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Menopause 48 years old: When It Begins, Symptoms, Stages, Treatment


When It Begins, Symptoms, Stages, Treatment

Menopause is the end of a woman’s menstrual cycle and fertility. It happens when:

  • Your ovaries no longer make estrogen and progesterone, two hormones needed for fertility.
  • Your periods have stopped for 1 year.

Menopause happens naturally with age. But it can also stem from surgery, treatment of a disease, or an illness. In these cases it can be called induced menopause, surgical menopause, or primary ovarian insufficiency, depending on the cause.

When Does It Start?

Menopause starts around age 51 when it happens naturally. But it can happen before you turn 40. This is called premature menopause. The age at which yours will start is mostly determined by your genes.

What Are the Symptoms?

When it starts naturally, the first sign may be an irregular menstrual cycle. Once it gets off-schedule, it should stop completely within about 4 years. You might also notice these symptoms:

Some symptoms can last for years and affect your quality of life.

What Are the Stages?

The process happens slowly over three stages:

Perimenopause. Your cycles will become irregular, but they haven’t stopped. Most women hit this stage around age 47. Even though you might notice symptoms like hot flashes, you can still get pregnant.

Menopause. This is when you’ll have your final menstrual period. You won’t know for sure it’s happened until you’ve gone a year without one. Hot flashes, vaginal dryness, sleep problems, and other symptoms are common in this stage.

Postmenopause. This begins when you hit the year mark from your final period. Once that happens, you’ll be referred to as postmenopausal for the rest of your life. Keep in mind that after more than 1 year of no menstrual periods due to menopause, vaginal bleeding isn’t normal, so tell your doctor if you have any ASAP.

Are There Any Tests for Menopause?

The most accurate way to tell if it’s happening to you is to watch your menstrual cycles for 12 months in a row. It helps to keep track of your periods and chart them as they become irregular. Menopause has happened when you have not had any period for an entire 12 months.

Your doctor can check your blood for follicle stimulating hormone (FSH). The levels will jump as your ovaries begin to shut down. As your estrogen levels fall, you’ll notice hot flashes, vaginal dryness, and less lubrication during sex.

The tissue in and around your vagina will thin as estrogen drops, too. The only way to check for this is through a Pap-like smear, but it’s rarely done. As this happens, you might have urinary incontinence, painful sex, a low sex drive, and vaginal itching.

How Can I Treat the Symptoms?

There are a bunch of ways.

Lifestyle changes. A healthy diet and regular exercise program will help manage your symptoms and boost your health. This is a great time to finally kick any old, unhealthy habits like smoking or drinking too much alcohol. To help with hot flashes, dress lightly and in layers. Avoid triggers like caffeine and spicy foods. And if you stay sexually active, that may help preserve your vaginal lining.

Prescription medication for hot flashes. If you still have your uterus, your doctor might prescribe treatment with estrogen and progesterone. This is called combination hormone therapy (HT) or hormone replacement therapy (HRT). It helps with hot flashes and night sweats, and it may help prevent osteoporosis. If you don’t have a uterus, you might get estrogen alone.

Hormone therapy isn’t for everyone. Don’t take it if you’ve ever had breast cancer, uterine or “endometrial” cancer, blood clots, liver disease, or a stroke. Also don’t take it if you might be pregnant or you have undiagnosed vaginal bleeding.

If you can’t or don’t want to take hormones, other medications can ease symptoms. They include antidepressants, antiseizure drugs, or blood pressure medications to help with hot flashes and mood swings.

Prescription and OTC medication for vaginal dryness and sleep problems. You can try topical estrogen, lubricants, and non-estrogen prescriptions for dryness and painful sex. OTC or prescription sleep aids can help if you have trouble falling asleep.

Nontraditional options. There are many unproven methods for treating menopause symptoms. Some work better than others. Acupuncture, meditation, and relaxation techniques are harmless ways to ease the stress of menopause, and some people believe they help. Many women also try herbal or natural remedies. Talk to a doctor before trying any of these.

Menopause Information | Mount Sinai

Hormone Therapy (HT)

Hormone therapy (HT), also known as menopausal hormone therapy (MHT) or hormone replacement therapy (HRT), uses medications that contain the female hormones that the body has stopped producing after menopause. The primary reasons that women use HT are for the relief of hot flashes and night sweats (vasomotor symptoms), and vaginal dryness.

Hormone therapy uses either:

  • Estrogen alone (known as estrogen therapy [ET]).
  • Estrogen in combination with progestogen (known as estrogen-progestogen therapy [EPT]).

Different types of estrogen are used in hormone therapy products. They include estradiol and conjugated estrogens.

The term “progestogen” encompasses both progesterone and progestin. Progesterone is the name for the natural hormone that the body produces. Progestin refers to a synthetic hormone that has progesterone effects. Because estrogen alone can increase the risk for uterine (endometrial) cancer, progestogen is added to estrogen to protect the uterine lining (endometrium) and reduce this risk.

Women receive either ET or EPT depending on whether they have a uterus:

  • Women who have a uterus (have not had a hysterectomy) receive estrogen plus progesterone or a progestin (EPT).
  • Women who do not have a uterus (have had a hysterectomy) receive estrogen alone (ET).

General Recommendations for HT

Current guidelines support the use of HT for the treatment of severe hot flashes that do not respond to non-hormonal therapies. General recommendations include:

  • HT may be started in women who have recently entered menopause.
  • HT should not be used in women who have started menopause many years ago.
  • Women should not take HT (either EPT or ET) if they have risks for stroke, heart disease, blood clots, and breast cancer.
  • Currently, there is no consensus on how long HT should be used or at what age it should be discontinued. Treatment should be individualized for a woman’s specific health profile.
  • HT should be used only for menopause symptom management, not for chronic disease prevention.

Initiating Therapy

Before starting HT, your doctor should give you a comprehensive physical exam and take your medical history to evaluate your risks for:

  • Heart disease
  • Stroke
  • Blood clots
  • Osteoporosis
  • Breast cancer

While taking HT, you should have regular mammograms and pelvic exams and Pap smears. Current guidelines recommend that if HT is needed, it should be initiated around the time of menopause. Studies indicate that the risk of serious side effects is lower for women who use HT while in their 50s. Women who start HT past the age of 60 appear to have a higher risk for side effects such as heart attack, stroke, blood clots, or breast cancer. HT should be used with care in this age group.

Women who experience premature menopause are usually prescribed HT or oral contraceptives to help prevent bone loss. These women should be reevaluated when they reach the age of natural menopause (around age 51) to determine whether they should continue to take hormones.

Discontinuing Therapy

When a woman stops taking HT, perimenopausal symptoms may recur. There is about a 50% chance of hot flashes recurring regardless of whether HT is suddenly stopped or gradually tapered off. When a woman reaches full menopause, symptoms will eventually go away.

Because HT offers protection against osteoporosis, when women stop taking HT their risks for bone thinning and fractures increases. For women who have used HT for several years, doctors should monitor their bone mineral density and prescribe bone-preserving medications if necessary.

