When does menopause typically start. What are the common symptoms of menopause. How can hormone replacement therapy help with menopause symptoms. What are the risks associated with hormone therapy. What non-hormonal treatments are available for menopause symptoms. How can lifestyle changes impact menopause symptoms. When should women seek medical advice for menopause.

Understanding Menopause: Timing and Symptoms

Menopause is a natural biological process that marks the end of a woman’s reproductive years. It’s a significant milestone in a woman’s life that comes with various physical and emotional changes. But when exactly does menopause occur?

The average age for menopause is between 45 and 55, with the majority of women experiencing it around 51. However, it’s important to note that menopause can occur earlier or later for some women. Factors such as genetics, lifestyle, and certain medical conditions can influence the timing of menopause.

Recognizing the symptoms of menopause is crucial for early intervention and management. Some of the most common symptoms include:

• Hot flashes and night sweats
• Irregular menstrual cycles
• Mood changes and irritability
• Vaginal dryness and discomfort
• Sleep disturbances
• Decreased libido
• Weight gain and slowed metabolism

It’s important to remember that every woman’s experience with menopause is unique. Some may experience severe symptoms, while others may have minimal discomfort.

Hormone Replacement Therapy: Benefits and Considerations

Hormone replacement therapy (HRT) is one of the most effective treatments for managing menopause symptoms. Dr. Jewel Kling, chair of the Division of Women’s Health at Mayo Clinic in Scottsdale, Arizona, emphasizes that HRT can significantly improve quality of life for many women experiencing menopause.

HRT involves taking estrogen, often combined with progestogen for women who still have their uterus. This combination helps prevent endometrial cancer, a potential risk of estrogen-only therapy in women with a uterus.

What are the benefits of hormone replacement therapy? HRT has been shown to effectively relieve several menopause symptoms, including:

• Hot flashes and night sweats
• Vaginal dryness and discomfort
• Mood swings and irritability
• Sleep disturbances
• Decreased bone density

According to recent guidelines from the North American Menopause Society, the benefits of HRT often outweigh the risks for healthy women under 60 or within 10 years of their final menstrual period. However, it’s crucial to consult with a healthcare provider to determine if HRT is right for you, as individual factors such as age, overall health, and personal preferences play a significant role in this decision.

Potential Risks of Hormone Replacement Therapy

While HRT can be highly beneficial for many women, it’s important to be aware of potential risks. Dr. Kling notes that the risks associated with HRT are generally low, especially for women who start therapy before age 60 or within 10 years of their last period. However, some risks to consider include:

• Increased risk of blood clots in the legs and lungs
• Slightly elevated risk of stroke, particularly with oral estrogen
• Potential increase in breast cancer risk, especially with combined estrogen-progestogen therapy
• Risk of endometrial cancer if estrogen is used alone in women with a uterus

It’s worth noting that the risk profile can vary depending on the type and method of HRT. For example, transdermal estrogen (patches, gels, or sprays) may carry a lower risk of blood clots compared to oral estrogen.

Non-Hormonal Therapies for Menopause Symptom Relief

For women who cannot or choose not to use hormone therapy, there are several non-hormonal options available to manage menopause symptoms. These alternatives can be effective and may have fewer side effects compared to HRT.

Medications

Certain medications can help alleviate specific menopause symptoms:

• Low-dose paroxetine: This medication has been shown to reduce hot flashes and night sweats in some women. At low doses, it typically doesn’t cause weight gain or negatively affect sexual function.
• Other antidepressants: In some cases, antidepressants may be prescribed to manage mood changes and other symptoms associated with menopause.

Mind-Body Techniques

Several mind-body approaches have shown promise in managing menopause symptoms:

• Cognitive Behavioral Therapy (CBT): This form of therapy can help women cope with the psychological aspects of menopause and may reduce the frequency and intensity of hot flashes.
• Clinical Hypnosis: Some studies suggest that hypnosis can effectively reduce hot flashes and improve sleep quality in menopausal women.
• Acupuncture: This traditional Chinese medicine technique may help alleviate hot flashes and improve overall well-being during menopause.
• Yoga and Meditation: These practices can help reduce stress and improve overall quality of life during the menopausal transition.

