When does menopause typically occur. What are the common symptoms of menopause. How can menopause impact overall health. What treatments are available for managing menopausal symptoms. How does menopause affect cardiovascular health.

The Basics of Menopause: Timing and Definition

Menopause marks the end of a woman’s reproductive years, signaling the cessation of menstrual cycles. But when does this transition typically occur? The average age for menopause in the United States is 51, though it can happen anywhere between the 40s and 50s. Medically, menopause is diagnosed after 12 consecutive months without a menstrual period.

It’s crucial to understand that menopause is a natural biological process, not a medical condition. However, the physical and emotional symptoms associated with this transition can significantly impact a woman’s quality of life, affecting sleep patterns, energy levels, and emotional well-being.

Recognizing the Signs: Common Symptoms of Menopause

As women approach menopause, they may experience a variety of symptoms during the perimenopause phase. These can include:

• Irregular periods
• Vaginal dryness
• Hot flashes and night sweats
• Sleep disturbances
• Mood changes
• Weight gain and slowed metabolism
• Thinning hair and dry skin
• Loss of breast fullness

It’s important to note that the experience of menopause can vary significantly among women. Some may have mild symptoms, while others might find their daily lives significantly affected.

The Unpredictable Nature of Perimenopausal Periods

During perimenopause, menstrual cycles often become irregular. Women might skip periods for a month or more, only to have them return for several months before disappearing again. This irregularity is normal and expected. However, it’s worth noting that despite these changes, pregnancy is still possible during perimenopause. If you’ve missed a period and are unsure whether you’ve entered menopause, it’s advisable to take a pregnancy test.

The Physiological Causes of Menopause

What triggers the onset of menopause? The primary cause is the natural decline in reproductive hormones. As women approach their late 30s, their ovaries begin producing less estrogen and progesterone, the hormones responsible for regulating menstruation. This gradual decline in hormone production leads to decreased fertility and eventually results in the cessation of menstrual periods.

Other Factors That Can Induce Menopause

While natural hormone decline is the most common cause, other factors can trigger menopause:

1. Surgical removal of ovaries (oophorectomy)
2. Hysterectomy (removal of the uterus)
3. Chemotherapy and radiation therapy
4. Primary ovarian insufficiency

Each of these factors can lead to immediate or premature menopause, often causing more abrupt and severe symptoms due to the sudden hormonal changes.

Health Implications of Menopause: Understanding the Risks

Does menopause increase the risk of certain health conditions? Indeed, the post-menopausal period is associated with an increased risk of several health issues, primarily due to the decrease in estrogen levels. Some of these include:

• Cardiovascular disease
• Osteoporosis
• Urinary incontinence
• Sexual function changes
• Weight gain and slowed metabolism

Cardiovascular Health and Menopause

How does menopause affect heart health? The decline in estrogen levels during menopause can increase the risk of cardiovascular disease. Estrogen is believed to have a protective effect on the heart, helping to maintain flexible blood vessels and promoting healthy cholesterol levels. As estrogen levels drop, women may experience an increase in LDL (bad) cholesterol and a decrease in HDL (good) cholesterol, potentially leading to a higher risk of heart disease and stroke.

To mitigate this risk, post-menopausal women are encouraged to adopt heart-healthy lifestyle habits, including regular exercise, a balanced diet rich in fruits, vegetables, and whole grains, and maintaining a healthy weight. Regular check-ups and discussions with healthcare providers about cardiovascular health are also crucial during this life stage.

Managing Menopausal Symptoms: Treatment Options and Lifestyle Changes

While menopause is a natural process, the symptoms can be disruptive to daily life. Fortunately, there are various treatment options available to manage these symptoms effectively. These range from lifestyle modifications to medical interventions.

Hormone Replacement Therapy (HRT)

What is hormone replacement therapy, and how does it help with menopausal symptoms? HRT involves supplementing the body with estrogen and, in some cases, progesterone to alleviate menopausal symptoms. It can be particularly effective in managing hot flashes, night sweats, and vaginal dryness. However, HRT is not suitable for everyone and carries certain risks, so it’s essential to discuss this option thoroughly with a healthcare provider.

Non-Hormonal Treatments

For women who cannot or choose not to use HRT, there are several non-hormonal options available:

• Selective serotonin reuptake inhibitors (SSRIs) for mood changes and hot flashes
• Gabapentin for hot flashes and sleep disturbances
• Vaginal moisturizers and lubricants for vaginal dryness
• Osteoporosis medications to maintain bone density

Lifestyle Modifications

How can lifestyle changes help manage menopausal symptoms? Adopting certain lifestyle habits can significantly improve the menopausal experience:

1. Regular exercise to improve mood, sleep, and overall health
2. A balanced diet rich in calcium and vitamin D for bone health
3. Stress reduction techniques such as yoga or meditation
4. Avoiding triggers for hot flashes (e.g., spicy foods, alcohol, caffeine)
5. Maintaining a cool sleeping environment
6. Quitting smoking to reduce hot flashes and improve overall health

Navigating the Emotional Aspects of Menopause

The hormonal changes during menopause can have a significant impact on emotional well-being. Many women experience mood swings, irritability, anxiety, or depression during this transition. It’s crucial to recognize these emotional changes as a normal part of the menopausal process and seek support when needed.

Coping Strategies for Emotional Well-being

How can women effectively manage the emotional challenges of menopause? Here are some strategies that can help:

• Practice mindfulness and relaxation techniques
• Engage in regular physical activity to boost mood and reduce stress
• Maintain social connections and seek support from friends and family
• Consider joining a support group for women going through menopause
• Explore cognitive-behavioral therapy to develop coping skills
• Discuss persistent mood changes with a healthcare provider, as they may recommend counseling or medication if needed

Remember, it’s okay to seek professional help if emotional symptoms are significantly impacting your quality of life. Many women find that a combination of lifestyle changes, support systems, and professional guidance can make the emotional journey through menopause more manageable.

The Importance of Regular Health Check-ups During and After Menopause

Why are regular health check-ups crucial during and after menopause? As the body undergoes significant changes during this transition, regular medical visits become increasingly important. These check-ups allow healthcare providers to monitor overall health, screen for potential issues, and provide personalized advice on managing menopausal symptoms.

Recommended Health Screenings

What health screenings should post-menopausal women prioritize? Here are some key examinations and tests that are often recommended:

• Mammograms for breast cancer screening
• Colonoscopies for colorectal cancer screening
• Bone density scans to assess osteoporosis risk
• Lipid profile tests to monitor cardiovascular health
• Thyroid function tests
• Pelvic exams and Pap smears
• Blood pressure and diabetes screenings

The frequency and necessity of these screenings may vary based on individual health histories and risk factors. It’s essential to discuss a personalized screening schedule with your healthcare provider.

The Role of Preventive Care

How does preventive care benefit post-menopausal women? Preventive care plays a crucial role in maintaining health and detecting potential issues early. This approach can include:

1. Vaccinations, such as flu shots and shingles vaccines
2. Lifestyle counseling on diet, exercise, and stress management
3. Discussions about sexual health and urinary incontinence
4. Mental health screenings
5. Fall prevention strategies

By prioritizing regular check-ups and preventive care, women can proactively manage their health during and after menopause, potentially reducing the risk of age-related health issues and improving overall quality of life.

Embracing a New Chapter: Life After Menopause

While menopause marks the end of the reproductive years, it also heralds the beginning of a new life stage. Many women find that post-menopausal years bring a sense of freedom and renewed energy. Without the concerns of menstrual cycles and contraception, women often feel more liberated to pursue new interests, travel, or focus on career goals.

Redefining Identity and Relationships

How does menopause impact a woman’s sense of self and relationships? This transition often prompts women to reassess their identities and roles. It can be a time of self-discovery and personal growth. Relationships may evolve as well, particularly intimate partnerships. Open communication about physical and emotional changes can strengthen bonds and lead to a deeper understanding between partners.

Embracing Wellness and Vitality

What steps can women take to maintain wellness and vitality after menopause? Post-menopausal years can be a time of vibrant health and active living. Here are some ways to embrace this new chapter:

• Cultivate new hobbies or revisit long-forgotten interests
• Prioritize self-care and stress management
• Maintain an active social life and nurture meaningful relationships
• Explore volunteering or mentoring opportunities
• Continue learning and challenging yourself mentally
• Focus on overall wellness through balanced nutrition and regular exercise

By approaching this life stage with a positive mindset and proactive health management, women can find that post-menopausal years offer opportunities for personal growth, renewed purpose, and continued vitality.

Menopause – Symptoms and causes

Overview

Menopause is the time that marks the end of your menstrual cycles. It’s diagnosed after you’ve gone 12 months without a menstrual period. Menopause can happen in your 40s or 50s, but the average age is 51 in the United States.

Menopause is a natural biological process. But the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt your sleep, lower your energy or affect emotional health. There are many effective treatments available, from lifestyle adjustments to hormone therapy.

Symptoms

In the months or years leading up to menopause (perimenopause), you might experience these signs and symptoms:

• Irregular periods
• Vaginal dryness
• Hot flashes
• Chills
• Night sweats
• Sleep problems
• Mood changes
• Weight gain and slowed metabolism
• Thinning hair and dry skin
• Loss of breast fullness

Signs and symptoms, including changes in menstruation can vary among women. Most likely, you’ll experience some irregularity in your periods before they end.

Skipping periods during perimenopause is common and expected. Often, menstrual periods will skip a month and return, or skip several months and then start monthly cycles again for a few months. Periods also tend to happen on shorter cycles, so they are closer together. Despite irregular periods, pregnancy is possible. If you’ve skipped a period but aren’t sure you’ve started the menopausal transition, consider a pregnancy test.

When to see a doctor

Keep up with regular visits with your doctor for preventive health care and any medical concerns. Continue getting these appointments during and after menopause.

Preventive health care as you age may include recommended health screening tests, such as colonoscopy, mammography and triglyceride screening. Your doctor might recommend other tests and exams, too, including thyroid testing if suggested by your history, and breast and pelvic exams.

Always seek medical advice if you have bleeding from your vagina after menopause.

Causes

Menopause can result from:

• Naturally declining reproductive hormones. As you approach your late 30s, your ovaries start making less estrogen and progesterone — the hormones that regulate menstruation — and your fertility declines.

  In your 40s, your menstrual periods may become longer or shorter, heavier or lighter, and more or less frequent, until eventually — on average, by age 51 — your ovaries stop releasing eggs, and you have no more periods.

• Surgery that removes the ovaries (oophorectomy). Your ovaries produce hormones, including estrogen and progesterone, that regulate the menstrual cycle. Surgery to remove your ovaries causes immediate menopause. Your periods stop, and you’re likely to have hot flashes and experience other menopausal signs and symptoms. Signs and symptoms can be severe, as hormonal changes occur abruptly rather than gradually over several years.

  Surgery that removes your uterus but not your ovaries (hysterectomy) usually doesn’t cause immediate menopause. Although you no longer have periods, your ovaries still release eggs and produce estrogen and progesterone.