Safety Concerns

Until 2002, doctors used to routinely prescribe HT to reduce the risk of heart disease and other health risks in addition to treating menopausal symptoms. That year, the results of an important study, called the Women’s Health Initiative (WHI), led doctors to revise their recommendations regarding HT.

The WHI, started in 1991, is an on-going health study of nearly 162,000 postmenopausal women. Part of the study focuses on the benefits and risks of hormone therapy. As new data are released and analyzed, there have been a number of changes in the way HT is prescribed and a better understanding of its risks.

Women who should not take hormone therapy include those with the following conditions:

  • Current, past, or suspected breast cancer
  • History of endometrial cancer
  • Vaginal bleeding of unknown cause
  • Current or past history of blood clots
  • High blood pressure that is untreated or poorly managed
  • History of angina, heart attack, or other heart or circulation problems

HT Forms and Regimens

HT comes in several forms:

  • Oral tablets or pills
  • Skin patches
  • Vaginal cream or tablet
  • Vaginal ring
  • Topical gel or spray

HT pills and skin patches are considered “systemic” therapy because the medication delivered affects the entire body. The risk for blood clots, heart attacks, and certain types of cancers is higher with hormone pills than with skin patches or other transdermal forms.

Vaginal forms of HT are called “local” therapy. Doctors generally prescribe vaginal applications of low-dose estrogen therapy to specifically treat menopausal symptoms such as vaginal dryness and pain during sex. This type of ET is available in a cream, tablet, or ring that is inserted into the vagina.

“Bioidentical” Hormones

“Bioidentical” hormone therapy is promoted as a supposedly more natural and safer alternative to commercial prescription hormones. Bioidentical hormones are typically compounded in a pharmacy. Some compounding pharmacies claim that they can customize these formulations based on saliva tests that show a woman’s individual hormone levels.

The FDA and many professional medical associations warn patients that “bioidentical” is a marketing term that has no scientific validity. Formulations sold in these pharmacies have not undergone FDA regulatory scrutiny. Some of these compounds contain estriol, a weak form of estrogen, which has not been approved by the FDA for use in any drug. In addition, saliva tests do not give accurate or realistic results, as a woman’s hormone levels fluctuate throughout the day.

FDA-approved hormones available by prescription come from different synthetic and natural sources, including plant-based. (For example, Prometrium is a progesterone derived from yam plants.)

Benefits of HT

Perimenopausal and Menopausal Symptoms

Systemic HT is mainly recommended for relieving menopausal symptoms such as hot flashes, night sweats, and sleep problems, as well as vaginal dryness. Local HT (delivered vaginally) is used specifically for treating vaginal dryness and atrophy; and accompanying pain during sexual intercourse. HT does not prevent certain other problems associated with menopausal changes, such as thinning hair or weight gain. It is unclear whether HT helps improve mood.


Estrogen increases and helps maintain bone density. HT may be useful for some women at high risk for osteoporosis, but for most women the risks do not outweigh the benefits. Other drugs, such as bisphosphonates, should be considered first-line treatment for osteoporosis. Duavee is a drug that contains a combination of conjugated equine estrogen and the selective estrogen receptor modulator (SERM) bazedoxifene. It is approved to treat hot flashes and prevent osteoporosis in women with a uterus.

Although HT may have some benefits in addition to menopausal symptoms, results from the Women’s Health Initiative (WHI) studies strongly indicate that HT should be used only for relief of menopausal symptoms, not for prevention of chronic disease.

Risks of HRT

Heart Disease, Heart Attack, and Stroke

HT may increase the risk of heart disease and heart attack in older women, or in women who began estrogen use more than 10 years after their last period. HT is probably safest in healthy women under age 60 who begin taking it within 10 years after the start of menopause. Taking HT in order to prevent heart disease is not recommended. Women who have a history of heart disease or heart attack should not take HT. HT may increase the risk of stroke.

Blood Clots

HT increases the risk for formation of blood clots in the veins (deep venous thrombosis) or in the lungs (pulmonary embolism). The risk for blood clots is higher with oral forms of HT than with transdermal forms (skin patches, creams). There appears to be little, if any, increase in the risk of blood clots when transdermal forms of HT are used.

Click to see an image detailing a pulmonary embolus.

Breast Cancer

Estrogen- progestogen therapy (EPT) increases the risk for breast cancer if used for more than 3 to 5 years. This risk appears to decline within 3 years of stopping combination HT.

Estrogen-only therapy (ET) does not significantly increase the risk of developing breast cancer if it is used for less than 7 years. If used for more than 7 years, it may increase the risk of breast (and ovarian) cancers, especially for women already at increased risk for breast cancer. The North American Menopause Society does not recommend ET use in breast cancer survivors as it has not been proven safe and may raise the risk of recurrence.

Both estrogen-only and combination HT increase breast cancer density, making mammograms more difficult to read. This can cause cancer to be diagnosed at a later stage. Women who take HT should be aware of the need for regular mammogram screenings.

The North American Menopause Society recommends that women who are at risk for breast cancer avoid hormone therapy and try other options to manage menopausal symptoms.

Ovarian Cancer

Long-term use (more than 5 to 10 years) of estrogen-only therapy (ET) may increase the risk of developing and dying from ovarian cancer. The risk is less clear for combination estrogen-progesterone therapy (EPT).

Endometrial (Uterine) Cancers

Taking estrogen-only therapy (ET) for more than 3 years significantly increases the risk of endometrial cancer. If taken for 10 years, the risk is even greater. Adding progesterone to estrogen (EPT) helps to reduce this risk. Women who take ET should anticipate uterine bleeding, especially if they are obese, and may need endometrial biopsies and other gynecologic tests. No type of hormone therapy is recommended for women with a history of endometrial cancer.

Lung Cancer

It is not clear if HT use is associated with an increased risk of lung cancer, women who smoke and who are past or current users of HT should be aware that that EPT may possibly promote the growth of lung cancers.

Gallbladder Disease

HT increases the risk of developing gallbladder disease.

Cognitive Function

The Women’s Health Initiative Memory Study and other studies suggest that combined HT does not reduce the risk of cognitive impairment or dementia and may actually increase the risk of cognitive decline. Researchers are continuing to study the effects of HT on Alzheimer disease risk.

Other Drugs Used for Menopausal Symptoms

Despite its risks, hormone therapy appears to be the most effective treatment for hot flashes. There are, however, nonhormonal treatments for hot flashes and other menopausal symptoms.


The antidepressants known as selective serotonin-reuptake inhibitors (SSRIs) are sometimes used for managing mood changes and hot flashes. A low-dose formulation of paroxetine (Brisdelle) is approved to treat moderate-to-severe hot flashes associated with menopause. Other SSRIs and similar antidepressant medicines are used “off-label” and may have some benefit too. They include fluoxetine (Prozac, generic), sertraline (Zoloft, generic), venlafaxine (Effexor), desvenlafaxine (Pristiq), paroxetine (Paxil, generic), and escitalopram (Lexapro, generic).