It’s important to note that the effectiveness of these techniques can vary among individuals, and they often require guidance from trained professionals for optimal results.

Lifestyle Modifications to Manage Menopause Symptoms

In addition to medical treatments and mind-body techniques, certain lifestyle changes can significantly impact menopause symptoms and overall health during this transition.

Weight Management

Dr. Kling points out that there is evidence suggesting weight loss may reduce hot flashes and night sweats. Maintaining a healthy weight through a balanced diet and regular exercise can also help with other menopause-related concerns such as:

• Reducing the risk of cardiovascular disease
• Improving bone density
• Boosting mood and energy levels
• Enhancing overall quality of life

Dietary Changes

Certain dietary modifications may help alleviate menopause symptoms:

• Increasing intake of phytoestrogen-rich foods like soy, flaxseeds, and whole grains
• Reducing consumption of caffeine and alcohol, which can trigger hot flashes in some women
• Ensuring adequate calcium and vitamin D intake for bone health
• Staying hydrated to combat dry skin and other symptoms

Regular Exercise

Engaging in regular physical activity can provide numerous benefits during menopause, including:

• Improving mood and reducing anxiety
• Enhancing sleep quality
• Maintaining a healthy weight
• Strengthening bones and muscles
• Reducing the risk of chronic diseases

A combination of aerobic exercise, strength training, and flexibility work is often recommended for optimal health during menopause.

The Importance of Individualized Care in Menopause Management

One of the key takeaways from Dr. Kling’s insights is the importance of individualized care when it comes to managing menopause. Every woman’s experience with menopause is unique, and what works for one person may not be suitable for another.

When considering treatment options, several factors need to be taken into account:

• Age and overall health status
• Severity of symptoms
• Personal preferences and lifestyle
• Family and personal medical history
• Available treatment options
• Cost considerations

It’s crucial for women to have open and honest discussions with their healthcare providers about their symptoms, concerns, and treatment preferences. This collaborative approach can lead to a more effective and satisfying menopause management plan.

When to Seek Medical Advice for Menopause Symptoms

While menopause is a natural process, it’s important to know when to seek medical advice. Women should consult with a healthcare provider if they experience:

• Severe or debilitating menopause symptoms that significantly impact quality of life
• Irregular bleeding patterns or heavy bleeding during perimenopause
• Symptoms of vaginal atrophy, such as severe dryness or pain during intercourse
• Signs of mood disorders, including depression or anxiety
• Concerns about bone health or osteoporosis risk

Early intervention can often lead to better management of symptoms and improved overall health outcomes. Healthcare providers can offer personalized advice, conduct necessary screenings, and recommend appropriate treatments based on individual needs and circumstances.

The Future of Menopause Care: Awareness and Education

As our understanding of menopause continues to evolve, there is a growing emphasis on the importance of early awareness and education. Many experts, including Dr. Kling, advocate for starting menopause education earlier in life.

Why is early menopause awareness important? There are several reasons:

• It allows women to recognize early signs and symptoms of perimenopause
• It provides time to make lifestyle changes that can ease the transition
• It enables women to have informed discussions with their healthcare providers
• It helps reduce stigma and misconceptions surrounding menopause
• It empowers women to take control of their health during this significant life stage

Educational initiatives targeting younger women, as well as ongoing public health campaigns, can play a crucial role in improving menopause awareness and preparedness. This proactive approach can lead to better outcomes and improved quality of life for women during and after the menopausal transition.

In conclusion, menopause is a complex and individual experience that requires a multifaceted approach to management. From hormone replacement therapy to lifestyle modifications and alternative treatments, there are numerous options available to help women navigate this transition. By staying informed, maintaining open communication with healthcare providers, and prioritizing overall health and well-being, women can approach menopause with confidence and optimism. Remember, as Dr. Kling emphasizes, “Women don’t need to simply tough it out. They can get help.”