• Chemotherapy and radiation therapy. These cancer therapies can induce menopause, causing symptoms such as hot flashes during or shortly after the course of treatment. The halt to menstruation (and fertility) is not always permanent following chemotherapy, so birth control measures may still be desired. Radiation therapy only affects ovarian function if radiation is directed at the ovaries. Radiation therapy to other parts of the body, such as breast tissue or the head and neck, won’t affect menopause.
• Primary ovarian insufficiency. About 1% of women experience menopause before age 40 (premature menopause). Premature menopause may result from the failure of your ovaries to produce normal levels of reproductive hormones (primary ovarian insufficiency), which can stem from genetic factors or autoimmune disease. But often no cause of premature menopause can be found. For these women, hormone therapy is typically recommended at least until the natural age of menopause in order to protect the brain, heart and bones.

Complications

After menopause, your risk of certain medical conditions increases. Examples include:

• Heart and blood vessel (cardiovascular) disease. When your estrogen levels decline, your risk of cardiovascular disease increases. Heart disease is the leading cause of death in women as well as in men. So it’s important to get regular exercise, eat a healthy diet and maintain a normal weight. Ask your doctor for advice on how to protect your heart, such as how to reduce your cholesterol or blood pressure if it’s too high.
• Osteoporosis. This condition causes bones to become brittle and weak, leading to an increased risk of fractures. During the first few years after menopause, you may lose bone density at a rapid rate, increasing your risk of osteoporosis. Postmenopausal women with osteoporosis are especially susceptible to fractures of their spine, hips and wrists.

• Urinary incontinence. As the tissues of your vagina and urethra lose elasticity, you may experience frequent, sudden, strong urges to urinate, followed by an involuntary loss of urine (urge incontinence), or the loss of urine with coughing, laughing or lifting (stress incontinence). You may have urinary tract infections more often.

  Strengthening pelvic floor muscles with Kegel exercises and using a topical vaginal estrogen may help relieve symptoms of incontinence. Hormone therapy may also be an effective treatment option for menopausal urinary tract and vaginal changes that can result in urinary incontinence.

• Sexual function. Vaginal dryness from decreased moisture production and loss of elasticity can cause discomfort and slight bleeding during sexual intercourse. Also, decreased sensation may reduce your desire for sexual activity (libido).

  Water-based vaginal moisturizers and lubricants may help. If a vaginal lubricant isn’t enough, many women benefit from the use of local vaginal estrogen treatment, available as a vaginal cream, tablet or ring.

• Weight gain. Many women gain weight during the menopausal transition and after menopause because metabolism slows. You may need to eat less and exercise more, just to maintain your current weight.

Oct. 14, 2020

How Will I Know I’m in Menopause? Menopause Stages, Symptoms, & Signs

Ahh, the menopause journey. No clear starting or ending point, odd diversions, and an estimated time of arrival that could span years. Menopause is certainly a trip. And needless to say, you could use some turn-by-turn directions.

First Point of Interest: Perimenopause  

Ready, set, perimenopause. In this phase, your body will start providing helpful physical clues that the menopause process is starting. And it can still be years before your last menstrual period.

Some common, normal signs include irregular periods, hot flashes, vaginal dryness, sleep disturbances, and mood swings—all results of unevenly changing levels of ovarian hormones (estrogen) in your body. Read more about how you’ll know you’re near menopause.

Pit Stop: Check your Contraception Options    

Trip Tip:  In perimenopause, there is still a slight chance you could become pregnant. So if you’d rather not go down that road, birth control is recommended until one year after your last period. Five effective options for midlife women include:

• Birth control pills, patches, or rings—added benefits include regular cycles and decreased bleeding, hot flashes and ovarian/uterine cancer risk.
• Progestin-alone pills, implants and injections—an option for those with a history of certain cancers, heart disease, high blood pressure, diabetes, blood clots, obesity, and smoking.
• Intrauterine devices with or without hormones—safe, highly effective, convenient, and long-term.
• Sterilization (Tubal ligation, fallopian tube inserts, or vasectomy for men)—low risk, effective, and permanent.
• Barrier methods (condoms, diaphragm, spermicide)—condoms are the only method than provides some protection from HIV and other sexually transmitted infections.

Detour: Primary Ovarian Insufficiency (POI)

One way to get to menopause earlier than usual is a condition called POI. With POI, younger women (under 40) have no or only occasional periods and elevated FSH levels, which signify fewer eggs in their ovaries. Some women with POI may have typical menopause-related symptoms, others may not. 

Trip Tip: POI means lower estrogen levels, which means negative effects on your bone density and possibly your brain and sexual function. Timely diagnosis is key. So if this sounds like you, the next stop should be your healthcare provider.  

Arriving at Destination: Natural Menopause

And here we are—natural menopause, the spontaneous, permanent ending of menstruation that is not caused by any medical treatment. Menopause is a normal, natural event. It’s defined as the final menstrual period and is confirmed when a woman has not had her period for 12 consecutive months.

Women in North America will likely experience natural menopause between ages 40 and 58, averaging around age 51. Some women, however, reach this phase in their 30s, others in their 60s. Typically, women reach menopause around the same age as their mothers and sisters.

Trip Tip: Smokers may get there about two years earlier than nonsmokers, while race, age at first period, use of birth control pills or fertility medications do not seem to be determining factors.

Recalculating: Postmenopause

The final stop along our midlife tour is postmenopause. This phase includes all the time after menopause, and still manages to muster up a surprise or two. Due to the continued decrease in estrogen levels during this time, symptoms like vaginal dryness and hot flashes may linger.

Trip Tip: Lower hormone levels also increase your risk for related diseases like osteoporosis.

Enjoy the Ride

Signs. Symptoms. Stops. Starts. Yep. This menopause tour is unique for every woman. So for all the where-the-heck-am-I moments along the way, stop by your menopause navigation station at www.menopause.org. Ready for a trip to class? Enroll in Menopause 101.

Predicting Your Menopause Age: What Factors Matter

It’s a question many women wonder about, especially if you’re thinking about planning a family and your 20s are but a distant memory.

How many more years of fertility might you have, and how much longer will it be before you start experiencing “the change?”

Here’s what does — and does not influence the age at when a woman reaches menopause.

The Top Factor

There are a number of factors that affect women’s age at menopause, but one is more important than any other: the age their mother experienced menopause.

“Menopause is strongly genetically linked, so you’re very likely to fall within a few years either way of the age your mother was at menopause,” says Nanette Santoro, MD, director of the division of reproductive endocrinology and infertility at the University of Colorado-Denver School of Medicine and a member of the board of directors of the American Society for Reproductive Medicine.

This isn’t always true, of course. Some women reach menopause at an unusually early age — before 45 or so — with no known cause, which could be the result of an inherited issue or a one-time genetic mutation. “These can be random events, but can also be passed on,” says Howard Zacur, MD, PhD, who directs the reproductive endocrinology and infertility division at Johns Hopkins School of Medicine.

Continued

So if your mother reached menopause at 40, but their sisters and your grandmother were all around the average age of 50, it’s unclear whether you’ll follow their path or theirs.

But if most of the women in your family, your mother included, reach menopause early, late, or somewhere in the middle, you can eye your calendar with some degree of confidence.

Menopause Age: 4 More Influences

Your mother’s age at menopause is a key factor, but not the only one. Here are four others to consider:

1. Smoking. No other lifestyle factor does more damage to your ovaries than smoking. So if you smoke and your mother didn’t, you’ll probably reach menopause earlier than they did. If they smoked and you don’t, you probably reach menopause later than they did.
2. Chemotherapy. Most forms of chemotherapy used in younger women are at least mildly toxic to the ovaries. Many women go through temporary menopause while undergoing chemotherapy; if cycles do return (they don’t always), you can still expect to reach regular menopause a couple of years earlier than you otherwise would have.
3. Ovarian surgery. “The more you operate on the ovaries, the more healthy tissue gets damaged,” says Marcelle Cedars, MD, director of the division of reproductive endocrinology at the University of California, San Francisco, School of Medicine. So if you’ve had diagnostic surgery for endometriosis, for example, Cedars recommends using medical options (such as hormonal suppression) to treat the condition in order to avoid repetitive surgeries.

Not a Factor

Here are three things you might think would influence menopause age, but don’t:

1. Age at first period. Although the average age of menarche (onset of first menstrual period) has been getting younger in U.S. women, there hasn’t been a corresponding shift in the average age at menopause. The average age at menarche is now about 12.4 years old, down from 13.3 in women born prior to the 1920s, but the average age at menopause has been around 51.5 for decades. “You would assume that a woman only has so many cycles in her life and if she menstruates later, she’ll reach menopause later, but that doesn’t seem to be true,” Cedars says.
2. Pregnancy and breastfeeding. These have no impact on menopause age.
3. Use of hormonal birth control methods. “Even if you’re using a birth control method that stops ovulation, it doesn’t stop the loss of follicles, the constant process of the ovary taking them from the resting pool of eggs,” Cedars says. “All the follicles available in the cohort that month die away, even if you’re not ovulating, so birth control doesn’t appear to delay menopause.”
4. Ethnicity. A study of premenopausal and early perimenopausal women found that race/ethnicity played no role in what age the women experienced menopause. The Study of Women’s Health Across the Nation (SWAN) looked at cross section of women from different races from 7 different states and found that most of the women experienced menopause between the ages of 52 and 54.

Continued

There is no way to delay menopause; it can only be sped up, not slowed down, by external factors.

And there are some factors that are still unknowns. For instance, researchers are studying bisphenol A (BPA), a chemical used to make certain plastics, in relation to various cancers as well as the reproductive system and metabolic processes.

Could BPA exposure influence age at menopause? “My guess would be no, since the age of menopause hasn’t changed much over the years as we’ve been exposed to more of these environmental toxins, but research will be exploring the role of substances like BPA in ovarian function,” Santoro says.

Predicting Menopause Age

Other than avoiding smoking, there’s probably not much you can do to influence the age at which you’ll reach menopause. But as you get closer to that time, it will be easier to predict more accurately when it will happen.

“If you’re over the age of 45 and skip at least three periods in a row, that tells us that you’re going to move on to menopause relatively soon,” Santoro says. “But we’re still working on blood tests to see if we can predict this more accurately.”

What Are the Signs and Symptoms of Menopause?

Women may have different signs or symptoms at menopause. That’s because estrogen is used by many parts of your body. As you have less estrogen, you could have various symptoms. Many women experience very mild symptoms that are easily treated by lifestyle changes, like avoiding caffeine or carrying a portable fan to use when a hot flash strikes. Some women don’t require any treatment at all. Other symptoms can be more problematic.

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 come 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 a few 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 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.

Vaginal health and bladder control. Your vagina may get drier. This could make sexual intercourse uncomfortable. Or, you could have other health problems, such as vaginal or bladder infections. Some women also find it hard to hold their urine long enough to get to the bathroom. This loss of bladder control is called incontinence. You may have a sudden urge to urinate, or urine may leak during exercise, sneezing, or laughing.