Several small studies have suggested that gabapentin (Neurontin), a drug used for seizures and nerve pain, may relieve hot flashes. This drug is sometimes prescribed “off-label” for treating hot flash symptoms. However, in 2013 the FDA decided against approving gabapentin for this indication because the drug demonstrated only modest benefit. Gabapentin may cause:

  • Drowsiness
  • Dizziness
  • Fatigue
  • Swelling of the hands and feet


Clonidine (Catapres, generic) is a drug used to treat high blood pressure. Studies show it may help manage hot flashes. Side effects include dizziness, drowsiness, dry mouth, and constipation.


Some doctors prescribe combinations of estrogen and small amounts of the male hormone testosterone to improve sexual function and increase bone density. Side effects of testosterone therapy include:

  • Increased body hair
  • Acne
  • Fluid retention
  • Anxiety
  • Depression

Testosterone also adversely affects cholesterol and lipid levels, and combined estrogen and testosterone may increase the risk of breast cancer. Many experts do not consider testosterone safe or effective for treatment of menopausal symptoms.

Non-Hormonal Treatments for Vaginal Dryness and Atrophy

Vaginal lubricants (such as KY Jelly and Astroglide) and moisturizers (such as Replens) can be purchased without a prescription and are safe and helpful for treating vaginal dryness and dyspareunia (painful sexual intercourse). Dyspareunia is a result of thinning vaginal tissues (vaginal atrophy) due to low estrogen levels.

The North American Menopause Society recommends lubricants and long-acting moisturizers as first-line treatments for vaginal atrophy. For women who still experience discomfort, low-dose vaginal (local) estrogen is the next option.

Ospemifene (Osphena) is approved as a non-hormonal prescription drug for treating menopausal-associated vaginal dryness and dyspareunia. Ospemifene is an oral drug (pill) that acts like an estrogen on vaginal tissues to make them thicker and less fragile. However, this drug may cause the lining of the uterus (endometrium) to thicken, which can increase the risk for uterine (endometrial) cancer. Because of this and other risks, ospemifene should only be taken for a short amount of time. Common side effects of ospemifene include hot flashes, vaginal discharge, and excessive sweating.

Menopause: Symptoms, causes, and treatments

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Menopause is a transition into a new phase of life. It begins when the menstrual cycle finishes. Menopause is not a health problem, and some experience it as a time of liberation. However, hormonal changes and other factors involved can cause discomfort.

Menopause usually starts between the ages of 40 and 58 years in developed countries, where the average age is 51 years. For some, it will occur earlier due to a medical condition or treatment, such as the removal of the ovaries.

Around the time of menopause, many females experience physical symptoms such as hot flashes, night sweats, vaginal dryness, and a reduced sex drive. It can also lead to anxiety, changes in mood, and a reduced sex drive.

These symptoms may start before menstruation ends, and they can last for several years. The impact on a person’s quality of life can range from mild to severe. However, there are ways of managing these symptoms.

Each person will experience menopause differently. Many have full, active lives throughout the transition and afterward, and some feel relieved by no longer having to deal with menstruation or birth control.

Maintaining a healthful diet and getting regular exercise can help a person feel better and boost their overall health in the long term. For those who experience menopause symptoms, treatments and support are available.

In this article, find out more about what to expect during menopause.

Menopause is the stage of life that follows the end of the menstrual cycles. Each person may experience menopause differently.

It can last for several years, and there are three stages:

Perimenopause is the transitional time that starts before menopause and includes the 12 months that follow a person’s last period.

Menopause starts either 12 months after the last period or when menstruation has stopped for a clinical reason, such as the removal of the ovaries.

Postmenopause refers to the years after menopause, although it can be difficult to know when menopause finished and postmenopause starts.

How long do menopause symptoms last? Find out here.

Around menopause, various physical and mental changes can occur, causing symptoms. Some of these start before menopause, and some continue after it.

The changes involved in perimenopause and menopause include:

Lower fertility

As a female approaches the end of the reproductive stage, but before menopause begins, estrogen levels start to fall. This reduces the chances of becoming pregnant.

Irregular menstruation

The first sign that menopause is approaching is usually periods occurring less regularly. They may come more or less frequently than usual, and they may be heavier or lighter.

Anyone who has concerns about menstrual changes should see a doctor, as these changes can also indicate pregnancy or some health issues.

Is it normal to have brown spotting after menopause?

Vaginal dryness and discomfort

Vaginal dryness, itching, and discomfort may start during perimenopause and continue into menopause. A person with any of these symptoms may experience chafing and discomfort during vaginal sex. Also, if the skin breaks, this can increase the risk of infection.

Atrophic vaginitis, which involves thinning, drying, and inflammation of the vaginal wall, can sometimes occur during menopause.

Various moisturizers, lubricants, and medications can relieve vaginal dryness and associated issues.

Learn more about atrophic vaginitis here.

Hot flashes

Hot flashes are common around the time of menopause. They cause a person to feel a sudden sensation of heat in the upper body. The sensation may start in the face, neck, or chest and progress upward or downward.

A hot flash can also cause:

  • sweating
  • red patches to form on the skin

Some people experience night sweats and cold flashes, or chills, in addition to or instead of hot flashes.

Hot flashes usually occur in the first year after menstruation ends, but they can continue for up to 14 years after menopause.

What does a hot flash feel like? Find out here.

Sleep disturbances

Sleep problems can arise during menopause, and they may stem from:

  • anxiety
  • night sweats
  • an increased need to urinate

Getting plenty of exercise and avoiding heavy meals before bedtime can help with managing these issues, but if they persist, contact a healthcare provider.

Click here for some tips on how to get better sleep.

Emotional changes

Depression, anxiety, and low mood are common during menopause. It is not unusual to experience times of irritability and crying spells.

Hormonal changes and sleep disturbances can contribute to these issues. Also, a person’s feelings about menopause may come into play. For example, distress about low libido or the end of fertility can contribute to depression during menopause.

While feelings of sadness, irritability, and tiredness are common during menopause, they do not necessarily indicate depression. However, anyone who experiences a low mood for 2 weeks or longer should see a doctor, who will be able to advise about the best course of action.

Anyone who has concerns about sleep or any changes related to menopause should contact a healthcare provider.

An article published in 2018 suggests that there may, in some cases, be a link between menopause and suicide. Anyone who is thinking about suicide should seek help from a counselor or health professional. There are also anonymous hotlines available.

Trouble focusing and learning

In the lead-up to menopause two-thirds of women may have difficulty with concentration and memory.

Keeping physically and mentally active, following a healthful diet, and maintaining an active social life can help with these issues. For example, some people benefit from finding a new hobby or joining a club or a local activity.

Physical changes

Various physical changes can develop around the time of menopause.

People may experience:

  • a buildup of fat around the abdomen
  • weight gain
  • changes in hair color, texture, and volume
  • breast reduction and tenderness
  • urinary incontinence

However, the link between these changes and menopause is not always clear. Some may occur independently at the same time as the transition, and age and lifestyle can also play a role.

