – from when it starts to the types of menopause symptoms you’ll feel as you age. But there are usually some signs to tell you where you‘re at in the process.

Knowing what stage of menopause you’re in can help you know what to expect and how to best manage your symptoms. It can also help you understand what’s normal, and when it’s a good idea to talk with a women’s health specialist.

We’re here to help. Read on to learn about the three stages of menopause, the symptoms you may experience at different ages, and when to seek care for menopause symptoms.

What are the three stages of menopause?

There are three stages of menopause: perimenopause, menopause and post-menopause. In everyday terms, those names can be translated to: when changes begin, when your menstrual cycle stops, and your new normal afterward. Here’s a closer look at what happens during each one.

Perimenopause: The beginning of menopause

Perimenopause – or pre-menopause – is a word that means “around menopause” and it’s when symptoms begin, leading up to menopause. This stage typically starts about 4-8 years before menopause. The age at which perimenopause begins varies – some women notice it in their 40s, but others can experience it as early as their mid-30s.

When you enter perimenopause, you’ll probably start to notice some early menopause symptoms, like changes to your period or mood shifts. These changes happen because your body’s estrogen and progesterone levels are starting to naturally decline. As your ovaries produce lower amounts of these hormones, your body adapts. It’s basically the reverse of what happened to your hormones as a teenager.

Menopause: The end of your menstrual cycle

Menopause refers to a specific point in time when your periods stop. You’re only in the menopause phase for one year, because when you’ve gone 12 consecutive months without a period, you enter post-menopause.

Reaching menopause means that you’re no longer able to bear children (become pregnant). Every woman – except for those who’ve had their ovaries removed before puberty – will go through menopause.

At what age does menopause start?

The average age for menopause is around 51. But some women experience menopause in their 40s – with a small percentage experiencing signs of menopause earlier. Some women may not reach menopause until their 60s.

There’s no way to know your exact menopause age until it happens, but genetics seems to play a strong role. You may get a general idea of when to expect menopause based on when your family members went through it, particularly your mother.

Genetics isn’t the only thing that can impact when menopause starts. Medical factors can also influence menopause timing. For example, if someone’s ovaries are removed, symptoms will begin to show immediately.

Certain medical conditions like autoimmune diseases have also been associated with early menopause. Women who’ve undergone treatments like radiation therapy or chemotherapy are also more likely to show symptoms earlier.

Post-menopause: After menopause

Post-menopause simply means “after menopause”, and you reach this point when it’s been 12 months since your last period. Post-menopause signals the end of your reproductive years, and you’ll be in this stage for the rest of your life. While your ovaries are still making low levels of the hormones estrogen and progesterone, you are no longer ovulating (releasing eggs), so you can’t become pregnant.

You’ll continue to experience menopause symptoms for about 2-7 years after your final menstrual cycle (it can be longer for some people), but after that time, symptoms often get milder or completely go away.

Women in post-menopause are at a higher risk for certain health conditions like heart disease and postmenopausal osteoporosis. You and your primary care doctor can work together on a plan to prevent or manage those conditions.

Menopause symptoms by age

Menopause symptoms evolve over time as your body slowly decreases the levels of reproductive hormones it’s making. Here’s a breakdown of menopause symptoms you may experience by age.

Menopause symptoms at age 40

For the majority of women, menopause symptoms don’t start this early. If menopause happens before age 40, it’s called premature menopause. If it happens between ages 40-45, it’s known as early menopause. Fewer than 10% of women experience premature or early menopause.

But if you’re in your early 40s and are regularly experiencing symptoms such as changes to your period’s timing or flow, hot flashes, mood changes or sleep problems, don’t ignore them. Talk with a women’s health specialist.

A specialist like an OB-GYN or certified nurse-midwife (CNM) can work with you to determine whether your symptoms are related to menopause, or another reason such as hormonal disorders or other health conditions.

Menopause symptoms at age 45

Around the age of 45, many women enter pre-menopause and start to notice the first signs that menopause is coming. For some women, the symptoms are mild and short-lasting. For others, menopause symptoms can be disruptive and long-lasting.

Some of the earliest signs of menopause may include:

Changes to your period

Period changes are usually the first signs of menopause. For example, your period may start to happen every 6-8 weeks. Or you may miss a couple months before it comes back again. You may also have a heavier flow or a lighter flow from time to time.