Share this infographic and help spread the word about things women can do to stay healthy after menopause.

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. You might have trouble falling back to sleep if you wake up during the night.

Sex. You may find that your feelings about sex are changing. You could be less interested. Or, you could feel freer and sexier after menopause. After 1 full year without a period, you can no longer become pregnant. But remember, you could still be at risk for sexually transmitted diseases (STDs), such as gonorrhea or even 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.

Your body seems different. Your waist could get larger. You could lose muscle and gain fat. Your skin could get thinner. You might have memory problems, and your joints and muscles could feel stiff and achy. Are these changes a result of having less estrogen or just related to growing older? Experts don’t know the answer.

In addition, in some women, symptoms may include aches and pains, headaches, and heart palpitations. Since menopausal symptoms may be caused by changing hormone levels, it is unpredictable how often women will have hot flashes and other symptoms and how severe they will be. Talk with your doctor if these symptoms are interfering with your everyday life. The severity of symptoms varies greatly around the world and by race and ethnicity.

Read about lifestyle changes to improve hot flashes and night sweats, and ways to get a good night’s sleep during the menopausal transition.

Read about this topic in Spanish. Lea sobre este tema en español.

For More Information on Menopause

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

National Institutes of Health Menopausal Hormone Therapy Information
(Información de los Institutos Nacionales de la Salud sobre la terapia hormonal para la menopausia)
www.nih.gov/PHTindex.htm (en inglés)

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:
June 26, 2017

Menopause, Perimenopause and Postmenopause

Overview

As you age, your hormone levels drop. The strongest symptoms of menopause happen during the largest drop in your hormone levels.

What is menopause?

Menopause is a stage in life when you stop having your monthly period. It’s a normal part of aging and marks the end of your reproductive years. Menopause typically occurs in your late 40s to early 50s. However, women who have their ovaries surgically removed undergo “sudden” surgical menopause.

Why does menopause happen?

Natural menopause — menopause that happens in your early 50s and is not caused by surgery or another medical condition — is a normal part of aging. Menopause is defined as a complete year without menstrual bleeding, in the absence of any surgery or medical condition that may cause bleeding to artificially stop (use of hormonal birth control, overactive thyroid, etc.) As you age, the reproductive cycle begins to slow down and prepares to stop. This cycle has been continuously functioning since puberty. As menopause nears, the ovaries make less of a hormone called estrogen. When this decrease occurs, your menstrual cycle (period) starts to change. It can become irregular and then stop. Physical changes can also happen as your body adapts to different levels of hormones. The symptoms you experience during each stage of menopause (perimenopause, menopause and postmenopause) are all part of your body’s adjustment to these changes.

What are the hormonal changes during menopause?

The traditional changes we think of as “menopause” happen when the ovaries no longer produce high levels of hormones. The ovaries are the reproductive glands that store eggs and release them into the fallopian tubes. They also produce the female hormones estrogen and progesterone as well as testosterone. Together, estrogen and progesterone control menstruation. Estrogen also influences how the body uses calcium and maintains cholesterol levels in the blood.

As menopause nears, the ovaries no longer release eggs into the fallopian tubes, and you’ll have your last menstrual cycle.

How does natural menopause occur?

Natural menopause is the permanent ending of menstruation that is not brought on by any type of medical treatment. For women undergoing natural menopause, the process is gradual and is described in three stages:

• Perimenopause or “menopause transition”: Perimenopause can begin eight to 10 years before menopause, when the ovaries gradually produce less estrogen. It usually starts in a woman’s 40s, but can start in the 30s as well. Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last one to two years of perimenopause, the drop in estrogen accelerates. At this stage, many women may experience menopause symptoms. Women are still having menstrual cycles during this time, and can get pregnant.
• Menopause: Menopause is the point when a woman no longer has menstrual periods. At this stage, the ovaries have stopped releasing eggs and producing most of their estrogen. Menopause is diagnosed when a woman has gone without a menstrual period for 12 consecutive months.
• Postmenopause: This is the name given to the period of time after a woman has not bled for an entire year (the rest of your life after going through menopause). During this stage, menopausal symptoms, such as hot flashes, may ease for many women. However, some women continue to experience menopausal symptoms for a decade or longer after the menopause transition. As a result of a lower level of estrogen, postmenopausal women are at increased risk for a number of health conditions, such as osteoporosis and heart disease. Medication, such as hormone therapy and/or healthy lifestyle changes, may reduce the risk of some of these conditions. Since every woman’s risk is different, talk to your doctor to learn what steps you can take to reduce your individual risk.

How long does perimenopause (the menopause transition) last?

The length of each stage of the menopause transition can vary for each individual. The average length of perimenopause is about four years. Some women may only be in this stage for a few months, while others will be in this transition phase for more than four years. If you have gone more than 12 months without having a period, you are no longer perimenopausal. However, if there are medications or medical conditions that may affect periods, it can be more difficult to know the specific stage of the menopause transition.

What is premature menopause?

Menopause, when it occurs between the ages of 45 and 55, is considered “natural” and is a normal part of aging. But, some women can experience menopause early, either as a result of a surgical intervention (such as removal of the ovaries) or damage to the ovaries (such as from chemotherapy). Menopause that occurs before the age of 45, regardless of the cause, is called early menopause. Menopause that occurs at 40 or younger is considered premature menopause.

Symptoms and Causes

What are the symptoms of menopause?

You may be transitioning into menopause if you begin experiencing some or all of the following symptoms:

• Hot flashes (a sudden feeling of warmth that spreads over the body).
• Night sweats and/or cold flashes.
• Vaginal dryness; discomfort during sex.
• Urinary urgency (a pressing need to urinate more frequently).
• Difficulty sleeping (insomnia).
• Emotional changes (irritability, mood swings, mild depression).
• Dry skin, dry eyes or dry mouth.

Women who are still in the menopause transition (perimenopause) may also experience:

• Breast tenderness.
• Worsening of premenstrual syndrome (PMS).
• Irregular periods or skipping periods.
• Periods that are heavier or lighter than usual.

Some women might also experience:

• Racing heart.
• Headaches.
• Joint and muscle aches and pains.
• Changes in libido (sex drive).
• Difficulty concentrating, memory lapses (often temporary).
• Weight gain.
• Hair loss or thinning.

These symptoms can be a sign that the ovaries are producing less estrogen, or a sign of increased fluctuation (ups and downs) in hormone levels. Not all women get all of these symptoms. However, women affected with new symptoms of racing heart, urinary changes, headaches, or other new medical problems should see a doctor to make sure there is no other cause for these symptoms.

What are hot flashes and how long will I have them?

Hot flashes are one of the most frequent symptoms of menopause. It is a brief sensation of heat. Hot flashes aren’t the same for everyone and there’s no definitive reason that they happen. Aside from the heat, hot flashes can also come with:

• A red, flushed face.
• Sweating.
• A chilled feeling after the heat.

Hot flashes not only feel different for each person — they also can last for various amounts of time. Some women only have hot flashes for a short period of time during menopause. Others can have some kind of hot flash for the rest of their life. Typically, hot flashes are less severe as time goes on.

What triggers a hot flash?

There are quite a few normal things in your daily life that could set off a hot flash. Some things to look out for include:

• Caffeine.
• Smoking.
• Spicy foods.
• Alcohol.
• Tight clothing.
• Stress and anxiety.

Heat, including hot weather, can also trigger a hot flash. Be careful when working out in hot weather — this could cause a hot flash.

Can menopause cause facial hair growth?

Yes, increased facial hair growth can be a change related to menopause. The hormonal change your body goes through during menopause can result in several physical changes to your body, including more facial hair than you may have had in the past. If facial hair becomes a problem for you, waxing or using other hair removers may be options. Talk to your healthcare provider about your options to make sure you don’t pick a product that could harm your skin.

Is having a hard time concentrating and being forgetful a normal part of menopause?

Unfortunately, concentration and minor memory problems can be a normal part of menopause. Though this doesn’t happen to everyone, it can happen. Doctors aren’t sure why this happens. If you’re having memory problems during menopause, call your healthcare provider. There are several activities that have been shown to stimulate the brain and help rejuvenate your memory. These activities can include:

• Doing crossword puzzles and other mentally stimulating activities like reading and doing math problems.
• Cutting back on passive activities like watching TV.
• Getting plenty of exercise.

Keep in mind that depression and anxiety can also impact your memory. These conditions can be linked to menopause.

Can menopause cause depression?

Your body goes through a lot of changes during menopause. There are extreme shifts in your hormone levels, you may not be sleeping well because of hot flashes and you may be experiencing mood swings. Anxiety and fear could also be at play during this time. All of these factors can lead to depression.

If you are experiencing any of the symptoms of depression, talk to your healthcare provider. During your conversation, your provider will tell you about different types of treatment and check to make sure there isn’t another medical condition causing your depression. Thyroid problems can sometimes be the cause of depression.

Are there any other emotional changes that can happen during menopause?

Menopause can cause a variety of emotional changes, including:

• A loss of energy and insomnia.
• A lack of motivation and difficulty concentrating.
• Anxiety, depression, mood changes and tension.
• Headaches.
• Aggressiveness and irritability.

All of these emotional changes can happen outside of menopause. You have probably experienced some of them throughout your life. Managing emotional changes during menopause can be difficult, but it is possible. Your healthcare provider may be able to prescribe a medication to help you (hormone therapy or an antidepressant). It may also help to just know that there is a name to the feeling you are experiencing. Support groups and counseling are useful tools when dealing with these emotional changes during menopause.

How does menopause affect my bladder control?

Unfortunately, bladder control issues (also called urinary incontinence) are common for women going through menopause. There are several reasons why this happens, including:

• Estrogen. This hormone plays several roles in your body. It not only controls your period and promotes changes in your body during pregnancy, estrogen also keeps the lining of your bladder and urethra healthy.
• Pelvic floor muscles. Supporting the organs in your pelvis — your bladder and uterus — are called the pelvic floor muscles. Throughout your life, these muscles can weaken. This can happen during pregnancy, childbirth and from weight gain. When the muscles weaken, you can experience urinary incontinence (leakage).

Specific bladder control problems that you might have can include:

• Stress incontinence (leakage when you cough, sneeze or lift something heavy).
• Urge incontinence (leakage because your bladder squeezes at the wrong time).
• Painful urination (discomfort each time you urinate).
• Nocturia (feeling the need to get up in the night to urinate).

Will I start menopause if I have a hysterectomy?

During a hysterectomy, your uterus is removed. You won’t have a period after this procedure. However, if you kept your ovaries — removal of your ovaries is called an oophorectomy — you may not have symptoms of menopause right away. If your ovaries are also removed, you will have symptoms of menopause immediately.

Diagnosis and Tests

How is menopause diagnosed?