What are the most effective ways to lose weight during menopause?

Increased risk of some health conditions

After menopause, the risk of certain health issues appears to increase. Menopause does not cause these conditions, but the hormonal changes involved may play some role.

Osteoporosis: This is a long-term condition in which bone strength and density decrease. A doctor may recommend taking vitamin D supplements and eating more calcium-rich foods to maintain bone strength.

Find out more about osteoporosis treatments.

Cardiovascular disease: The American Heart Association (AHA) note that, while a decline in estrogen due to menopause may increase the risk of cardiovascular disease, taking hormone therapy will not reduce this risk.

Breast cancer: Some types of breast cancer are more likely to develop after menopause. Menopause does not cause breast cancer, but hormonal changes involved appear to increase the risk.

Skin changes can also occur around the time of menopause. Find out more.

Most information about menopause describes the experiences of cisgender, heterosexual women. However, menopause can affect anyone who is born with ovaries.

A person who transitions to male but who retains their ovaries may experience menopause when their ovaries stop producing eggs.

If a person starts taking supplementary testosterone as part of their transition, they may experience menopause symptoms then. Also, menopause symptoms can develop when a person undergoes surgery to remove their ovaries.

When transitioning involves any of these experiences, the symptoms of menopause will be the same as those of cisgender women.

However, transgender people can face additional difficulties, depending on the attitude of their medical team. It is essential that transgender people have access to healthcare providers who understand their needs and can address them effectively.

Menopause is not a health problem but a natural transition. However, it can involve unwanted physical and mental changes.

Anyone who has concerns about these changes should seek medical advice. A doctor may recommend one or more of the following:

Hormone therapy

This treatment helps balance the body’s hormone levels by providing supplemental estrogen and a synthetic version of the hormone progesterone.

Hormone therapy comes in various forms, including skin patches and topical creams. It can help reduce the occurrence of hot flashes and other menopause symptoms.

However, using it may increase the risk of developing certain diseases and health conditions.

A person should not use hormone therapy if they have risk factors for the following health problems, or if they have a personal or family history of these issues:

  • heart disease
  • blood clots
  • high levels of triglycerides in the blood
  • gallbladder disease
  • liver disease
  • stroke
  • breast cancer

It is important to discuss the possible benefits and risks of hormone therapy with a doctor before deciding to use it.

Other treatments

A person may find that the following can also help relieve symptoms:

  • over-the-counter gels and other products for vaginal dryness
  • prescription pills, creams, and rings for vaginal dryness
  • low-dose hormonal birth control pills for hot flashes, vaginal dryness, and mood changes
  • low-dose antidepressants for hot flashes, even among people who do not have depression

Tips for managing the challenges of menopause include:

  • getting regular exercise
  • practicing relaxation and deep breathing exercises
  • having a healthful diet that includes plenty of fresh fruits, vegetables, and whole grains
  • quitting smoking and avoiding secondhand smoke
  • limiting the intake of alcohol
  • seeking counseling for anxiety, mood changes, and relationship concerns
  • establishing good sleeping habits and getting plenty of rest
  • doing Kegel exercises to strengthen the pelvic floor
  • talking to friends and family about the experience of menopause
  • exploring new ways of enjoying intimacy with a partner
  • joining a club, volunteering, or taking up a new hobby

Can I use coconut oil for vaginal dryness?

Keeping an active sex life

Menopause can reduce a person’s sex drive and lead to vaginal dryness, but it also removes the need for birth control. For some, this can make sex more enjoyable.

Having sex often can increase vaginal blood flow and help keep the tissues healthy.

Some tips for maintaining sexual health and activity during menopause include:

  • staying physically active
  • avoiding tobacco products, recreational drugs, and alcohol
  • taking the time to become aroused, which will improve lubrication
  • doing Kegel exercises to strengthen the pelvic floor
  • not using any strong soaps around the vagina, as these can worsen irritation

Also, menopause symptoms lead some people to find satisfying forms of sex that do not involve the vagina as much or at all.

It is worth remembering that, while a woman cannot become pregnant once menopause starts, it is still important to use barrier protection during penetrative sex to protect against sexually transmitted infections.

Often, sexual partners will be getting older — and may be experiencing menopause — at the same time. They, too, may be feeling a drop in sex drive. Opening up about any concerns can help both partners feel better and explore new forms of intimacy.

What can I do about breast tenderness during menopause?

Menopause is a stage in life, not an illness. Most women experience natural menopause during midlife. However, surgery and other factors can cause menopause to start earlier.

Natural menopause

A female’s reproductive years last from puberty to menopause — from one natural transition to another.

Toward menopause, the levels of the hormones estrogen and progesterone in the body fall because they are no longer necessary to support reproduction. These changes trigger menopause.

Surgery and treatment

If a person undergoes surgery to remove their ovaries, they will experience menopause. If this happens before middle age, doctors may refer to it as “early menopause.”

A doctor may recommend hormone therapy to reduce some symptoms, but as always, it is important to discuss the risks as well as the potential benefits of this treatment.

Some treatments, such as chemotherapy and radiotherapy, can cause the ovaries to stop working either temporarily or permanently. The likelihood of this happening depends on the person’s age and the type and location of the treatment.

A person who experiences menopause because of a clinical treatment will experience the same symptoms as a person who experiences natural menopause. However, the symptoms may appear more abruptly, because the physical change is more sudden.

A person may also experience sadness or depression about an early loss of fertility. Some people decide to freeze eggs or pursue other options for having children later in life before undergoing this type of treatment. Counseling is often available.

It is also important to discuss related health effects with a doctor, as people who experience menopause early may have a higher risk of developing heart disease and osteoporosis.

Premature menopause

Some people experience menopause earlier than others for reasons other than medical interventions.

Doctors consider menopause to be “premature” if it develops before the age of 40 and “early” if it starts between the ages of 40 and 45. Early menopause naturally occurs in around 5% of females.

Sometimes, menopause develops early if a person has:

  • a genetic condition that affects the chromosomes, such as Turner’s syndrome
  • an autoimmune disease
  • in rare cases, an infection, such as tuberculosis, malaria, or mumps

Anyone who experiences changes in menstrual patterns before the age of 45 should see a doctor.

Menopause is not an illness, but many people benefit from seeing their doctors when menstruation ends.

A doctor can often confirm whether the reason for this change is perimenopause or menopause by asking some questions. They may also test hormone levels and perform other analyses of the blood and urine to rule out health issues. No tests, however, can conclusively indicate that menopause has begun.

People can check their hormone levels at home with testing kits, some of which are available for purchase online.

For many people, menopause is not the only transition that occurs during middle age. Changes in relationships and work or home life — such as children moving away — can also have a significant impact. When more than one of these changes occurs in a short period, it can feel overwhelming.

However, many people live active, healthy lives throughout menopause and for many decades afterward, and midlife can often be the start of a new chapter.