Menopause symptoms: Mayo Clinic expert outlines hormone and nonhormonal therapies

• By

  Sharon Theimer

  January 19, 2023

SCOTTSDALE, Arizona — Menopause, the end of menstrual cycles, can produce symptoms such as hot flashes, night sweats, insomnia and mood changes. Women do not need to suffer in silence: Many treatment options are available. Jewel Kling, M.D.,  chair of the Division of Women’s Health at Mayo Clinic in Scottsdale, Arizona, describes hormonal and nonhormonal therapies.

“We sometimes hear the question, ‘Do I need to treat hot flashes or night sweats?’ and the answer for many may be, ‘Yes,'” Dr. Kling says. “Because hot flashes and night sweats affect quality of life and productivity at work and at home for women.”

Hormone replacement therapy is an estrogen medication; for women with a uterus, hormone therapy typically includes estrogen plus progestogen medication to prevent endometrial cancer. For women younger than 60 or within 10 years after their final period, the benefit of hormone therapy outweighs the risk in healthy women with postmenopausal symptoms, according to recent guidelines from the North American Menopause Society.  

“Many factors affect a woman’s decision whether to use hormones and if she uses them, which particular regimen is best to relieve her symptoms,” Dr. Kling says. “Common factors  considered include age, underlying health, symptom severity, preferences, available treatment options, and of course, cost considerations. One important consideration is whether the potential benefits outweigh the potential risks.”

• Many studies have shown that systemic hormone therapy such as a pill, patch, gel or spray, helps with hot flashes, night sweats, and vulva vaginal symptoms, Dr. Kling says.

There’s also strong evidence that long-term treatment with estrogen therapy or estrogen plus progestogen therapy reduce the risk of fractures after menopause.

“Along with these benefits often comes improvement with menopause-related symptoms, including those most likely bothersome, including disturbed sleep, mood problems, and diminished sexual satisfaction,” Dr. Kling says. “Addressing these symptoms can lead to a better quality of life.”

Among risks:

• With oral systemic estrogen therapy or estrogen plus progestogen therapy, risks include blood clots in the legs and lungs, and stroke.

“Stroke is dependent on the age at which a woman starts hormone therapy. Specifically, the risks are low for women younger than 60 or within 10 years after their last period,” Dr. Kling says. “There do not appear to be the same risks associated with transdermal estrogen products such as patches, particularly when we use lower doses.”

• Use of estrogen alone by women who have a uterus carries a risk of uterine cancer; that risk can be lowered by including progestogen or an estrogen selective estrogen receptor modulator, also known as the SERM (selective estrogen receptor modulator) combination.

• Breast cancer risks should also be considered, and appear slightly higher, particularly in women with a uterus who use estrogen plus a progestogen.

“However, overall, the risk of serious events with hormone therapy are rare,” Dr. Kling says. “For women with only vaginal symptoms, low-dose vaginal estrogen can be used. Low-dose vaginal estrogen does not have the same risks as systemic therapy because the body absorbs very little.”

Hormone therapy generally isn’t an option for women with breast cancer, other hormonally mediated cancers or blood clot issues, and other women may simply wish to avoid hormone therapy, Dr. Kling says. There are many nonhormonal therapies ranging from mind-body techniques to medication that can bring relief with few or no side effects:

• There is some evidence that losing weight may reduce hot flashes and night sweats.
• Among medications, low-dose paroxetine has been shown to help some women with symptoms such as hot flashes. At low doses, it doesn’t appear to cause weight gain or have adverse sexual effects.
• In some cases, antidepressants may be appropriate, and the health care practitioner and patient will weigh benefits and risks, Dr. Kling says.
• Mind-body techniques include cognitive behavioral therapy and clinical hypnosis, both of which depend on expert guidance for success, Dr. Kling says. Some patients have found relief from acupuncture, yoga and meditation.