There are several ways your healthcare provider can diagnose menopause. The first is discussing your menstrual cycle over the last year. If you have gone a full year (12 straight months) without a period, you may be postmenopausal. Another way your provider can check if you are going through menopause is a blood test that checks your follicle stimulating hormone (FSH) level. FSH is a hormone produced by the pituitary gland — this gland is located at the base of your brain. However, this test can be misleading during the beginning of menopause when your body is transitioning and your hormone levels are fluctuating up and down. Hormone testing always need to be interpreted in the context of what is happening with the menstrual period.

For many women, a blood test is not necessary. If you are having the symptoms of menopause and your periods have been irregular, talk to your healthcare provider. Your provider may be able to diagnose menopause after your conversation.

Management and Treatment

Can menopause be treated?

Menopause is a natural process that your body goes through. In some cases, you may not need any treatment for menopause. When treatment for menopause is discussed, it’s about treating the symptoms of menopause that disrupt your life. There are many different types of treatments for the symptoms of menopause. The main types of treatment for menopause are:

It is important to talk to your healthcare provider while you are going through menopause to craft a treatment plan that works for you. Every person is different and has unique needs.

What is hormone therapy?

During menopause, your body goes through major hormonal changes, decreasing the amount of hormones it makes — particularly estrogen and progesterone. Estrogen and progesterone are produced by the ovaries. When your ovaries no longer make enough estrogen and progesterone, hormone therapy can be used as a supplement. Hormone therapy boosts your hormone levels and can help relieve some symptoms of menopause. It’s also used as a preventative measure for osteoporosis.

There are two main types of hormone therapy:

• Estrogen therapy (ET): In this treatment, estrogen is taken alone. It’s typically prescribed in a low dose and can be taken as a pill or patch. ET can also be given to you as a cream, vaginal ring, gel or spray. This type of treatment is used after a hysterectomy. Estrogen alone can’t be used if a woman still has a uterus.
• Estrogen Progesterone/Progestin Hormone Therapy (EPT): This treatment is also called combination therapy because it uses doses of estrogen and progesterone. Progesterone is available in its natural form, or also as a progestin (a synthetic form of progesterone). This type of hormone therapy is used if you still have your uterus.

Hormone therapy can relieve many of the symptoms of menopause, including:

• Hot flashes and night sweats.
• Vaginal dryness.
• Irritability and mood swings.
• Hair loss.

Are there any risks related to hormone therapy?

Like most prescribed medications, there are risks for hormone therapy. Some known health risks include:

• Endometrial cancer (only increased if you still have your uterus and are not taking progestin together with the estrogen).
• Gallstones and gallbladder issues.
• Blood clots.

Going on hormone therapy is an individualized decision. Discuss all past medical conditions and your family history with your healthcare provider to understand the risks versus benefits of hormone therapy for you.

What are non-hormonal therapies for menopause?

Though hormone therapy is a very effective method for relieving menopause symptoms, it’s not the perfect treatment for everyone. Non-hormonal treatments include changes to your diet, lifestyle and using over-the-counter options. These treatments are often good options for women who have other medical conditions or have recently been treated for breast cancer. The main non-hormonal treatments that your provider may recommend include:

• Changing your diet.
• Avoiding triggers to hot flashes.
• Prescription medications, which have been shown to help.

Diet

Sometimes changing your diet can help relieve menopause symptoms. Limiting the amount of caffeine you consume every day and cutting back on spicy foods can make your hot flashes less severe. You can also add foods that contain plant estrogen into your diet. Plant estrogen (isoflavones) isn’t a replacement for the estrogen made in your body before menopause. Foods to try include:

• Soybeans.
• Chickpeas.
• Lentils.
• Flaxseed.
• Grains.
• Beans.
• Fruits.
• Vegetables.

Avoiding triggers to hot flashes

Certain things in your daily life could be triggers for hot flashes. To help relieve your symptoms, try and identify these triggers and work around them. This could include keeping your bedroom cool at night, wearing layers of clothing, or quitting smoking. Weight loss can also help with hot flashes.

Exercising

Working out can be difficult if you are dealing with hot flashes, but exercising can help relieve several other symptoms of menopause. Exercise can help you sleep through the night and is recommended if you have insomnia. Calm, tranquil types of exercise like yoga can also help with your mood and relieve any fears or anxiety you may be feeling.

Joining support groups

Talking to other women who are also going through menopause can be a great relief for many. Joining a support group can not only give you an outlet for the many emotions running through your head, but also help you answer questions you may not even know you have.

Can my doctor prescribe non-hormonal medications?

There are several non-hormonal medications that your doctor can prescribe. These are typically used to treat hot flashes. Speak to your doctor about what specific non-hormonal medications might work best for you.

Outlook / Prognosis

Can I get pregnant during menopause?

The possibility of pregnancy disappears once you are postmenopausal, you have been without your period for an entire year (assuming there is no other medical condition for the lack of menstrual bleeding). However, you can actually get pregnant during the menopause transition (perimenopause). If you don’t want to become pregnant, you should continue to use some form of birth control until you have gone fully through menopause. Ask your healthcare provider before you stop using contraception.

For some women, getting pregnant can be difficult once they’re in their late 30s and 40s because of a decline in fertility. However, if becoming pregnant is the goal, there are fertility-enhancing treatments and techniques that can help you get pregnant. Make sure to speak to your healthcare provider about these options.

What are the long-term health risks associated with menopause?

There are several conditions that you could be at a higher risk of after menopause. Your risk for any condition depends on many things like your family history, your health before menopause and lifestyle factors (smoking). Two conditions that affect your health after menopause are osteoporosis and coronary artery disease.

Osteoporosis

Osteoporosis, a “brittle-bone” disease, occurs when the inside of bones become less dense, making them more fragile and likely to fracture. Estrogen plays an important role in preserving bone mass. Estrogen signals cells in the bones to stop breaking down.

Women lose an average of 25% of their bone mass from the time of menopause to age 60. This is largely because of the loss of estrogen. Over time, this loss of bone can lead to bone fractures. Your healthcare provider may want to test the strength of your bones over time. Bone mineral density testing, also called bone densitometry, is a quick way to see how much calcium you have in certain parts of your bones. The test is used to detect osteoporosis and osteopenia. Osteopenia is a disease where bone density is decreased and this can be a precursor to later osteoporosis.

If you have osteoporosis or osteopenia, your treatment options could include estrogen therapy.

Coronary artery disease

Coronary artery disease is the narrowing or blockage of arteries that surround the heart muscle. This happens when fatty plaque builds up in the artery walls (known as atherosclerosis). This buildup is associated with high levels of cholesterol in the blood. After menopause, your risk for coronary artery disease increases because of several things, including:

• The loss of estrogen (this hormone also contributes to healthy arteries).
• Increased blood pressure.
• A decrease in physical activity.
• Bad habits from your past catching up with you (smoking or excessive drinking).

A healthy diet, not smoking and getting regular exercise are your best options to prevent heart disease. Treating elevated blood pressure and diabetes as well as maintaining cholesterol levels with medications for selected at-risk people are the standards of care.

Will hormone therapy help prevent long-term health risks?

The benefits and risks of hormone therapy vary depending on a woman’s age and her individual history. In general, younger women in their 50s tend to get more benefits from hormone therapy as compared to postmenopausal women in their 60s. Women who undergo premature menopause are often treated with hormone therapy until age 50 to avoid the increased risk that comes from the extra years of estrogen loss.

Living With

How do I know if changes in my periods are normal perimenopausal symptoms or something to be concerned about?

Irregular periods are common and normal during perimenopause (the menopause transition). But other conditions can cause abnormalities in menstrual bleeding. If any of the following situations apply to you, see a doctor to rule out other causes.

• Your periods are changing to become very heavy, or accompanied by blood clots.
• Your periods last several days longer than usual.
• You spot or bleed after your period.
• You experience spotting after sex.
• Your periods occur closer together.

Potential causes of abnormal bleeding include hormonal imbalances, hormonal treatments, pregnancy, fibroids, blood-clotting problems or, rarely, cancer.

Can menopause affect sleep?

Some women may experience trouble sleeping through the night and insomnia during menopause. Insomnia is an inability to fall asleep or stay asleep at night. This can be a normal side effect of menopause itself, or it could be due to another symptom of menopause. Hot flashes are a common culprit of sleepless nights during menopause.

If hot flashes keep you awake at night, try:

• Staying cool at night by wearing loose clothing.
• Keeping your bedroom well-ventilated.

Avoiding certain foods and behaviors that trigger your hot flashes. If spicy food typically sets off a hot flash, avoid eating anything spicy before bed.

Can menopause affect my sex life?

After menopause, your body has less estrogen. This major change in your hormonal balance can affect your sex life. Many menopausal women may notice that they’re not as easily aroused as before. Sometimes, women also may be less sensitive to touch and other physical contact than before menopause.

These feelings, coupled with the other emotional changes you may be experiencing, can all lead to a decreased interest in sex. Keep in mind that your body is going through a lot of change during menopause. Some of the other factors that can play a role in a decreased sex drive can include:

• Having bladder control problems.
• Having trouble sleeping through the night.
• Experiencing stress, anxiety or depression.
• Coping with other medical conditions and medications.

All of these factors can disrupt your life and even cause tension in your relationship. In addition to these changes, the lower levels of estrogen in your body can actually cause a decrease in the blood supply to the vagina. This can cause dryness. When you don’t have the right amount of lubrication in the vagina, it can be thin, pale and dry. This can lead to painful intercourse.

Don’t be afraid to talk to your healthcare provider about any decreases you are experiencing in your sex drive. Your provider will discuss options to help you feel better. For example, vaginal dryness can be treated with over-the-counter, water-soluble or silicone lubricants. Your healthcare provider can also prescribe estrogen or nonestrogen hormones to treat the vaginal tissue. This may be prescribed in a low-dose cream, pill or vaginal ring.

Do all menopausal women experience a decrease in sexual desire?

Not all women experience a decreased sexual desire. In some cases, it’s just the opposite. This could be because there’s no longer any fear of getting pregnant. For many women, this allows them to enjoy sex without worrying about family planning.

However, it is still important to use protection (condoms) during sex if not in a monogamous relationship. Once your doctor makes the diagnosis of menopause, you can no longer become pregnant. However, when you are in the menopause transition (perimenopause), you can still become pregnant. You also need to protect yourself from sexually transmitted infections (STIs). You can get an STI at any time in your life.

Will I still enjoy sex after menopause?

You should still be able to enjoy sex after menopause. Sometimes, decreased sex drive is related to discomfort and painful intercourse. After treating the source of this pain (vaginal dryness), many women are able to enjoy intimacy again. Hormone therapy can also help many women. If you are having difficulties enjoying sex after menopause, talk to your healthcare provider.

Can menopause be a positive time of life?

Menopause can certainly be a positive time of life. Too often, myths foster misconceptions about this normal process of aging. Although menopause can cause some noticeable and uncomfortable changes, these can be effectively managed.

Premature and early menopause – Better Health Channel

Menopause occurs when a woman stops ovulating and her monthly period (menstruation) ceases. Most women reach menopause between the ages of 45 and 55, with the average age being around 51. However, about one per cent of women experience menopause before the age of 40 years. This is known as premature menopause. Menopause between 41 and 45 years of age is called early menopause.