What Is Perimenopause And How Young Can It Start? : Shots

Katherine Streeter for NPR

Katherine Streeter for NPR

Sarah Edrie says she was about 33 when she started to occasionally get a sudden, hot, prickly feeling that radiated into her neck and face, leaving her flushed and breathless. “Sometimes I would sweat. And my heart would race,” she says. The sensations subsided in a few moments and seemed to meet the criteria for a panic attack. But Edrie, who has no personal or family history of anxiety, was baffled.

She told her doctor and her gynecologist about the episodes, along with a few other health concerns she was starting to notice: Her menstrual cycle was becoming irregular, she had trouble falling asleep and staying asleep, and she was getting night sweats. Their response: a shrug.

It wasn’t until Edrie went to a fertility clinic at age 39 because she and her partner were having trouble conceiving that she got answers. “They were like, ‘Oh, those are hot flashes. It’s because you’re in perimenopause,’ ” she says.

If you haven’t heard the term “perimenopause,” you’re not alone. Often when women talk about going through menopause, what they’re really talking about is perimenopause, a transitional stage during which the body is preparing to stop ovulating, says Dr. Jennifer Payne, who directs the Women’s Mood Disorders Center at Johns Hopkins University.

“Technically, menopause is only one day in a woman’s life, which is exactly when she has not had a period for 12 months,” she says. “It’s the period of time leading up to menopause that causes all the trouble.”

And it can start earlier than you might think. Many listeners wrote to us in response to our call-out for individual experiences with menopause to say that they struggled to get medical support for perimenopause in their mid-30s and early 40s.

When Edrie went back to her OB/GYN with the fertility clinic’s conclusion, she says the doctor shrugged again and told her that menopause is a normal part of life. She wasn’t satisfied with that answer. “Yeah, it’s a normal part of life, but it would be great if we could talk about it and figure out strategies.”

With that spirit in mind, we reached out to endocrinologists, gynecologists and psychiatrists for advice about navigating this major life transition.

How early can perimenopause start?

It’s quite possible for women to start to notice things changing in their mid-30s. Most women arrive at menopause between the ages of 45 and 55, but perimenopause can start as much as a decade beforehand. And about 1% of women in the U.S. reach menopause at age 40 or younger.

How do you know if you’re starting perimenopause?

The most telling symptom is changes in your menstrual cycle, says psychiatrist Hadine Joffe, the executive director of the Connors Center for Women’s Health and Gender Biology at the Brigham and Women’s Hospital in Boston.

“It’s the menstrual cycle pattern that really defines this lead-up to menopause,” she says. During perimenopause, periods “might be shorter, then a long one, or then a skipped one, or then the flow might be different,” says Joffe.

There’s no blood or hormone test that can “diagnose” perimenopause. Joffe says a hormone test isn’t helpful because hormonal cycles become erratic and unpredictable during this stage.

“There’s not really one point in time when a hormone test is done that can be definitive,” she says. Even if you took several tests over time, “you might get a very different readout.”

Surprisingly, sometimes doctors aren’t prepared to help women recognize the start of this life phase. Edrie was upset at her doctors’ responses — or lack thereof. “I felt so disappointed in the medical industry. How many women has my OB/GYN seen and not recognized the symptoms of perimenopause?”

What symptoms to expect

Be prepared for your PMS symptoms to possibly shift, becoming either more or less extreme, says Dr. Cynthia Stuenkel, a founding member of the North American Menopause Society and a professor and endocrinologist at the University of California, San Diego, School of Medicine. “Women might not get the same kind of breast tenderness or mood shifts that they may have noted in the past,” she says.

Mood problems like depression can spike during perimenopause, especially among women who have previously experienced them. Many of our listeners wrote in to say that during perimenopause, they felt incredibly irritable and quick to anger in a way that they had never experienced before.

And of course, many — but not all — women experience hot flashes, though they may not recognize them. “It’s hard, because no one sits us down and teaches us, ‘Here’s what a hot flash feels like,’ ” Stuenkel says. “I’ve seen women who think they’re having panic attacks, or heart palpitations. That can be frightening.”

Other common symptoms include more frequent urinary tract infections, difficulty sleeping through the night, vaginal dryness that can make sex painful, night sweats and a decrease in libido.

What treatments are there for symptoms?

Some symptoms, like heavy or irregular periods, can be managed with an oral contraceptive, which can “shut down the body’s own erratic hormonal fluctuations,” says Stuenkel.

“This can kind of be a lifesaver,” she says. Such medication may help with hot flashes, too.

In some cases, doctors may prescribe menopausal hormone therapy, or very low doses of hormones to supplement estrogen levels. Stuenkel says it’s not a fit for everyone, but it doesn’t deserve the bad reputation it has in some circles. She says there was an “exodus” from the use of hormone replacement therapy after the Women’s Health Initiative trial halted a study over safety concerns in 2002. But many clinicians now feel much more comfortable using hormone therapy again and usually recommend low doses, selectively, for shorter periods of time.

For people who cannot take estrogen therapy, or choose not to, Stuenkel says some drugs in the antidepressant family, such as SSRIs and SNRIs, can help with hot flashes. Stuenkel says, “While they’re not perfect, they can take the edge off and help enough so that women can get a better night’s sleep.”

There are an abundance of nonhormonal, nondrug treatment options for managing symptoms, some of which have significantly more evidence backing them than others. In 2015, a North American Menopause Society panel found that cognitive behavioral therapy and hypnosis were significantly effective in treating hot flashes. The same panel also found that popular herbal remedies (like black cohosh, dong quai and evening primrose) are “unlikely to help,” although some NPR listeners who wrote in said they got relief from some of those treatments.

For depressive and anxiety symptoms, women may want to seek out professional counseling or a psychiatrist.

When do I need to see a doctor?

You might not need to at all. Some people sail right through menopause with little trouble. But if you are experiencing symptoms that are interfering with your life, it’s worth making an appointment. Some of these symptoms could indicate other problems that need treatment, such as fibroids or even cancer.

Ways to cope with symptoms

For people approaching this stage of life or who are already going through it, here are four steps for making this transition more manageable.

1. Get educated

“Information is key,” says Joffe. She suggests that people approaching perimenopause age empower themselves with knowledge.

The Massachusetts General Hospital Blum Center has a curated list of suggested books. The National Women’s Health Information Center has a section on menopause and perimenopause. The American College of Obstetricians and Gynecologists also has a perimenopause FAQ.

2. Monitor your health

Joffe encourages people to track symptoms: “menstrual patterns, hot flash patterns, mood issues, major life triggers.” Using a paper calendar or an app to monitor symptoms can make it easier to give your doctor details that can be otherwise hard to remember.

“Knowing that information, somebody can say, ‘Well, over the last six months, I only had two periods or I had hot flashes almost every day,’ ” Joffe says, “or, ‘My mood was as bad as it gets for only two days or for a third of the time.’ ”

And if you bring a thorough health history to your physician and they still give you a shrug, consider a specialist. “There are OB/GYNs that specialize in perimenopause and menopause,” Joffe says.