That said, it’s important to know you can still get pregnant during perimenopause. So, continue to use birth control in the lead up to menopause as you normally would. Also, if you’ve missed your period and you’re not sure whether perimenopause has started, consider taking a pregnancy test as a first step.

Mood changes

As your hormone levels change, you may find yourself feeling more irritable, anxious, sad or forgetful than usual. Your sex drive (libido) can also decrease or increase.

These changes are very typical as your body approaches menopause. So be kind to yourself, practice self-care and ask for help if you’re having trouble.

Sleeping problems (insomnia)

You may find it difficult to fall asleep, or you may wake up in the middle of the
. Sleep trouble can contribute to a persistent feeling of tiredness, which can also affect your mood.

The good news is that sleep issues like insomnia can be treated. Lifestyle changes such as cutting back on caffeine, limiting screen time before bed and exercise can be extremely helpful. There are over-the-counter medications and supplements like melatonin that can help – but ask your doctor for a recommendation before you start taking something. Sleep medicine is an option, too.

Ready to talk menopause? We’re here for you at any age and any stage.

Menopause symptoms at age 50

Most women will have their last period around the age of 50. After 12 months without a period, menopause is complete and post-menopause begins.

As menopause gets closer, your estrogen and progesterone levels start to decline more rapidly. As a result, your symptoms will likely become more intense.

Your periods will probably become more irregular until they finally stop. You may experience greater mood swings and an increase in insomnia. And you’ll likely start experiencing new symptoms that are common right around, or right after, reaching menopause, including:

Hot flashes and chills

Hot flashes are sensations of heat that develop around your face, neck and chest, and may spread to other areas of your body. They usually last for just a few minutes.

Alongside the feeling of heat, your skin may redden, you may sweat, your heart rate might increase, and your mood may change. Afterward, you may feel chills.

Doctors aren’t sure why hot flashes happen, but there are ways to lessen their impact. Some tips include:

• Try to stay in cooler environments
• Dress lightly or wear layers you can remove
• Find effective ways to manage stress
• Monitor your diet (foods that are spicy, processed or fatty can trigger hot flashes)
• Reduce how much caffeine or alcohol you drink

Hot flashes can happen during pre-menopause, but they’re most often reported right around menopause and in the first few years of post-menopause.

Night sweats (hot flashes during the night)

When hot flashes occur at night, they’re called night sweats. Night sweats can prevent you from getting a good night’s sleep and make you more irritable the next day. Sleeping with fewer blankets, in lighter clothing and with a fan can be helpful to stay more comfortable.

Weight gain

Some people find that, even without changing their diet or lifestyle, they begin to gain weight during menopause. This is because the drop in estrogen levels also lowers your ability to maintain muscle mass, which can slow down your metabolism. This means that during and after menopause, you won’t need as many calories to maintain your current weight.

Menopause symptoms at age 55 and above

Around age 55, most women have entered their post-menopausal years. After menopause, your body adjusts to the lower amount of estrogen and progesterone, and many women feel more productive, alert and free – now that they don’t have to worry about birth control or managing a period.

Post-menopausal years do bring some new symptoms with them, however. Some things to expect include:

Dryer or thinner skin and hair

Estrogen plays a role in collagen production. Collagen makes up your skin, hair, bones and many other tissues around your body. Because your estrogen levels are lower after menopause, your skin or hair may become dryer or thinner.

Vaginal dryness or sensitivity

Lower estrogen levels can also cause vaginal tissue to become dryer and thinner. This may result in discomfort or pain during sex.

Vaginal dryness or sensitivity usually happens after menopause, but it isn’t unusual to notice it earlier. A moisturizer or lubricant can often relieve these symptoms and help you feel more comfortable.

Pelvic floor muscle problems

Did you know that estrogen also helps support the sides of your bladder? Less estrogen can lead to weaker pelvic floor muscles. That’s why urinary incontinence and frequent urination can be common after menopause. Your doctor can help you identify the best treatment options to improve your symptoms, including lifestyle changes, pelvic floor therapy or medication.

When should I see a doctor for menopause help?

The way you experience each stage of menopause will be unique. For example, maybe you don’t get hot flashes, but insomnia leaves you feeling tired and irritable. Or perhaps the first sign of change is vaginal dryness.