In some cases, early or premature menopause is brought on by surgical removal of the ovaries, or by medical treatments such as radiation therapy and chemotherapy. In the case of premature ovarian insufficiency (POI), the woman’s ovaries spontaneously stop producing eggs and the underlying cause may not always be found. For many women, the loss of their fertility is devastating, particularly if they had planned to have children and menopause occurs before they are able to. 

Most women with premature or early menopause will experience a long period of postmenopausal life. Unless there are reasons why a woman is unable to take hormone therapy, hormone treatment, which may be the combined oestrogen and progesterone oral contraceptive pill, or menopause hormone therapy (MHT) – also known as hormone replacement therapy (HRT) – will be recommended to counteract the health risks of early or premature menopause. These may include early onset of osteoporosis, and cardiovascular disease.

Symptoms of premature and early menopause

The symptoms of early menopause are the same as for menopause at the typical age and can include:

• menstrual cycle changes, including changes to the usual bleeding pattern, particularly irregular bleeding
• hot flushes
• sweats
• sleep disturbance
• urinary problems, such as increased frequency of urination or incontinence
• vaginal dryness
• increase in mood changes
• increase or decrease in weight
• aches and pains.

Causes of early or premature menopause

Premature menopause means a woman’s ovaries have spontaneously stopped working before she has reached the age of 40 years. Women can be affected in their teens or early 20s. About one in 1000 women reach menopause before the age of 30.

Some possible causes include:

• unknown causes – in the vast majority of cases (60%), the cause can’t be found. This is known as idiopathic premature menopause
• autoimmune conditions – about 10 to 30 per cent of affected women have an autoimmune disease such as hypothyroidism, Crohn’s disease, systemic lupus erythematosus or rheumatoid arthritis
• genetic conditions – about 5 to 30 per cent of women with early or premature menopause have an affected female relative, which suggests a genetic link. Genetic conditions which can lead to early or premature menopause include:  
  • galactosaemia – this is when the body cannot convert the carbohydrate galactose into glucose. It is thought that the unconverted galactose could be toxic to the ovaries
  • conditions characterised by enzyme problems, such as congenital adrenal hyperplasia
  • Turner’s syndrome – this chromosomal abnormality can cause early menopause, but this is usually evident before puberty
  • Fragile X premutation
• viral infections – the evidence is inconclusive, but it is thought that a viral infection, such as mumps or cytomegalovirus, could trigger premature menopause in some women.

Induced menopause

Menopause can be specifically induced for medical reasons, such as cancer surgery. For example, a woman with ovarian cancer will require surgery to remove her ovaries. 

Early menopause can also be triggered by radiation therapy or chemotherapy. About one in two women treated for leukaemia or Hodgkin’s disease will experience menopause early.

In cases of premature menopause caused by cytotoxic treatments such as chemotherapy, the ovaries can sometimes start working again after a period of time. This depends on many factors, including the woman’s age, the types of drugs used and the dosage. Chemotherapy for breast cancer in premenopausal women may also lead to early menopause. 

Diagnosis of premature or early menopause

Premature and early menopause is diagnosed using a number of tests including: 

• medical history, family history and medical examination
• investigations to rule out other causes of amenorrhoea (absence of periods), such as pregnancy, extreme weight loss, other hormone disturbances and some diseases of the reproductive system
• investigations into other conditions associated with premature or early menopause, such as autoimmune diseases
• genetic tests to check for the presence of genetic conditions associated with premature or early menopause
• blood tests to check hormone levels.

Treatment for early or premature menopause

There is no treatment available to make the ovaries start working again. 

Rarely, the ovaries may spontaneously start working again, for reasons unknown. According to some studies, about one in 10 women who are diagnosed with premature ovarian insufficiency (POI) get pregnant, for reasons that are not yet clear. 

Women with early menopause have a long period of postmenopausal life, which means they are at increased risk of health problems such as early onset of osteoporosis and heart disease. For this reason, it is recommended that they take some form of hormone therapy until they reach the typical age of menopause (around 51 years old). This may be the combined oestrogen and progestogen oral contraceptive pill, or menopausal hormone therapy (MHT). Either option treats menopausal symptoms and reduces the risk of early onset of osteoporosis and heart disease. 

Emotional impact of early or premature menopause 

Premature menopause can be emotionally devastating. Some of the common issues women may face include: 

• grief at the prospect of not having children
• fear of ‘growing old before their time’
• concern that their partner won’t find them sexually attractive anymore
• self-esteem problems.

Psychological counselling and support groups may help women come to terms with their experience of early or premature menopause. 

Genetic counselling

If you have been diagnosed with a genetic condition that is thought to have caused your premature menopause, it may be helpful to speak to a genetic counsellor. Genetic counsellors are health professionals qualified in both counselling and genetics. As well as providing emotional support, they can help you to understand the condition, what causes it, how it is inherited (if it is), and what a diagnosis means for your health and for your family. Genetic counsellors are trained to provide information and support that is sensitive to your family circumstances, culture and beliefs.

A genetic counsellor can also explain what genetic testing options are available to you and other family members. 

The Genetic Support Network of Victoria (GSNV) is connected with a wide range of support groups throughout Victoria and Australia and can connect you with other individuals and families affected by the condition.

Where to get help

Menopause – NHS

The menopause is when a woman stops having periods and is no longer able to get pregnant naturally.

Periods usually start to become less frequent over a few months or years before they stop altogether. Sometimes they can stop suddenly.

The menopause is a natural part of ageing that usually occurs between 45 and 55 years of age, as a woman’s oestrogen levels decline. In the UK, the average age for a woman to reach the menopause is 51.

But around 1 in 100 women experience the menopause before 40 years of age. This is known as premature menopause or premature ovarian insufficiency.

Symptoms of the menopause

Most women will experience menopausal symptoms. Some of these can be quite severe and have a significant impact on your everyday activities.

Common symptoms include:

Menopausal symptoms can begin months or even years before your periods stop and last around 4 years after your last period, although some women experience them for much longer.

When to see a GP

It’s worth talking to a GP if you have menopausal symptoms that are troubling you or if you’re experiencing symptoms of the menopause before 45 years of age.

They can usually confirm whether you’re menopausal based on your symptoms, but a blood test to measure your hormone levels may be carried out if you’re under 45.

Treatments for menopausal symptoms

Your GP can offer treatments and suggest lifestyle changes if you have severe menopausal symptoms that interfere with your day-to-day life.

These include:

Your GP may refer you to a menopause specialist if your symptoms do not improve after trying treatment or if you’re unable to take HRT.

What causes the menopause?

The menopause is caused by a change in the balance of the body’s sex hormones, which occurs as you get older.

It happens when your ovaries stop producing as much of the hormone oestrogen and no longer release an egg each month.

Premature or early menopause can occur at any age, and in many cases there’s no clear cause.

Sometimes it’s caused by a treatment such as surgery to remove the ovaries (oophorectomy), some breast cancer treatments, chemotherapy or radiotherapy, or it can be brought on by an underlying condition, such as Down’s syndrome or Addison’s disease.

Page last reviewed: 29 August 2018
Next review due: 29 August 2021

90,000 MENOPAUSE, CLIMAX: learn, heal and not be afraid

The extinction of the ovarian function carries with it a train of changes in the female body. Menopause, or menopause. What every woman should know in order to enter this period as comfortably as possible.

We are talking with Yulia Medvedeva, a gynecologist-endocrinologist of the Interdistrict Department of Family Health.

– Yulia Gennadievna, here the ovaries reduce the production of estrogen, and here they say about this age “baba berry again”.What good is it when this is the start of various problems?

– I would not say that there are no advantages. There are also many advantages to age. A woman gains life experience, she looks more calmly at everyday troubles, becomes wiser. Step – this is how menopause is translated. We just go to another level. But not all women have a negative experience of the manifestation of menopause, a certain percentage endure this period without pathological symptoms. They just get amenorrhea. Apparently, these women are so genetically programmed.

– Is the onset of menopause menopause?

– Menopause begins from the last menstruation onwards. Menopause and menopause are synonymous.

– How does menopause usually go? What is a woman experiencing?

– Menopause is such a symptom complex that not only changes the female genital area, but also many other organs and systems. For example, if before the age of 40 a woman had no risk of myocardial infarction, now the risk increases significantly, and these diseases are more severe than in men.Immediately, as a rule, blood pressure rises, migraines occur. In women with a low estrogen background, the bone apparatus suffers: osteopenia develops, the leaching of calcium from the bones. When we do densometry at 40-45 years old, we see osteopenia in 70% of patients. Today it is osteopenia, and in a year it is osteoporosis, that is, the risks of fractures of the hip neck and lumbar vertebrae increase. But the first thing that suffers, I repeat, is the cardiovascular system. As soon as estrogens drop, heart disease develops.

– Then every woman would have a sick heart.

– Our women are not examined. And after all, everyone has a different supply of estrogen, everything is individual here. But the heart gets hit first, with the onset of menopause the number of heart attacks increases significantly. Further there may be vegetative manifestations: hot flashes, fever. Menopause proceeds in different directions. Some people may have hot flashes during a normal cycle, while others do not have their periods, but they do not. This is genetically determined.A woman can look at her mother, grandmother and expect the same in herself.

– If we talk about the naturalness of the process, but with the “cure” approach, this is puzzling. Is it necessary to treat what is natural?

– But there is a pathological menopause. It is called “a symptom of climacteric disorders”, that is, having vegetative disorders, and it must be treated. But it is imperative to check with a doctor, regardless of the presence of menopause symptoms.

– Why does the body react so sharply to a decrease in estrogen levels?

– Because there are estrogen receptors throughout the body that must receive this hormone. They are found in bones, joints, heart muscle, blood vessels.

– They talk about the pathological and physiological course of menopause. What is the difference? And which is more natural: to experience a range of vasomotor difficulties or to go through the menopausal period unnoticed?

– I don’t think it’s correct to ask that.

– Why?

– Because it is genetically determined. As we can judge, one leg has curves, the other has straight – which of them is healthier and more genetically correct, if everything in her family has crooked legs? All people are individual, and women cannot be approached with one standard. If she has vegetative symptoms, we must correct them. If they are not there, the woman lives quietly further, and we must examine her according to the standards and be calm if her indicators do not require correction yet.But surveys need to be done annually. After all, we cannot know what health a woman will have next year.

– Let’s be honest. When a woman comes to the gynecologist for MHT (menopausal hormone therapy), she is often not prescribed any tests.

– How so? There is an order from the Ministry of Health – screening before prescribing HRT. There should be mammography with a shelf life of no more than a year, cytology with a shelf life of a year, biochemistry with a lipid spectrum of blood, a coagulogram and blood insulin should be looked at.This is what will determine if hormone therapy is allowed. But if a woman does not ask so much for hormonal drugs, then there is no need to persuade her, because the risk of negative manifestations from the female reproductive system is very high for some.