3. Practice smart self-care

Joffe encourages women to protect themselves from things that might worsen their mood or well-being. This includes reducing stress when they can and making sure they get enough sleep.

“Sleep is critical,” she says. “Getting a good night’s sleep, and making sure it’s not broken in the middle of the night.”

There are lots of online tools and apps to help with sleep, she adds.

And familiar health advice like getting enough exercise, eating well and moderating alcohol consumption apply to perimenopause too, says Dr. Steven Goldstein who is the co-author of Could It Be … Perimenopause? and a professor of obstetrics and gynecology at the New York University School of Medicine.

At her doctor’s suggestion, Edrie developed a mindfulness practice. She says, “I thought it sounded a little ‘woo-woo’ at first, but being able to pay attention to what my body is doing and why helps me separate those symptoms from what I need to get through my day. So I’m not overwhelmed by what my body is putting me through.”

4. Cultivate community

Most of the women who wrote to NPR about their experiences going through perimenopause said that they felt alone and isolated during this transition.

Having a community to talk to can make it easier to cope with the changes, says Payne, who’s going through perimenopause herself. She says she has found support from a few close friends from college.

“To be able to reach out to a group of women who are our same age and say, ‘Did you go through this? And, you know, it does provide support. I think that’s another version of a coping skill,” she says.

Edrie says she joined a few Facebook groups dedicated to perimenopause and found one in particular where she got tips on coping with one of her most troublesome symptoms: brain fog. The conversations made her feel understood and validated.

“I can post about it in this group, and, you know, 10 women will be like, ‘Oh, last week, that totally happened to me,’ or like, ‘I forgot my kid’s computer on the top of my car and drove away,’ ” she says.

She says that being able to commiserate helps her get through symptoms “that maybe don’t have a magic pill.” Some of her online friendships have even taken shape offline. Edrie has met up with some of the Facebook group members while touring the country with her band.

Now she’s a big proponent of finding community and speaking out. “As we get older, we get more and more quiet about what’s going on with our bodies and ourselves and our lives. We kind of just, buck up and deal with it.”

“And I feel like if we talked more about the things that are happening to our bodies — even if we can’t actually do anything about some of these things — it would just be better for society in general if we were more vocal about it.”

Menopause and Perimenopause: The Basics

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Top things to know

  • Menopause is when menstrual cycles end. The average age at menopause is 51 in Western countries, though ethnicity, behavior, and environment may influence menopause timing.

  • Perimenopause is the transition into menopause. Menstrual changes start, on average, 4 years prior to menopause, though that’s not the case for everyone.

  • Lifestyle modifications, medications, and supplements may help with uncomfortable menopause changes.

What is menopause? 

Menopause is when someone’s menstrual cycles come to an end, and pregnancy is no longer possible. The word menopause is from the Greek root word men, meaning “month” and pausis meaning pause or cessation.

Menopause is a unique experience—humans are 1 of only 4 species on the planet who experience it (1). For some people, it’s both an ending and a beginning. It can bring a lot of new changes, and for some people it might not feel like much of a change at all.

Menopause is a normal life phase, but can also be induced by surgery, drug treatments, or medication. It technically begins after your last menstrual period, but your healthcare provider will consider you to have reached menopause after 12 months without a period (2).

What is perimenopause?

Perimenopause is the body’s transition into menopause (peri comes from the Greek word for “around”). You may not have heard the term before, because people often confuse perimenopause (the transition period) with menopause (the time after your last period).  

Perimenopause can be as short as a few months or last up to 8 years. On average, it lasts around 4–5 years (3-6). During perimenopause, hormone levels fluctuate and then decline, giving rise to new sensations, symptoms, and changes. Experiences of perimenopause vary widely across people and cultures.

Why it’s important to know about menopause and perimenopause

Every woman and person with a cycle who goes through the natural aging process will experience these life stages. Despite this, they are still underrepresented in culture and research.

Knowing what changes are possible can help you identify the transition in yourself. Also, because it’s still possible to have or develop reproductive conditions like polycystic ovary syndrome (PCOS) or endometriosis during perimenopause, it’s important to know what the probable signs of perimenopause are, and what symptoms might be signs of something else.

When does perimenopause start? What is the average age of menopause?

The exact start of perimenopause—the transition into menopause—is hard to pinpoint. One study that tracked women as they transitioned into menopause found that menstrual irregularity began on average between ages 47 and 48. But it can begin much earlier or later. In that same study, of those who were still menstruating at age 45, about 1 in 3 reported menstrual irregularity. At age 52, about 1 in 10 reported that they were still menstruating normally (3). There are other perimenopausal changes and symptoms that may be felt before menstrual irregularity begins, which may help in identifying a different starting point of perimenopause, but more research is needed.

Menopause—when periods actually stop— happens on average at age 51, but most people reach it anywhere between ages 45–55 (3,5,7,8). About 4 in 10 women reach menopause by age 50, 9 in 10 will reach it by age 55 (3).  

Menopause is considered “early” when before age 45, and  “premature” when it happens before age 40. Premature menopause is also sometimes called primary ovarian insufficiency (POI) or premature ovarian failure (not the greatest of terms). About 1 in 100 people experience premature menopause for non-surgical or chemotherapy-related reasons (8-10). 

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Early menopause can be caused or influenced by cigarette smoking, certain medications,  chemotherapy, and possibly insulin resistance and type 2 diabetes (10,11). 

People who have an oophorectomy (removal of the ovaries) will undergo menopause immediately. Sometimes people who have had a hysterectomy (removal of the uterus) will also experience early menopause, even if their ovaries are not removed (9,11). People who have had menopause induced due to surgery, drug treatments, or medication generally do not experience perimenopause, since there is an abrupt stop to their reproductive function. But people with induced menopause may still experience symptoms of menopause.

How long does menopause last? (How long does perimenopause last?)

You might ask: how long does menopause last? Perimenopause is the transition period, and menopause is the time after your last period. 

The menstrual cycle irregularities of perimenopause last an average of about 4 years, from the beginning of menstrual irregularity to the last period. But it can last anywhere from a few months to ~8 years (3-6). About 1 in 10 people may experience the transition more abruptly, with only a few months of menstrual irregularity. These people also tend to report fewer symptoms like hot flashes (3).

What can affect the age of menopause?

Smoking: yes.

Hormonal birth control: maybe. 

Your genetics, environment, and lifestyle may all play a role in how you experience perimenopause, and the timing of perimenopause and menopause. People who reach menopause later in life tend to have shorter transitions (10). Smokers tend to be slightly younger at perimenopause and have shorter transitions, reaching menopause about a year earlier than average. There are likely other differences due to ethnic background and/or related environmental and behavioral factors, but more research is needed on this topic (12).