Menopause symptoms can often be managed by maintaining a healthy diet, exercising regularly and taking advantage of home remedies or over-the-counter medications.

But if your symptoms are intense enough to affect daily activities or keep you from doing the things you love, it may be time to seek advice and care for menopause symptoms.

OB-GYNs and certified nurse-midwives, along with experienced nurse practitioners and other women’s health experts, can listen to your concerns and symptoms, and work with you to create a personalized care plan. Care options might include lifestyle changes, hormone replacement therapy (HRT), and supplements or medications.

Some menopause symptoms might be harder to talk about than others – but don’t wait. Women’s health specialists have heard it all, and they have the expertise needed to help you manage menopause symptoms. The sooner they know what’s bothering you, the sooner they can help you find the right way to manage your symptoms.

Ready to talk menopause? We’re here for you at any age and any stage.

Menopause

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[ii] United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Aging 2019: Highlights (ST/ESA/SER.A/430). https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf

[iii] UNAIDS. The Gap Report 2014: People aged 50 years and older. Geneva, Switzerland. (2014). UNAIDS. https://www.unaids.org/sites/default/files/media_asset/12_Peopleaged50yearsandolder.pdf

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Key Facts

• Menopause is one of the stages in a woman’s life cycle that marks the end of reproductive age. After menopause, a woman cannot become pregnant except in rare cases when special fertility treatments are used.
• Most women experience menopause between the ages of 45 and 55 as a natural part of biological aging.
• Menopause occurs as a result of the decline in ovarian follicular function and a decrease in circulating estrogen levels.
• The menopausal transition can be gradual. It usually starts with changes in the menstrual cycle. “Perimenopause” means the period that begins with the onset of the first signs and ends one year after the last menstrual period.
• Perimenopause can last for several years, affecting physical, emotional, mental and social well-being.
• Symptoms of perimenopause can be alleviated with various non-hormonal and hormonal agents .
• Menopause may result from surgical or medical procedures.
  

How does menopause proceed?

For most women, menopause is associated with the cessation of monthly periods (also known as “periods”) due to the decline of ovarian follicular function. This means that the ovaries stop releasing eggs for fertilization.

The regularity and length of the menstrual cycle varies during a woman’s reproductive life, but the age of natural menopause for women worldwide is typically between 45 and 55 years of age.

Natural menopause is considered to occur after the absence of menses for 12 consecutive months without any other obvious physiological or pathological causes and in the absence of clinical intervention.

Some women experience menopause earlier (before age 40). This “premature menopause” may be due to certain chromosomal abnormalities, autoimmune disorders, or other unknown causes.

It is impossible to predict when a woman will go through menopause, although there are links between the age of menopause and several demographic, medical and genetic factors.

Menopause may also occur as a result of surgery to remove both ovaries or medical interventions that suppress ovarian function (eg, radiation therapy or chemotherapy).

Many women stop menstruating before menopause, such as those who have undergone certain surgeries (hysterectomy or surgical removal of the lining of the uterus) and those who take certain hormonal
contraceptives and other medicines that lead to infrequent or no periods. However, they may experience other changes associated with the menopausal transition.

Changes associated with menopause

Hormonal changes associated with menopause can affect physical, emotional, mental and social well-being. The symptoms experienced during and after the menopausal transition vary significantly from woman to woman. Some have symptoms
practically absent. Others may experience severe symptoms that can affect daily activities and quality of life. Some may experience symptoms for several years.

Symptoms associated with menopause include the following:

• hot flashes and night sweats. Hot flashes are sudden sensations of heat in the face, neck, and chest, often accompanied by reddening of the skin, sweating (sweating), rapid heart rate, and intense physical discomfort.
  which may last several minutes;
• changes in the regularity and course of the menstrual cycle, ending in the cessation of menstruation;
• vaginal dryness, pain during intercourse and urinary incontinence;
• difficulty sleeping/insomnia; and
• mood changes, depression and/or anxiety.

These changes may also affect the composition of body tissues and increase the risk of cardiovascular disease. The advantage of women over men in terms of the risk of developing cardiovascular diseases is gradually decreasing.
not with a significant drop in estrogen levels after menopause. Menopause can also lead to weakening of the pelvic floor structures, which increases the risk of pelvic organ prolapse. Loss of bone density during menopause is significant
a factor contributing to an increase in the incidence of osteoporosis and fractures.