– There are studies that claim that with hormone therapy in menopause, in some cases, women have increased cancer risks.

– But there are other studies, the statistics are still controversial.There is no clear data yet. But our health ministry has put hereditary cancer on the list of contraindications. If a woman has a history of operated on cervical cancer, or it has been with close relatives, this is an absolute contraindication. What to invent a bicycle, we work according to orders.

– Does hormone therapy always solve problems?

– This should be decided by the doctor tête-à-tête. There is a whole range of contraindications for hormone therapy.

– But in another number of cases, HRT solves the problem of a woman in menopause?

– Yes.

– How long can hormone therapy last without harm to health?

– The doctor decides everything under individual supervision. A safe duration of admission is considered 5 years. And then the cards will lay down. Ideally, of course, the longer the better, because you keep your youth. There are women who take synthetic drugs for 7-8 years. And there are those in whom you see bad mastopathy, hyperplasia, so you must immediately cancel it. That’s what observation is for.

– How often should a woman see a doctor on MHT?

– At the first dose in a month and then every six months.

– What is your opinion that hormone therapy should be started in advance, without waiting for the unpleasant manifestations of menopause?

– Now according to the latest recommendations, only in the period when the last menstruation ends, and not earlier than in a year. It is hormonal therapy.

– And if a woman begins to experience negative feelings before that?

– Phytopreparations exist.

– They may not relieve symptoms, not help a woman, but you do not recommend taking hormones, what should I do?

– It is necessary to select phytopreparations, there is a wide range of them now. Someone will help.

– Are synthetic hormones and their plant forms, herbal medicine in the form of dietary supplements equally effective? Are there studies to support the effectiveness of herbal remedies in menopause?

– These are phytoestrogens and it doesn’t matter what they are called.There are many studies that show their effectiveness. When they give lectures on menopause, no one calls them dietary supplements. They have a hormone-like effect anyway, and not all dietary supplements have such an effect. Phytoestrogens do not have the obvious side effects of hormones. They will suit a wider range of women, and you need to start with them.

– If a woman is not worried about anything, is it really necessary to go to a gynecologist with the fact that her period is over?

– According to the orders, once a year a woman must come to the gynecologist, take cytology and do mammography or ultrasound of the mammary glands, according to age.But in general, people come to us mainly with complaints about pathological manifestations of perimenopause, and then we understand where to go next and how to help. As a rule, when the cycle is broken, their manifestations immediately begin. This is happening at the same time.

– Does this mean that from now on you can not use protection?

– No, it doesn’t. Violation of the cycle does not mean that there can be no independent ovulation, it is imperative to think over contraception for women 45+.She is picked up by a doctor.

– But can you live without hormone therapy?

– You can.

– Sometimes hormones are not allowed. What to do then?

– There are micro doses, but they, as a rule, do not remove hot flashes, they are only to maintain the cardiovascular system. And then there is the placebo effect, and the woman feels better. Hot flashes often subside over time.

– Give general advice to women who have entered or who are yet to enter the mature stage of life.

– Come and deal with the doctor. Everything is individual, you cannot buy the drug, like a friend. Sometimes these symptoms mask other endocrine problems, such as thyroid disease. There are vegetative problems: memory loss, cycle disturbances, so I also prescribe TSH to my patients, and some of them have thyroid disease. Therefore, it is impossible to independently treat menopause with female hormones, it may be other endocrine diseases. There are such cases in practice.

Interdistrict Family Health Department

Consultations, diagnostics and prescription of treatment for women in menopause.

Sign up by phone. 8 (3519) 34-32-41; 8 (3519) 34 – 04 – 23.

Address: Southern complex GAUZ “City Hospital No. 2”, st. Labor, 36.

N.S. Cherepanova, press service of GAUZ “City Hospital No. 2, Magnitogorsk”

90,000 Let’s Talk Menopause – Kemma

Many women ask questions: when menstruation stops at the age of 45 and older – is it “menopause”? What to do? Do I need some kind of treatment?

To answer these questions, let’s start with a little theory: let’s define the concepts of “Menopause” and “climacteric syndrome”.

Menopause (synonyms for menopause, menopause) is the absence of menstruation for 12 months, due to a decrease in ovarian function. This is a normal physiological process. Natural menopause occurs in women between the ages of 45 and 50. If menstruation stops earlier than 40-45 years old, it is considered early menopause. If menstruation stops at the age of more than 50 years – late. There is a concept of natural menopause (“extinction” of the ovaries is associated with age-related depletion of the ovarian supply of eggs) and artificial (caused by surgical removal of the ovaries, radiation or drug exposure).

Menopause syndrome (pathological menopause) is a pathological condition that occurs in some women in the menopausal period. It can manifest itself as vegetative-vascular symptoms (“hot flashes”, a sudden feeling of heat, skin redness, increased or decreased blood pressure, increased sweating), neuropsychic symptoms (mood lability, increased anxiety, aggressiveness, tearfulness, general weakness, drowsiness, forgetfulness, decreased libido, inattention, etc.), metabolic and trophic disorders (dry skin, vaginal mucosa, brittle nails, wrinkles, hair loss, decreased bone density, etc.)

So, any therapy should be carried out either for prophylactic purposes, or for the purpose of treating an already formed disease.

It is generally accepted that hormone replacement therapy should be prescribed to women whose ovaries are removed (at any age) and / or symptoms of menopause have begun, i.e.that is, a “disease” appeared, that is, in the following cases:

1. Climacteric syndrome and urogenital atrophy (dryness, burning sensation of the external genital organs, the presence of diseases associated with a decrease in the effect on the tissues of “female” sex hormones, such as leukoplakia, constantly showing inflammation in the vagina, in the tissues of the cervix) – i.e. e. developed symptoms of climacteric syndrome
2. Surgical removal of ovaries at any age, regardless of the presence of manifestations of climacteric syndrome.
3. Already diagnosed osteoporosis and osteopenia (decreased bone mineral density, risk of pathological fractures even from minor injuries)
4. Prevention of osteoporosis in women with surgical menopause, premature menopause and secondary amenorrhea.

If a woman does not suffer from symptoms of pathological menopause, the appointment of hormonal therapy is not recommended. But!! preventive therapeutic measures are required, both medication (non-hormonal) and non-medication:

1. Complexes of special physiotherapy exercises have a good effect.It has been proven that daily exercise has a positive effect on various mechanisms of the nervous system, which is very important for reducing psychoneurotic symptoms. Physiotherapy exercises can be recommended in the form of morning exercises or group exercises. The type of exercise and its amount is determined by the doctor. Regular physical activity, especially walking, increases oxygen metabolism, lowers insulin levels, and normalizes carbohydrate metabolism.
2. Weight control is also included in the complex of non-drug therapy.Proper nutrition is very important. A woman’s diet should be dominated by vegetables and fruits, vegetable fats. Limit your carbohydrate intake. During this period, it is recommended to include in the daily diet foods rich in phytoestrogens, for example, soy, flaxseed oil, parsley leaves, etc.
3. Vitamin deficiency is replenished with the help of vitamin complexes, which must include vitamins A, C, E.
4. Drug therapy It is mainly used to treat moderate to severe climacteric syndrome to normalize the state of the nervous system.For this purpose, sedatives may be recommended to the patient. With prolonged climacteric syndrome, accompanied by chronic diseases, tranquilizers, antidepressants and antipsychotics are prescribed.

Hormone replacement therapy

Recommended in the absence of any effect from non-hormonal therapy. It is carried out in order to compensate for age-related hormonal changes occurring in a woman’s body during menopause.

Hormonal preparations are selected strictly individually, depending on the absence or presence of menstruation, symptoms that have appeared, their severity, the presence or absence of other chronic diseases, and the results of a preliminary examination.

This allows you to plan the duration of therapy, types of hormonal drugs and their dose.

Depending on the clinical manifestations of the syndrome in each specific case, estrogens, gestagens and their various combinations can be used. A prerequisite for effective hormone therapy is the individual selection of drugs and their doses, taking into account the degree of hormonal deficiency in the patient. Any hormones should be prescribed only by the attending physician obstetrician-gynecologist and taken under strict supervision.It is usually recommended to start therapy no later than the first 6-12 months after the first appearance of hot flashes and other symptoms. At the initial stage, symptoms are much easier to correct, and also more likely to prevent the development of a severe form of the syndrome. It is not recommended to start hormone therapy if the woman has been absent for more than five years.

There are also non-hormonal (homeopathic) remedies with hormone-like action. It is also best to pick them up with a doctor.

Given the above information, I would recommend that women over 45 years old visit an obstetrician-gynecologist in order to assess their current health and take preventive measures to reduce the risks of menopausal syndrome and early menopause.

And for women who are already worried about the above symptoms, I recommend to undergo a more complete examination: consultation, examination, ultrasound of the pelvic organs, mammography (according to indications, ultrasound of the mammary glands), cytology from the cervix, cervical canal, colposcopy, complete blood count , blood test for fasting glucose, cholesterol, lipid profile, biochemical blood test with electrolytes, densitometry (assessment of bone density), blood test for TSH, vitamin D.If necessary – consultation of a therapist, endocrinologist, neuropathologist.

Based on the results of the examination, the doctor will recommend you one or another method of treatment and / or prevention of menopause pathology.

Climax (Menopause)

Menopause – a new stage of life, a step between youth and old age. This is a difficult period for every woman, socially, professionally and biologically.“In the worries of a woman during menopause, the worries of a teenage girl come to life: again, body image and attractiveness become important moments in life,” writes psychologist Irina Mikhina.

Climax. What is it

Has nature given a lot of time for a woman to reproduce?
The reproductive system has a certain time limit for childbirth, and this is reasonable: a woman must have time to raise her child, to put him on his feet. And if the woman in labor is, say, 70 years old? Therefore, with age, before menopause, the number of follicles with eggs in the ovary decreases – both the ability to conceive and the level of sex hormones decrease.

Climax – age-related changes in the woman’s body, the period of extinction of sexual functions, the gradual cessation of menstruation, the end of the childbearing period. This is a physiological process, the reason for its occurrence lies in hormonal changes in the body. Moreover, it takes place in every woman in different ways: some do not even notice its onset, while others suffer from menopausal symptoms. This period can be divided into two phases: premenopause and postmenopause.

Premenopause is the initial stage when the ovaries gradually decrease their functioning. It is characterized by a change in the intervals between menstruation, a change in their duration and the amount of outgoing blood. This period can last from two to six years. Postmenopause is the period from the last menstruation to the end of the functioning of the ovaries, it lasts up to eight years. The average age of the onset of menopause is about 50 years. Early menopause can occur at 35-40 years old, late – at 55-65 years old.

Climax can occur not only due to the natural restructuring of the body, but also due to gynecological surgery (so-called surgical menopause), for example, removal of the ovaries. Moreover, the cause of menopause can be not only the fact of the operation, but also a certain psychological state after the operation, caused by infertility, stress, psychological trauma.