A person’s pregnancy history and their history of oral contraceptives (OCs) use might delay menopause. Studies on the topic are mixed—some studies have found an association, and others not—and the biological reason why this would be the case (if true) is not fully understood (5,10,13). Although being pregnant and using OCs suppresses ovulation, they don’t suppress the development (and death) of eggs prior to the point of ovulation, so why using OCs would impact timing of menopause is still unclear.

Menopause symptoms & signs: Physical and emotional changes of perimenopause

Perimenopause is whole-body change. It influences everything in your body that involves estrogen and progesterone, along with other hormones and proteins. Some of these changes and symptoms go away after menopause is reached, and others are longer lasting. Some advocates argue that these changes can be felt well before changes show up in the menstrual cycle, but there is little research on this so far.

The changes during perimenopause and after menopause are caused by the decline in the number of eggs in the ovaries. The menstrual cycle is driven, in part, by the development of eggs. This process impacts our levels of estrogen and progesterone, among other hormones. Once the number of eggs in the ovaries decreases beyond the point when reproductive hormone levels can be maintained, changes start to occur.

It can be difficult to know when ovulation will happen during perimenopause, so use reliable contraception if you are having penis-vagina sex. Getting pregnant becomes more difficult during this time, but it’s still possible.

To get an idea of when you’ve entered perimenopause, track changes to your menstrual cycle, and be aware of other common symptoms and changes you might be experiencing. 

Common changes and symptoms in perimenopause include:

  • Hot flashes (aka hot flushes) 

  • Sweating 

  • Disturbed sleep 

  • Changes in mood and anxiety 

  • Migraines 

  • Increased forgetfulness 

  • Changes in sexual desire 

  • Vaginal dryness and itchiness

  • Lowered fertility/infertility

  • Increased abdominal body fat (14-19). 

Lasting physical changes to be aware of include loss of bone density, vaginal dryness, changes in urination function, and changes in sexual function (14,20,21). 

Fortunately, the end of menstrual cycles also means the end of any negative symptoms you may have experienced during your cycle, like cramps, as well as the risk of unintended pregnancy.

How the menstrual cycle changes before and during perimenopause

1. At first, you may notice that your period arrives slightly earlier each cycle (ie shorter menstrual cycles) and is heavier.

As you approach perimenopause, your hormone levels begin to change. This happens before your periods become unpredictable. For some people, one of the earliest signs of perimenopause is that their periods arrive slightly earlier—meaning that their menstrual cycle shortens, by ~2–4 days This is due to a shortening of the follicular phase (the first part of the menstrual cycle), as ovulation happens more quickly (19,22-25).

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(Note: Cycles can also become shorter for other reasons, so don’t assume you’re entering early menopause if your cycle becomes slightly shorter in your 30s. Average cycle length decreases with age, from about 29 days for people in their 20s, to 26 days for those in their 40s (26,27). Cycles can also become shorter due to a shortening of the luteal phase, caused by any factor leading to a decrease in the ovary’s production of progesterone after ovulation (28).)   

During perimenopause, less estrogen is produced. But before perimenopause, estrogen levels can actually rise for a while, and progesterone levels typically decrease (19,29). This is what shortens the follicular phase, and may also cause other changes, symptoms, or sensations. You may notice changes to the heaviness of your period during this time. Lower progesterone—with or without higher estrogen—may also lead to heavier periods, which is more common in early perimenopause (19).

2. Later, you may have irregular cycles and bleeding changes. 

As the number of follicles in your ovaries decreases, ovulation becomes less common, and hormone levels start to fluctuate more and more. Menstrual cycles might become longer, and then progressively more variable—longer and shorter, with menstrual periods that are heavier, lighter, and far less predictable (19,23,30,31). 

The heaviness of your period will also fluctuate. Cycles without ovulation may have lighter periods, while periods that come after a long cycle may be long (32). On average, about 6 of the final 10 cycles before menopause are prolonged and anovulatory (where ovulation doesn’t occur) (33). In the 1-2 years before menopause, it’s common for cycles to last more than 5 weeks (31,33). 

3. No period, period.

As ovulation becomes rare, your period might go away for months at a time, and then return (6). This phase lasts between 1-3 years for most people, but again, everyone is different (6). Eventually, menopause is reached, and cycles comes to an end, along with the period.

About 1 in 10 people may stop menstruating more abruptly, with much less prolonged irregularity (3).

Menopause treatments: How can I manage symptoms of menopause and perimenopause? 

You might have searched for “menopause treatment.” Quick reminder: perimenopause is the transition period before menopause. It is a normal function of the body, but some of the changes it causes can feel uncomfortable, or even rageful. 

If you are experiencing symptoms that affect your quality of life, such as hot flashes, vaginal dryness, changes in mood, or difficulty sleeping, seeing a healthcare provider or a perimenopause specialist can be a good idea. 

Lifestyle changes for menopause symptoms 

There are some simple changes you can make in your lifestyle to help you cope with menopausal symptoms. 

Some dietary adjustments may be helpful, (see below and in the supplementation section), but there is no known “menopause diet” to provide guaranteed menopausal symptom relief. Much more research is needed to understand what lifestyle changes may be useful treatments for menopausal symptoms. 

Some first steps that may be helpful:

Prepare for hot flashes

Dressing in layers and having cool water and beverages available to you may help with managing hot flashes (21). 

Drink in moderation 

Drinking less than 1 drink per day probably doesn’t decrease rates of hot flashes, but the effects of drinking higher amounts of alcohol are unclear, and may worsen symptoms—you’ll have to see what’s true for you (34).


Exercise has been found to be beneficial for overall wellbeing during and after perimenopause. Studies have also found that exercise, particularly aerobic exercise might reduce hot flashes, though the effect is small if it exists (35). A recent study that looked specifically at resistance training (i.e. lifting weights) also decreased the frequency of hot flashes (36). 

Stop smoking 

Smoking has been linked to increased hot flashes and night sweats (34).

Maintain a healthy weight 

This may help to protect against hot flashes and night sweats, since people with heavier body masses tend towards having more frequent symptoms (34). 

Invest in personal lubricant and vaginal moisturizer 

These will be helpful for relieving symptoms of vaginal dryness and pain during sex (37,38).

Hormone replacement therapy (HRT) for menopause symptoms

Hormone replacement therapy (HRT), also called hormone therapy, is sometimes prescribed during or after the menopausal transition to help relieve certain symptoms, like hot flashes, night sweats, and vaginal dryness. HRT involves taking synthetic or “bioidentical” forms of estrogen and often synthetic progesterone. “Systemic” HRT goes throughout the whole body and can be taken in several forms, like pill, patch, gels, creams, and sprays. For people who are only experiencing vaginal symptoms, “local” HT used inside the vagina in the form of a cream, ring, or tablet may be recommended (21,39). 

Also, data suggest that systemic HRT lowers the risk of osteoporosis, coronary heart disease (CHD) and overall mortality in people who take it around menopause, particularly for those who have had a hysterectomy and use estrogen-only HRT, but more information is needed (39. 