“There are many ways to help women deal with the discomfort and diminished quality of life associated with menopause,” Dr. Kling says. “Women don’t need to simply tough it out. They can get help.”

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Sharon Theimer, Mayo Clinic Communications, newsbureau@mayo. edu

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Definition, Symptoms, Causes, Treatment, and Complications

Written by WebMD Editorial Contributors

Medically Reviewed by Poonam Sachdev on March 31, 2023

• What Is Menopause?
• Menopause Causes
• Menopause Symptoms
• What Happens During Menopause?
• What Conditions Cause Premature Menopause?
• What Doesn’t Cause Premature Menopause?
• How Long Do Symptoms of Menopause Last?
• Menopause Diagnosis
• Menopause Treatment
• Alternative and Complementary Menopause Treatments
• Menopause Complications
• More

Menopause is the end of your menstrual cycles. The term is sometimes used to describe the changes you go through just before or after you stop having your period, marking the end of your reproductive years. Menopause usually happens around age 50. 

Women are born with all of their eggs, which are stored in their ovaries. Their ovaries also make the hormones estrogen and progesterone, which control their period (menstruation) and the release of eggs (ovulation). Menopause happens when the ovaries no longer release an egg every month and menstruation stops.

Menopause is a regular part of aging when it happens after the age of 40. But some women can go through menopause early. It can be the result of surgery, like if their ovaries are removed in a hysterectomy, or damage to their ovaries, such as from chemotherapy. If it happens before age 40, for any reason, it’s called premature menopause.

First signs of menopause

Most women nearing menopause will begin experiencing vasomotor symptoms (VMS). The most common is hot flashes. During a hot flash there is a sudden feeling of warmth that spreads over the upper body, often with blushing, a racing heart, and sweating. These flashes can range from mild in most women to severe in others.

You may also notice other symptoms of menopause such as:

• Uneven or missed periods
• Vaginal dryness
• Sore breasts
• Needing to pee more often
• Trouble sleeping
• Emotional changes
• Dry skin, eyes, or mouth

Symptoms of menopause

Other symptoms include:

• Fatigue
• Depression
• Crankiness
• Headaches
• Joint and muscle aches and pains
• Weight gain
• Hair loss
• Changes in libido (sex drive)

Natural menopause isn’t caused by any type of medical or surgical treatment. It’s slow and has three stages:

• Perimenopause. This phase usually begins several years before menopause, when your ovaries slowly make less estrogen.  Perimenopause lasts until menopause, the point at which your ovaries stop releasing eggs. In the last 1 to 2 years of this stage, estrogen levels fall faster. Many women have menopause symptoms.
• Menopause. This is when it’s been a year since you had a period. Your ovaries have stopped releasing eggs and making most of their estrogen.
• Postmenopause. These are the years after menopause. Menopausal VMS such as hot flashes and night sweats usually ease. But health risks related to the loss of estrogen increase as you get older.

Your genes, some immune system disorders, or medical procedures can cause premature menopause. Other causes include:

• Premature ovarian failure (or primary ovarian insufficiency). When your ovaries prematurely stop releasing eggs, for unknown reasons, your levels of estrogen and progesterone change. When this happens before you’re 40, it’s called premature ovarian failure. Unlike premature menopause, premature ovarian failure isn’t always permanent.
• Induced menopause. This happens when your doctor takes out your ovaries for medical reasons, such as uterine cancer or endometriosis. It can also happen when radiation or chemotherapy damages your ovaries.

Some things you might think would influence menopause age, but don’t:

Hormonal birth control. Even if you’re using a birth control method that stops ovulation, it doesn’t stop your loss of follicles — the constant process of your ovary taking them from your resting pool of eggs. All of your follicles available that month die away, even if you’re not ovulating, so experts don’t think that birth control delays menopause.