There are a number of non-hormonal and hormonal agents that can help relieve menopausal symptoms. Symptoms that affect health and well-being should be discussed with a healthcare professional to determine available options
their relief, taking into account medical history, values ​​and preferences.

Pregnancy is still possible during perimenopause. To avoid unwanted pregnancy, it is recommended to use contraceptives for 12 consecutive months after the last menstrual period. Pregnancy after menopause without fertility treatment,
involving the use of donor eggs or previously frozen embryos is unlikely.

During perimenopause and after menopause, sexually transmitted infections (STIs), including HIV, can still be contracted through unprotected sex, including oral, anal, and vaginal sex. Thinning of the walls of the vagina after
menopause increases the chance of damage and ruptures, which increases the risk of HIV transmission through vaginal sex.

The importance of understanding menopause

It is very important to consider menopause as one of the life cycle stages. The state of health of a woman entering the perimenopausal period is largely determined by the previous state of health, reproductive history, lifestyle and factors
environment. Perimenopausal and postmenopausal symptoms can be devastating to personal and professional life, and the changes brought about by menopause impact a woman’s health as she ages. Therefore rendering
Perimenopausal health care plays an important role in promoting healthy aging and improving quality of life.

Menopause can be an important transitional period, both socially and biologically. Socially, how a woman experiences menopause can be influenced by gender norms, family and sociocultural factors, including how aging
women and the menopausal transition are accepted in her culture.

The global population of postmenopausal women is growing. In 2021, women aged 50 and over made up 26% of all women and girls in the world. This figure has increased from 22% 10 years earlier[i]. In addition, women’s life expectancy is longer
than in men. In 2019d. women aged 60 worldwide could expect to live an average of 21 more years[ii].

Menopause can be an important opportunity to reassess your health, lifestyle, and goals.

Menopause-related public health issues

Perimenopausal women need access to quality health care and to communities and systems that can support them. Unfortunately, awareness of and access to menopause services remains serious.
problem in most countries. Often, menopause-related issues are not discussed in families, communities, workplaces, and health care settings.

Women may not be aware that the symptoms they experience are associated with menopause and that there are counseling and treatment options available to help relieve discomfort. Women experiencing menopausal symptoms may feel uncomfortable
or shame that prevents them from drawing attention to their experiences and asking for support.

Health care providers may not be trained to recognize perimenopausal and postmenopausal symptoms and counsel patients about treatment options and health care after the menopausal transition. Currently in programs
The training of many medical professionals has given limited attention to the problem of menopause.

In many countries, the sexual well-being of menopausal women is neglected. This means that common gynecological effects of menopause, including vaginal dryness and pain during intercourse, may remain.
without attention. Similarly, older women may not consider themselves at risk of contracting sexually transmitted infections, including HIV[iii], and may not receive safe sex or testing advice from their doctors.

Many governments do not have the health policy and funding to include diagnostic, counseling and treatment services for menopause as part of routine services. Menopause services are
presents a particular challenge in the presence of other urgent and competing health financing priorities.

WHO activities

WHO believes that social, psychological and physical health support during the menopausal transition and after menopause should be an integral part of health care. WHO aims to improve understanding of menopause through
following events:

• raising awareness of menopause and its impact on women at the individual and community levels, as well as on the health and socioeconomic development of countries;
• advocacy for the inclusion of diagnostic, treatment and counseling services for menopausal symptoms in the universal health coverage package;
• Promoting the inclusion of menopause education and treatment options in pre-service training programs for health workers; and
• promoting a lifelong approach to health and well-being (including sexual health and well-being) by ensuring that women have access to relevant health information and services to promote healthy
  aging and a high quality of life before, during and after menopause.

Notes:

and self-identify as women), transgender men and some individuals who do not identify as either male or female are also going through menopause.

In this fact sheet, “women” are referred to according to available data, which usually does not specify gender identity. There is little data available on the experience of menopause among transsexuals and individuals with
gender identity. Transgender people and individuals with different gender identities have their own age-related health needs that clinicians should consider, including referral to specialized
services.