The most dangerous companion of menopause is a change in calcium metabolism. The absorption of calcium, which provides bone density, is also influenced by the level of hormones, primarily estrogen.Therefore, the “strongest” bones are in women aged 25-30, and then the bone density begins to decrease by 0.1-0.2% per year. With menopause, this process accelerates to 3-4% per year, after its end it goes a little slower, at the level of 2% and leads to a significant thinning of bone tissue – osteoporosis. The resulting fragility of bones is the main threat to the life of older women. And that is why it is so important to start early hormone replacement therapy (HRT), which will help maintain sufficient bone density.

At the onset of climax it is necessary to consult a gynecologist and visit him about 2 – 3 times a year. You will be offered to undergo an examination, because menopause for each woman is individual and involves various methods of correction and will prescribe an individual, suitable treatment for you.

Remember that only a gynecologist will select the correct therapy for you, not a pharmacist in a pharmacy!

90,000 health of women during menopause “Medvestnik

G hormonal therapy can reduce b iomarkers of inflammation in women at the beginning of menopause

Hormone therapy (HT) with estradiol has been shown to reduce biomarkers of inflammation associated with atherosclerosis in postmenopausal women.This conclusion was made by experts from the University of Southern California, reports the Healio portal.

Researchers analyzed data on the effect of HT on biomarkers of inflammation in 535 healthy postmenopausal women who participated in the ELITE (Early Versus Late Intervention Trial With Estradiol), which compares early and late estradiol treatment. The average age of the participants was 60.6 years. The subjects were divided into 2 groups: the first included women in early postmenopause (n = 227), and the second – in late postmenopause (n = 308).Participants were randomly assigned to take oral 17-beta-estradiol (1 mg on average over 5 years) or placebo. The experts measured 12 biomarkers of inflammation from collected serum samples from women at the time of enrollment, after 12 months and 36 months of follow-up.

The analysis found that, compared with the placebo group, participants who received HT had, on average, reduced levels of E-selectin (mean difference –0.131), intercellular adhesion molecule-1 (ICAM-1) (mean difference –0.037) , interferon gamma (mean difference –0.144) and interleukin-8 (mean difference –0.249).It has been noted that greater reductions in inflammation biomarkers were observed in early postmenopausal women.

In conclusion, the experts stressed the need for further research among the wider population to confirm their findings.

Potential of aestrol for the treatment of menopausal symptoms investigated

According to a team of scientists led by experts from the Yale Diabetes Center, aestrol may improve the safety profile for the treatment of menopausal symptoms in women.

In a randomized, double-blind, placebo-controlled study published in the August issue of the journal Menopause, experts from the University of Liege, Belgium, conducted an analysis of 257 postmenopausal women (32 of them underwent bilateral oophorectomy). The age of the participants was 40 – 65 years old. All subjects reported 7 or more moderate or severe hot flashes per day. The patients were divided into groups according to which they were prescribed to take 2.5, 5, 10 or 15 mg of estrol or placebo once a day for 12 weeks.

Found that the rate of moderate to severe hot flashes decreased in all women who took estrol in any of the dosages. This trend was most clearly seen when comparing participants who used 15 mg of estrol, with those who were prescribed a placebo, at 4 weeks (a decrease of 66% versus 49%) and 12 weeks (82% versus 65%). At the same time, endometrial hyperplasia was not observed.

An association was found between symptoms of menopause and an increased risk of CVD and stroke

Women with two or more moderate or severe symptoms of menopause have an increased risk of cardiovascular disease (CVD) and stroke.This conclusion was made by scientists from the State Institute of Heart and Vascular. Hershey in Pennsylvania (Penn State Heart and Vascular Institute in Hershey, Pennsylvania).

The trial reviewed data from the Women’s Health Initiative-Calcium and Vitamin D trial, double-blind, randomized, placebo-controlled trial in 36282 postmenopausal women. The age of the participants was 50 – 79 years old. The subjects were randomly assigned to two groups: one woman was given a placebo and the other was given 1000 mg of calcium carbonate and 400 IU (international units) of vitamin D per day.The average follow-up period for the participants was 7 years.

Results showed no association between the severity of vasomotor symptoms and any of the health outcomes included in this study. However, experts found that women who reported two or more symptoms of menopause had a higher overall risk of CVD (relative risk (RR) 1.35) and stroke (RR 1.4) compared with participants without such symptoms. … In addition, subjects who reported one symptom of menopause also found an increased risk of stroke (RR = 1.2) compared to asymptomatic women.

What you need to know and do with menopause

Nature is arranged in such a way that a woman goes through several stages during her life. First, the girl becomes a woman – she starts menstruating and has the opportunity to become pregnant and give birth to children. By the age of 50, when carrying a pregnancy, giving birth to healthy children and raising them is already problematic, the next stage begins – the stage of attenuation of the reproductive function, which manifests itself as the cessation of menstruation – menopause.

Climax does not occur instantly.And not even in six months – a year. This process develops systematically and in stages, it can last 2-5 years.

The average age of its onset in women is 52 years. But this is preceded by various, but quite definite complaints that appear precisely at menopause. And with this complex of complaints, women of 45-50 years old most often turn to a therapist (according to various statistics, up to 80% of women after 50 years of age are observed and receive treatment from a therapist, while a gynecologist provides, at best, advice).Meanwhile, more often than not, these are the first signs of menopause and the approaching menopause. These complaints include:

• excessive sweating
• hot flashes (sometimes, up to 20-30 times a day)
• increase in blood pressure,
• vision problems,
• heartbeat,
• increased headaches,
• frequent urination,
• irritability, depression,
• decreased sex drive,
• dry skin,
• dry vagina,
• hair problems (loss),
• insomnia,
• A sharp significant increase in weight (in the absence of changes in lifestyle and diet).

All these are hormone-dependent processes: “The late reproductive period and the period of menopause is associated with a deficiency of the main female sex hormones – estrogens. Estrogen deficiency is associated not only with a complex of vegetative-vascular disorders, but also with psycho-emotional and metabolic-endocrine manifestations. Further, such estrogen-deficient states as dryness in the vagina, frequent urination, etc., make themselves felt. Osteoporosis is a separate serious problem ”(Ekaterina Alekseevna Reisner, Ph.MD, obstetrician-gynecologist)

It is also arranged by nature that a healthy woman should go through a period of menopause without any special inconveniences, noticing only that menstruation has stopped. “However, due to poor ecology, highly artificial nutrition, incessant stress and a sedentary lifestyle, the internal adaptive reserves of the female body are depleted by menopause and cannot ensure a smooth transition to a new stage of life – menopause” (Alexander Sergeevich Gavrilenko, Ph.D., obstetrician-gynecologist, homeopath).

What to do?

Yes, when such complaints appear, you can first visit a therapist or specialized specialists (neurologist, ophthalmologist, urologist, cardiologist, etc.). If no pathological conditions have been identified, then the next mandatory step is a visit to the gynecologist. But you can immediately contact a gynecologist. In the Territory of Health, we always conduct a general examination of women of this age in order to assess the state of women’s health:

• doing mammography,
• we are doing an ultrasound of the pelvis and abdominal cavity.
• we take scraping for oncocytology,
• we look at the indicators of LH and FSH in the blood,
• we look at the indicators of the coagulation system,
• we watch the level of sugar, cholesterol,
• assess the condition of the veins in the legs (externally and with the help of USG (ultrasound),
• We are performing densitometry (assessment of bone density).

The sooner you seek help, the softer the correction of your condition can be, the more effective the help (including hormonal ones!) Will be.At the first stage – when you are just entering the late reproductive period, and when changes in the body, at times, are noticeable only by blood tests for hormones (LH FSH) – may be enough targeted herbal medicine, individually selected homeopathy, acupuncture, yoga, qigong. In some cases, temporary relief can be provided by sedatives, electrosleep, etc. But that doesn’t solve the whole problem.

“Of course, it would be correct to approach menopause in the most healthy state that you inherited.To a large extent, individual homeopathic treatment can help preserve and prevent splashing your health. Correctly selected homeopathy will be able to delay the premature onset of menopause and support the fading production of its own hormones, approach the climacteric period softer, without many unpleasant symptoms. “(Alexander Sergeevich Gavrilenko, Ph.D., obstetrician-gynecologist, homeopath)

Hormone replacement therapy.

• This is a quick and effective way to cope with the manifestations of climacteric syndrome and reduce the risk of climacteric complications.“Most women need hormonal adjustments. We can give a “pill” and return it 5-10 years ago! Moreover, the earlier you start taking the selected hormonal drugs, the more lasting the effect they will bring. There is a concept of a “therapeutic window”: if a woman does not take hormones for 5 years after the onset of menopause, then she acts worse. In every cell, in every tissue there are receptors for sex hormones, and if they do not receive them from year to year, the receptors will atrophy. “(Galina Vladimirovna Ovsyannikova, obstetrician-gynecologist). One caveat – hormone replacement therapy is not suitable for everyone, it has many contraindications. According to scientific studies, the positive effect is clearly higher than the possible risks and harm in only 15% of women. That is why women who are on hormone replacement therapy are examined annually in order to understand whether it is possible to continue taking medications further.
• Contrary to popular belief, women on hormone replacement therapy do not have a higher risk of cancer than others.It’s just that these women visit a gynecologist regularly, and cancer is diagnosed in them more often at earlier stages. According to oncology, all women of late reproductive age are at risk, regardless of whether they are taking hormones or not.
• “People are often afraid of hormone therapy. At receptions I am often asked the question – “if I drink hormones, will I get fat, my mustache will grow? … And then I answer: “Now, if you do not drink hormones, you run the risk of getting fat, and your mustache may grow.”There is a difference – will the climax start at 50 or will it be postponed until 57? This is a choice of a woman’s quality of life. Her health ”(Galina Vladimirovna Ovsyannikova, obstetrician-gynecologist).

Possible complications of late reproductive age (problems solved by hormone-sensing therapy).

• Endometrial hyperplasia (often occurs when a violation, lengthening of the cycle, when several periods fall out, which then provokes prolonged and heavy bleeding). In case of hyperplasia, most often – according to the results of an ultrasound scan – they are sent for scraping.And then hormonal blockage of the ovaries is prescribed to avoid the re-growth of the endometrium. We prefer to send for scraping only in extreme cases (with prolonged bleeding, with a high degree of growth). If the growth of the endometrium, detected by ultrasound, is small, then we recommend observation until the natural onset of menopause in order to carry out curettage. We will definitely do a “pipe-test”, which allows us to monitor with great reliability the benign quality of the processes in the uterus, take an analysis for tumor markers and release it for follow-up (after three months, then every 6 months).
• Risk of diabetes mellitus. An increase in insulin and blood sugar levels in the pre-menstrual period may indicate a predisposition to diabetes.
• Osteoporosis (fragility of bones). “Densitometry” (examination for bone density) is very important. It is corrected hormonally in combination with calcium supplements.