Ethnicity. A study of premenopausal and early perimenopausal women found that race and ethnicity play no role in the age when you experience menopause. The Study of Women’s Health Across the Nation (SWAN) looked at women from different races from seven states and found they experienced menopause around the same age.

Menopause is different in each woman. In general, the symptoms of perimenopause last about 4 years.

You might suspect that you’re going into menopause. Or your doctor will say something, based on symptoms you’ve told them about.

You can keep track of your periods and chart them as they become uneven. The pattern will be another clue to your doctor that you’re perimenopausal or nearing menopause.

Your doctor might also test your blood for levels of:

• Follicle-stimulating hormone (FSH). This usually goes up as you near menopause.
• Estradiol. This tells your doctor how much estrogen your ovaries are making. This level will go down in menopause.
• Thyroid hormones. This shows problems with your thyroid gland, which can affect your period and cause symptoms that look like menopause.

Menopause is a natural process. Many symptoms will go away over time. But if they’re causing problems, treatments can help you feel better. Common ones include:

• Hormone replacement therapy (HRT). This is also called menopausal hormone therapy. You take medications to replace the hormones that your body isn’t making anymore. Certain drugs or combinations can help with hot flashes and vaginal symptoms, as well as making your bones stronger. But they can also put you at higher risk of health problems like heart disease or breast cancer, so you should take the lowest dose that works for the shortest time possible.
• Topical hormone therapy. This is an estrogen cream, insert, or gel that you put in your vagina to help with dryness.
• Nonhormone medications. The depression drug paroxetine (Brisdelle, Paxil) is FDA-approved to treat hot flashes. The nerve drug gabapentin (Gralise, Neuraptine, Neurontin) and the blood pressure drug clonidine (Catapres, Kapvay) might also ease them. Medicines called selective estrogen receptor modulators (SERMs) help your body use its estrogen to treat hot flashes and vaginal dryness.
• Medications for osteoporosis. You might take medicines or vitamin D supplements to help keep your bones strong.

Lifestyle changes

Lifestyle changes help many women deal with menopause symptoms. Try these steps:

• If you’re having a vasomotor symptom like hot flashes, drink cold water, sit or sleep near a fan, and dress in layers.
• Use an over-the-counter vaginal moisturizer or lubricant for dryness.
• Exercise regularly to sleep better and prevent conditions like heart disease, diabetes, and osteoporosis.
• Strengthen your pelvic floor muscles with Kegel exercises to prevent bladder leaks.
• Stay socially and mentally active to prevent memory problems.
• Don’t smoke. Tobacco might cause early menopause and increase hot flashes.
• Limit how much alcohol you drink, to lower your chance of getting breast cancer and help you sleep better.
• Eat a variety of foods and keep a healthy weight to help with hot flashes.
• Practice things like yoga, deep breathing, or massage to help you relax.

Menopause diet. What you eat might affect when you enter menopause, research suggests.

After tracking more than 35,000 British women for 4 years, researchers found that menopause tends to start earlier for those whose diets are heavy in refined carbs. In contrast, it seems to begin later for those who eat a lot of fish and legumes.

“In particular, a higher consumption of oily fish was found to delay the timing of natural menopause by approximately 3 years, and fresh legumes — such as peas and green beans — was linked to a later menopause by around a year,” said study author Yashvee Dunneram.

“On the other hand, a higher consumption of refined carbohydrates — such as pasta and rice — hastened the onset of menopause by 1.5 years,” said Dunneram.

“Refined carbs are one of the main culprits for insulin resistance. A high level of circulating insulin could interfere with sex hormone activity and boost estrogen levels, both of which might increase the number of menstrual cycles and deplete egg supply faster, thus causing an earlier menopause. “

As for those with a vegetarian diet, researchers found they experience menopause about a year earlier than meat eaters. The high-fiber and low-animal-fat content in some vegetarian meals has been linked to low estrogen levels.

But meat eaters who ate higher daily amounts of savory foods — such as potato chips, pretzels, and peanuts — experienced menopause about 2 years earlier than meat eaters who didn’t.