2) Although menopause is not a disease, in this fact sheet what women experience during perimenopause and postmenopause is
called symptoms because it can cause discomfort that affects quality of life.

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[i] United Nations, Department of Economic and Social Affairs. (2021) World Prospects 2021. https://population.un.org/wpp/Download/Standard/Population/

[ii] United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Aging 2019: Highlights (ST/ESA/SER.A/430). https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf

[iii] UNAIDS. The Gap Report 2014: People aged 50 years and older. Geneva, Switzerland. (2014). UNAIDS. https://www.unaids.org/sites/default/files/media_asset/12_Peopleaged50yearsandolder.pdf

Women’s Health

Sexual and Reproductive Health and Research (English)

Aging

Sexual health

Climax. What is important to know? | Blog

Climacteric syndrome (aka menopause) is a period in a woman’s life during which the work of the ovaries decreases and the amount of hormones they produce decreases. The main result of these physiological processes is the cessation of female reproductive function.

The period of menopause in most women comes after 48-52 years. Its symptoms include both hot flashes or sweating and the risk of developing serious illnesses. That is why menopause must be kept under control, visit a doctor regularly, and perform prescribed diagnostic procedures.

Stages and types of menopause

Menopause in women does not occur immediately. The climacteric period includes three main stages:

preliminary or pre-menopause. Menstruation does not stop, but ovarian function decreases. The stage lasts up to 2 years;

menopause. Caused by the cessation of menstruation. The beginning of the period is the absence of menstruation for 12 months. Usually occurs at 50-52 years;

postmenopausal. This stage is characterized by a further decrease in female sex hormones until the complete cessation of the functioning of the ovaries.

The duration and timing of these stages are individual and depend on various factors, including the woman’s lifestyle and health status.

Menopause is also distinguished by the severity of manifestations:

first or mild degree. It is characterized by infrequent (up to 10 times a day) hot flashes, which are the main manifestation of menopausal syndrome;

second degree or medium. Symptoms are more pronounced, and hot flashes are not the only manifestation of this condition;

severe or third degree. Signs of menopause are strongly pronounced, not limited to hot flashes, the number and frequency of which is quite large (more than 20 times a day). Working capacity decreases, the general state of health worsens significantly.

Symptoms of menopause

The preliminary stage (before menopause) often occurs without obvious signs. But it also happens vice versa, when a woman is worried about not one, but several symptoms at once. In addition, manifestations can differ significantly in different periods of time.

Early signs of climacteric syndrome include:

hot flashes, goosebumps, sweating;

rapid pulse;

headaches;

pressure surges;

abrupt mood changes;

sleep problems;

memory impairment;

decreased sexual desire.

When menopause occurs, menstruation stops in women. Other signs during this period of development of the syndrome include the following:

dryness of the skin and mucous membranes of the genital and urinary tract;

pain during sex;

urinary incontinence;

muscle and joint pain;

hair loss.

In the future, after menopause, various complications of menopause are possible:

hypertension;

atherosclerosis;

osteoporosis.

Also increases the risk of developing diabetes, hearing, vision and mental abilities are reduced.

In order to prevent these diseases and problems, during menopause, women are advised to regularly visit their doctor in Kyiv, monitor their health and adhere to the prescribed treatment.

Diagnosis of menopause

Diagnostic examinations of climacteric syndrome are carried out by gynecologists of our clinic. They examine and interview the patient, establish the relationship between menopause and various manifestations of menopause. An important diagnostic task is also the identification of concomitant diseases, such as hypertension, diabetes mellitus, etc.

During menopause, women may be prescribed various tests, including:

laboratory tests for hormones, lipid spectrum, coagulation;

cytological and microscopic: their purpose is to exclude the presence of atypical cells in the cervix.

To exclude the development of complications of menopause, such types of studies as ultrasound of the pelvic organs, mammography, radiography of bone tissues, ECG are used.

Menopause treatment

Menopause is a physiological process that occurs with age in any woman. Therefore, the therapeutic effect, as a rule, is aimed at minimizing negative manifestations, that is, facilitating the course of menopause. So with a mild degree of the syndrome, special treatment may not be required at all. If there are minor complaints about the general state of health, the following is prescribed:

hormone replacement therapy;

vitamins, especially A, C and group B;

physiotherapy, including massage, exercise therapy, etc.