Menopause treatment, diagnostics in Kazan – “Scandinavia” Kazan

When menopause comes

On average, regular periods stop at age 45.Each woman has her own biological age of the onset of menopause. The period of perimenopause, when the menstrual cycle is disturbed, but menstruation comes, can last for several years. Menopause comes with the last menstrual period.

A sign of the onset of menopause may be the absence of menstruation throughout the year. Also, menopause can be determined using ultrasound and examination of the patient’s hormonal levels.

Menopause can occur earlier – both at 35 and at 30 years old – due to genetic abnormalities or surgical interventions.Hormone tests can be used to assess ovarian reserve.

Climax is the period of natural extinction of the function
the ovaries, through which any woman passes.
Ovaries stop producing estrogen – female
sex hormones – why women face
with a significant deterioration in the quality of life.
The specialists of “Scandinavia” (“Ava-Kazan”) help to choose the right one
hormonal drugs and control their action.

Menopause symptoms

In 40% of women, menopause is accompanied by symptoms that seriously reduce the quality of life:

• Hot flashes and chills in the face and neck;
• Excessive sweating;
• Increased fatigue;
• Headaches;
• Irritability, depression, mood swings;
• Frequent urination;
• Vaginal dryness.

Sabirova Firaya Maratovna
General Director of JSC “Scandinavia” (“Ava-Kazan”) “,
Obstetrician-gynecologist-reproductologist of the highest category

“Climax is a multifaceted problem, because complications arise that are not related to gynecology: with the cardiovascular, skeletal systems, neurology. But a woman should know that menopause is not hopelessness, and by working with it, old age can be delayed.”

The decline in reproductive function increases the risk of developing cancer, endocrine, cardiovascular, urological diseases and diseases of the skeletal system.

With the onset of menopause, a woman is more prone to hypertension, heart attacks and strokes. The mammary gland, genitals, pelvic muscles, skin are all also dependent on estrogen. When the ovaries stop producing female hormones, the walls of the vagina descend, and there are frequent urges to use the toilet.Since estrogens are involved in the metabolism of glucose and calcium in the body, with menopause, a woman begins to manifest diabetes mellitus and osteoporosis.

Hormone therapy for menopause

The only way to avoid the effects of menopause is hormone replacement therapy. The drugs work like their own estrogens and have a prophylactic effect on estrogen-dependent systems and organs.

However, just go to the pharmacy and buy hormonal
drugs are not allowed – you must first go through
preliminary examination to avoid complications.

For the initial assessment of the condition of a woman in the climacteric period in “Scandinavia” (Ava-Kazan) carry out:

• Specialized consultation of a gynecologist on menopause;
• Consultation of an endocrinologist;
• ultrasound;
• Mammography;
• General smear for flora;
• Oncocytology smear / colposcopy;
• ECG;

If necessary – consultation of a therapist, cardiologist, vascular surgeon and psychotherapist.

For your convenience, Antiage

checks have been developed

The doctor examines the function of the thyroid gland. The gynecologist must make sure that the woman does not have large myomatous nodes and tumor processes, even benign ones. In addition, related specialists check the condition of the mammary glands, liver, cardiovascular system and hemostasis. Non-hormonal drugs may be sufficient to relieve symptoms.

Health control in “Scandinavia” (“Ava-Kazan”)

The main thing in hormone therapy is monitoring the patient’s condition.After prescribing the drugs, even if the woman has no complaints, she comes to the “Scandinavia” (“Ava-Kazan”) clinic every three months, where specialists study the effect of hormones on the thyroid gland, mammary gland and hemostasis. If there is a negative effect of hormones, the drug is replaced with another one. After two years of using one hormonal agent, once a year is sufficient.

A specialized reception for menopause in “Scandinavia” (“Ava-Kazan”) is a consultation with a gynecologist who understands the problems of patients, a full range of necessary examinations in one institution and the availability of related specialists.

“We want people to take care of their health. And we are ready to help them, but they must come to us. Working with menopause is a postponement of old age ”, – notes Firaya Sabirova.

Sabirova Firaya Maratovna

General Director of JSC “Scandinavia” (“Ava-Kazan”) “,
Obstetrician-gynecologist-reproductologist of the highest category

90,000 signs, symptoms, at what age does it start and how to relieve the condition?

Alarming thoughts about menopause begin to visit women long before the first signs of menopause appear.According to statistics, at the age of 35, most women are thinking about how menopause will change their lives. Sometimes women are so afraid of these changes that they even acquire neurosis for themselves. Meanwhile, menopause is not at all as terrible as it seems – you just need to know what to prepare for.

Stages of Menopause, or New Stages in a Woman’s Life

Menopause is the period when the body prepares to “turn off” the reproductive system. During this time, the amount of estrogen, the female sex hormone, decreases, and this process is accompanied by a variety of changes in health.The extinction of ovarian functions is a long process that takes 5-6 years, and sometimes more.

Menopause begins approximately 2 years before the last menstrual period and ends 3-4 years after it.

This whole long process can be divided into three stages:

Premenopause

On average, it begins at the age of 45, although this is very individual – sometimes the first signs appear at the age of 38-40, and sometimes women are almost until the 50th birthday they do not feel any changes.The ovaries are still working, but menstruation becomes irregular, and the intervals between them increase. During this period, a woman may feel hot flashes for the first time, some note a decrease in libido, bouts of blues and headaches.

Menopause

The average age of a woman at the time of menopause is 50–53 years. The ovaries stop working, menstruation stops, although they can still come with a very long interval. The changes caused by the lack of estrogen begin to manifest themselves especially clearly.During this period, the bones become fragile, the development of cardiovascular diseases and even diabetes mellitus is possible.

Postmenopause

This term refers to the period from the last menstruation to the end of life. During postmenopause, all the unpleasant symptoms that plagued with menopause, as a rule, disappear.
Most of the climacteric symptoms occur during premenopause and menopause. Both of these periods together can last an average of 5 to 10 years.

Menopause signs: first alarm bells

Menopause manifests itself in different ways.However, you should not think that you will definitely have to feel all the unpleasant symptoms on yourself at once. More than half of women admit that they experience only minor inconveniences, every tenth does not experience the typical signs of menopause at all. The discomfort associated with the approach of menopause affects only a third of all women. However, it is necessary to know how menopause manifests itself.

Hot flashes

This is perhaps the most typical sign of menopause. Hot flashes are a sudden increase in body temperature – it seems that the face is “on fire”, red spots appear on the neck and chest.Hot flashes occur regularly, up to several times a day.

Sweating

Usually, excessive sweating does not occur on its own, it only accompanies hot flashes.

Bone fragility

During menopause, the body loses calcium, making bones fragile. Scientists have calculated that during menopause, a woman loses up to 2-3% of bone mass annually.

Changes in appearance

Gradually the fatty layer under the skin atrophies, the amount of collagen that kept the skin smooth and elastic decreases.The skin becomes thin, wrinkles appear. With age, metabolism slows down and women notice that they begin to gain weight, even if they do not change the principles of a healthy diet.

Attacks of weakness

Often women after menopause complain of an unreasonable loss of strength and decreased performance.

Emotional instability

Menopause affects not only the physical, but also the psychological state – some women note that they have become more irritable than usual, others often feel melancholy and melancholy, others complain of tearfulness and sentimentality that is unusual for them.Very rarely, a low mood can even lead to depression.

Sleep disorders

Insomnia is often one of the first signs of menopause. Already at the age of 40–45, some women begin to fall asleep worse, they often wake up at night, and in the morning they can hardly get out of bed. Almost one third of women of mature age are faced with some kind of sleep disorders.

Problems in the intimate sphere

Often women during menopause notice that sex becomes painful – the mucous membrane of the genitals becomes thinner and more sensitive, and the amount of natural lubrication decreases.

It would seem that the signs are quite obvious, but most women cannot say for sure whether they are associated with the approach of menopause or this is just a coincidence. After all, all the symptoms of menopause are atypical. People suffer from insomnia for a variety of reasons, a bad mood is also characteristic not only of women during menopause, and fatigue with the modern rhythm of life is a completely natural thing. To track the onset of menopause and take action in time, any woman after 40 years should regularly, about once every six months, visit an endocrinologist.Today there are special tests for the level of follicle-stimulating hormone – they are often called “tests for menopause.” These tests are very accurate and can tell for sure whether menopause has started or not. You can even buy such a test strip at a pharmacy, but its accuracy is not so high in comparison with laboratory research methods.

By the way
The time of the onset of menopause is largely determined by genetics. Often in a daughter, it begins at about the same age as the mother.However, personal characteristics and habits can also bring menopause closer – smoking, stress, addiction to too strict diets and weight deficiency.

How to stop the symptoms of the onset of menopause? Life is just beginning!

It is not at all necessary to stoically endure the symptoms of menopause. Today there are many ways to bring health back to normal and prolong youth.

Hormone replacement therapy

A very effective method based on replenishing the lack of own sex hormones.You just need to take pills containing their synthetic counterparts on time. But such therapy has a lot of contraindications – oncology, diseases of the liver, gallbladder and pancreas, chronic headaches, thrombophlebitis, mastopathy, a history of stroke or heart attack, diabetes mellitus, endometriosis and acute thromboembolic disease. In addition, choosing the right hormonal drug can be difficult – with the wrong choice, side effects such as swelling and chest pain are possible.

Herbal medicine

Herbal preparations and preparations can solve many of the problems that women face during menopause.Of course, provided there is no allergy. They can balance mood, relieve insomnia, and improve overall tone. Their effectiveness, perhaps, is not so pronounced, however, they have fewer contraindications and side effects.

Drug therapy

Many tools have been developed that can help menopausal women to eliminate unpleasant psychological symptoms. These drugs work in several ways at once – they reduce anxiety, improve mood, and also help normalize sleep, relieve somatic and autonomic disorders (feeling short of breath, vascular problems, sweating, hot flashes and dizziness).To achieve a lasting effect, they need to be taken in a course that should be repeated from time to time. Among the means that can help eliminate some of the symptoms of menopause, for example, “Afobazol”.

“Afobazol” reduces the severity of climacteric syndrome by 2 times (by 53%), and is also able to stop or significantly weaken vegetative-vascular (including night “hot flashes”), asthenic and anxiety-depressive manifestations of climacteric syndrome. The drug reduces anxiety, tension, tearfulness, irritability, normalizes sleep, reduces sweating, dizziness.In a word, the action of “Afobazol” broadly covers the symptoms of menopause. However, it is neither addictive nor withdrawal. To achieve the best effect, Afobazol should be taken for 2–4 weeks, even if the condition improves noticeably earlier.

“Afobazol” practically has no contraindications and side effects, however, you should consult your doctor before you start taking it.

Psychotherapy

As a rule, the greatest discomfort for a woman is caused not so much by the physical manifestations of menopause as by depressed mood and fear of the future.However, menopause is a completely natural phenomenon that does not at all imply the end of an active life. Take a look at the screen – many actresses and singers who are considered divas and sex symbols have long crossed the 45-year mark, but nothing terrible has happened to them. Classes with a psychologist allow you to tune in the right mood and get rid of anxiety.