More research is needed to further understand the diet-menopause connection.

Some studies have found that soy products relieve hot flashes, but researchers are still looking into it. There aren’t many large studies on whether other supplements such as black cohosh or “bioidentical” hormones work for menopause symptoms. Talk to your doctor before starting any herbal or dietary supplements.

Yoga, tai chi, and acupuncture are safer ways to manage menopause symptoms.

The loss of estrogen linked with menopause is tied to the following health problems that become more common as women age.

After menopause, women are more likely to have:

• Bone loss (osteoporosis)
• Heart disease
• Bladder and bowels that don’t work like they should
• Higher risk of Alzheimer’s disease
• More wrinkles
• Poor muscle power and tone
• Weaker 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)

It can be tough to manage the sexual changes that come along with menopause, like vaginal dryness and a loss of sex drive. You might also find that you don’t enjoy sex as much and have trouble reaching orgasm. As long as it isn’t painful, regular sexual activity may help keep your vagina healthy by promoting blood flow.

Your ovaries have stopped sending out eggs once you’re in menopause, so you can’t get pregnant. But you can still get a sexually transmitted disease. Use safer sex practices if you’re not in a relationship with one person.

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Often this phenomenon signals that a woman will no longer be able to have children, because her reproductive function fades with the onset of menopause. From a medical point of view, menopause is a process in which there is a change in the level of hormones in the body. Menopause is only said to occur when there is no menstruation for one calendar year or more. Menopause is treated by an obstetrician-gynecologist.

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Causes

Menopause is a natural state of the female body that occurs at a certain time. This process is associated with gradual hormonal changes and is considered irreversible. The average age for the onset of menopause is fifty years. However, physicians are aware of cases when menopause develops in both thirty-year-old young women and in elderly people over sixty years old. Early menopause often occurs against the background of insufficient weight, smoking. At the same time, overweight people often experience a later menopause.

Doctors note that early menopause often occurs for a number of other reasons:

• Genetics. If one of the closest relatives menopause occurred about forty years or a little later, there is a high probability that in your case menopause will come earlier.
• Lifestyle. Some of the factors that accelerate the onset of menopause, we have already called. These are smoking and underweight. The fact is that cigarettes contribute to a decrease in the natural level of the hormone estrogen, which in the end can lead to menopause. On average, women who smoke have menopause one to three years earlier than non-smokers. Insufficient BMI (body mass index) also leads to a decrease in estrogens. Other factors that trigger the process of an earlier menopause are a vegetarian diet, a sedentary lifestyle, lack of basic physical activity, and insufficient sun exposure.
• Chromosomal defects. Such violations really lead to early menopause. For example, patients with Turner syndrome, in which the ovaries do not function at full strength, note the premature onset of menopause.
• Some autoimmune diseases. Risk factors include rheumatoid arthritis and thyroid disease. Any such conditions that cause the ovaries to work incorrectly start menopause earlier.

Symptoms

Every woman can complain about certain symptoms of menopause. It is worth noting that this condition is individual, so we will name only the most common signs:

• Tides. They occur in 75% of women during menopause and are sudden and short-term increases in body temperature. In addition to this, hot flashes lead to an increase in heart rate, dizziness.
• Vaginal atrophy, i.e. thinning of the tissues of the urethra and vagina. This can cause the development of vaginitis, urinary tract infections, pain during sex.
• Weakening of the pelvic floor muscles. In the future, this condition can cause urinary incontinence, prolapse of the intestines, uterus, prolapse of the rectum.
• Side effects from the cardiovascular system. They are accompanied by dizziness, numbness or tingling in the limbs, rapid pulse.
• Absence of menstruation for one year.
• Fatigue, irritability, nervousness and insomnia may also accompany the development of menopause.

Diagnosis

The diagnosis of menopause is made after taking the patient’s medical history. During a visual examination on the gynecological chair, the doctor may note the thinning of the tissues of the vagina, the prolapse of the organs and the weakening of the muscles. At the appointment, you will also need to tell when the last menstruation was, what other symptoms of menopause bother you.

For a more accurate diagnosis and assessment of a woman’s health, the following tests can be additionally ordered:

• general blood and urine analysis;
• swabs for urogenital infections
• smear for microscopy;
• Ultrasound of the thyroid gland, uterus and vagina;
• blood for lipid metabolism and hormones.

Treatment

There are several effective regimens for relieving symptoms during menopause. Most often for the treatment of menopause prescribed:

• hormone therapy, that is, additional intake of female hormones – estrogen and progesterone;
• drugs that allow you to deal with unpleasant side effects – hot flashes, irritability, insomnia, dizziness.

Menopause treatment will not stop its progression, especially if it occurs on time. But correctly prescribed funds can improve the condition of a woman, minimize the development of negative health effects.

How to delay the onset of menopause – an educational portal about women’s health Women First

Contents

• At what age does menopause occur?
• Age and stages of menopause
• Factors affecting the age of menopause
• Medications for menopause

Menopause increases the risks for women’s health and provokes accelerated aging. The question of how to delay the onset of menopause worries any woman. Is it possible to slow down the biological clock, what factors can bring or delay the onset of menopause, are there methods to reduce menopause symptoms and health consequences? The experts of the portal Women First tell.

At what age does menopause occur

The ancient Greek scientist Aristotle noted that menopause in women occurs at the age of 40. Back in the early 20th century, only a third of women lived to the age of menopause, and in the 90s in Russia menopause occurred on average at 45 years. And today in Africa and Latin America, most women complete the menopausal transition by age 45, and in India by age 47. However, women living in cities in North America, Europe, and Russia today experience menopause later in life. For European countries, the average age of menopause is 52 years, for the USA – 51.2 years, for Russia – 51.4 years.

However, although women in more socially and economically developed countries experience a later menopause, this period still inevitably comes in the life of every woman.

Age and stages of menopause

Completion of the reproductive period takes place in several stages:

• Late reproductive age. After 40 years, reproductive function is preserved, but gradually decreases due to a decrease in progesterone and a reduction in the follicular phase. This period can last from two to five years.
• Premenopause (menopausal transition). On average, it falls on the age of 45 to 47 years. The cyclical nature of menstruation and the nature of menstruation change, periods of amenorrhea occur, symptoms of menopause increase. The menopausal transition lasts an average of 2 to 3 years, but can be delayed up to 8 years or even more.
• Menopause. A clinical sign of the onset of menopause is the absence of menstruation in a woman for 12 months (under the age of 50 – 24 months). The production of female sex hormones stabilizes at a low level, which causes significant changes in health and well-being.
• Postmenopausal. 1 year after the cessation of menstruation, the menopausal transition is fully completed. Symptoms associated with menopause occur less frequently and lose intensity. However, the long-term effects of estrogen deficiency persist and may increase over time without concomitant therapy.

A sharp decrease in estrogen production in women over 50 provokes the development of conditions such as:

• Cardiological problems. Postmenopausal women are 2 to 3 times more susceptible to cardiovascular disease.
• Decreased bone mass. Bone loss begins as early as the menopausal transition and accelerates during menopause.
• Atrophic changes in the genitourinary system. On the part of the genital organs, there is a reduction in the size of the cervix, atrophy of the endometrium, dryness of the mucous membrane. Changes in the urinary system can lead to incontinence, atrophic cystitis.
• Deterioration of skin and hair. The lack of estrogen disrupts the production of collagen in the skin, which makes it lose its elasticity faster and becomes more prone to wrinkling. The hairline on the head thins, and the vellus hair on the face, on the contrary, can become thicker and thicker.

Although the severity of symptoms of menopause may vary from woman to woman, it is impossible to avoid them completely. But is there a chance to delay aging and on what factors does the time of menopause depend?

Factors affecting age at menopause

On a population scale, the time of menopause is affected by the general standard of living. But the main factor that determines the timing of menopause in an individual woman is heredity. Most likely, menopause will come to you at about the same age as to your close relatives (mother, sister, aunt). Some individual genetic faults and diseases can lead to early or premature menopause, however, in general, women in the same family enter menopause at about the same age with a variation of 1 to 2 years.

Modern research shows that several factors and lifestyle habits can also influence the age of menopause.

• History of breastfeeding. A large study, which used data from more than 100,000 participants, showed that women who breastfed during the first 7 to 12 months of a child’s life had a significantly lower risk of early and premature menopause. Adjusting for breastfeeding time, one pregnancy reduced this risk by 8%, two pregnancies by 16%, and three pregnancies by 22%. A woman who collectively breastfed her children for at least 25 months was 27% less likely to have a premature menopause than a woman who stopped breastfeeding before her baby was one month old.
• Level of education. Several studies, as well as a meta-analysis of 26 studies in 24 countries, found a clear association between women’s educational attainment and time to menopause. More educated women enter menopause on average 1 to 2 years later than women with a low level of education. The reasons for this stratification are not yet completely clear, but are probably related to the standard of living.
• Moderate alcohol consumption. Although alcoholism provokes an earlier onset of menopause, women who drink alcohol in moderation (1-3 drinks per week) go through menopause on average later than women who completely abstain from alcohol. However, the difference is not so significant that the possible benefits of drinking alcohol outweigh the potential harms of alcohol.
• Sufficient and varied diet with high protein levels. A large amount of fruits and protein in the diet, as well as sufficient intake of calories, is associated with a later onset of menopause. The risk of early menopause is reduced in women who eat more oily fish and dairy products. Also, menopause occurs on average later in women with a higher BMI than in underweight women, since adipose tissue is able to regulate the amount of estrogen.
• Smoking. This is the most serious factor that brings the onset of menopause closer. Age at menopause in women who smoke is on average 1 to 2 years lower than in non-smokers.

Thus, by making certain lifestyle changes, a woman can, if not delay the onset of menopause, then at least reduce the risk of premature menopause. However, the situation is complicated by the fact that changes in the body that affect the age of completion of the reproductive period are laid much earlier than the first precursors of menopause. Quitting smoking at a late reproductive age, a woman, no doubt, will improve her health, but she will no longer be able to delay menopause. If you have already encountered the first symptoms of menopause, the processes of premenopause cannot be stopped or slowed down, but their intensity and frequency can be reduced.

Menopause drugs

Existing medications are not designed to delay menopause, but to help reduce symptoms and possible harm to health during hormonal changes in the body. Since the first symptoms of menopause may appear several years before the cessation of menstruation, drug therapy can improve the quality of life of a woman when she suffers from frequent and intense hot flashes, urogenital atrophy, and other unpleasant phenomena associated with premenopause.

To combat these symptoms, hormone replacement therapy is prescribed, which involves taking estrogen and progesterone preparations, or estrogen alone (for women with a hysterectomy).

Replacement therapy can reduce many of the health risks associated with a decrease in estrogen levels, in particular, it prevents bone loss, reduces the effect of menopause on the heart and blood vessels, and relieves hot flashes. The appointment of replacement therapy should be carried out only by a doctor after collecting an anamnesis and a complete examination of the patient.

In addition to hormonal drugs, other means may be prescribed to alleviate the symptoms of menopause and improve the patient’s well-being:

• Antidepressants – reduce the frequency and intensity of hot flashes.
• Calcium and vitamin D – prevent osteoporosis and problems of the cardiovascular system.
• Other vitamin complexes and nutritional supplements – can help improve the condition of hair and skin, normalize heat transfer, stabilize the psycho-emotional state.

We emphasize once again: 90% of the time for the onset of natural menopause is laid down in genetics. Other factors affect the biological clock only to a small extent. However, the right diet, moderate physical activity, giving up bad habits and following the doctor’s recommendations will help you go through the menopause without complications and serious health consequences.

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