Systemic HRT also carries risks, including an increased chance of developing breast cancer, stroke, and blood clots (39-41). Risks vary by whether your form of HRT contains a progestin or not (39). Also, the risk of negative effects increases when people begin taking it after menopause, particularly 10 or more years from menopausal onset (39,40). The U.S. Federal Drug Administration (FDA) currently recommends that people who choose HRT take it “at the lowest dose that helps and for the shortest time” (41). 

(We have a whole article on HRT and different risks here.)

During perimenopause, some healthcare providers may also suggest using hormonal contraceptives to help manage abnormal bleeding and some other symptoms. Hormonal contraceptives can also help prevent unintended pregnancies, which are still possible during perimenopause.

Non-hormonal medications for menopause symptoms

Certain medications that are primarily used to treat depression, high blood pressure, and seizures—SSRIs, SSNRIs, clonodine, and gabapentin—have been found to also be effective in reducing hot flashes, although they may be less effective than HRT (21). 

There is also a type of medication called selective estrogen receptor modulators (SERMs) which are non-hormonal, but have effects similar to estrogen on certain parts of the body. One SERM, Ospemifene, is approved to treat painful sex caused by vaginal dryness (21,42). 

Similarly, a combination medication containing estrogen and a SERM, called Duavee, is used to treat hot flashes and prevent osteoporosis (weakened bones due to low density) (43). 

These medications can have unwanted side effects, so it’s important to have a discussion with your healthcare provider about benefits and risks.

Alternative and “natural” treatments and supplements for menopause symptoms 

There is no scientific consensus on the benefits or risks of any complementary or alternative treatment for menopausal symptoms. Many small trials may show individual benefits, but when data from multiple studies is analysed together the results are difficult to draw conclusions from (44). This important area of research is greatly underfunded, leaving people to test things on their own, or take other routes. 

Some examples of treatments that have been explored: 

Acupuncture for perimenopause and menopause

Acupuncture treatments seems to provide little to no effect on menopausal symptoms, though for some people it may be better than no treatment at all. 

Body mindfulness for perimenopause and menopause

Body mindfulness therapies like relaxation and breathing techniques may be helpful at providing some relief for hot flashes and are not harmful to try. 

Supplements for perimenopause and menopause

Plant and dietary supplements have mixed and unclear results, including Black cohosh (Actaea racemosa/Cimicifuga racemosa) a popular herb often prescribed for menopausal symptoms is not effective at relieving hot flashes. Phytoestrogens such as those found in soy may provide some benefit to relieving hot flashes and vaginal dryness, but no do help with night sweats (44-50). We’ll be writing more on current “natural” approaches to perimenopause symptom treatment. 

Using dietary supplements can also have negative side effects, and some supplements may interact with other medications, so speak with your healthcare provider before treating your perimenopausal symptoms with supplements. 

When should I see a healthcare provider?

During perimenopause and menopause, talk to your healthcare provider if:

  • You are concerned about the heaviness or length of your period

  • You begin to bleed between periods, especially if you have a history of polycystic ovary syndrome (PCOS), are higher weight, have a family history of uterine cancer, or have taken estrogen-only hormone therapy or certain medications to prevent breast cancer .  

  • You experience any spotting or bleeding after reaching full menopause

  • You experience bleeding during penetrative sex (2,51,52)

Abnormal bleeding during perimenopause

Although changes in bleeding are to be expected during perimenopause, some bleeding changes may be caused by abnormal changes to your endometrium (i.e. the lining of your uterus). If the endometrium becomes too thick and irregular, it can develop into cancer, but this can usually be prevented if caught early (2). 

Abnormal bleeding after menopause

In some cases, bleeding continues after menopause. It is easy to mistake this type of bleeding for symptoms of perimenopause, which may mislead someone to think they have not reached full-menopause when they actually have. 

Any spotting or bleeding after menopause is abnormal and should be checked out by a healthcare provider (2). Spotting or bleeding after menopause can be caused by a medical condition, such as uterine polyps (2). Uterine polyps are growths on the inside lining of the uterus (the endometrium), and become more common with age (53).

Menopause, Perimenopause and Postmenopause


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.


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.


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, 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.

What Are the Symptoms of Menopause & Perimenopause?

There are other symptoms of menopause besides changes in your period. Not everyone has the same symptoms. Some people have severe symptoms and others may have very mild ones.

What are common menopause symptoms?

Some common menopause symptoms are:

  • Irregular periods: Periods becoming shorter, longer, heavier, lighter. Skipping periods.

  • Hot flashes: A hot flash is a sudden, sometimes intense feeling of heat that rushes to your face and upper body. Hot flashes can be really uncomfortable, but they usually only last a few minutes. They can happen a few times a day, a few times a week, or a few times a month.

  • Night sweats: Hot flashes that wake you up in the middle of the night.

  • Sleep problems: You may have insomnia — trouble falling asleep or staying asleep. You may also start to wake up much earlier than you used to.

  • Vaginal changes: The lining of your vagina may become thinner, drier, or less stretchy. This can cause dryness or discomfort during sex.

  • Urinary or bladder infections:  You may have to pee more often or get more frequent urinary tract or bladder infections.

  • Mood changes: Hormone changes can make you feel anxious, irritable, and tired. Your sex drive might change, too.

  • Weaker bones: Your bones will probably weaken during menopause. If it’s really bad, it can lead to osteoporosis after menopause. Getting plenty of calcium and vitamin D, and exercising for at least 30 minutes most days of the week can help you maintain bone health. 

Some people may have a long and difficult perimenopause, up to 10–12 years. But most people find that the common menopause symptoms (like mood changes and hot flashes) are temporary and only last 3–5 years.

A few common menopause symptoms (like vaginal dryness and changes in sex drive) may continue or even get worse when menopause is over. Your doctor or nurse can talk with you about treatment if you have symptoms that bother you.

What are hot flashes?

Hot flashes can be a pretty unpleasant symptom of perimenopause and menopause. We don’t totally understand the cause of hot flashes.

Most people describe a hot flash as a sudden hot feeling that spreads all over your body — but mostly the upper body, like your arms, chest, and face.  You may also get sweaty, and your fingers may tingle and your heart may beat faster. A typical hot flash usually lasts anywhere from 1 to 5 minutes.

Hot flashes at night are called night sweats. Sometimes they can get so severe that you soak your sheets with sweat.

Hot flashes are super common. More than 3 out of 4 people have them while going through perimenopause and menopause.

Nothing will make hot flashes stop completely, but there are some things you can do to help get some relief. Wearing light, loose clothes, keeping your room cool, drinking cold liquids, and avoiding alcohol and caffeine can help you stay cool. 

Prescription hot flash treatments can be helpful, too. Hormone therapy works best to treat hot flashes, but other medicines like SSRIs and SNRIs (antidepressants) and clonidine (blood pressure medicine) may also help. Research shows that herbs, vitamins, acupuncture, and reflexology don’t help with hot flashes.

Can menopause affect my sex drive?

Yes, menopause can affect your sex drive — but it doesn’t mean your sex life is over.

Dealing with the physical and emotional symptoms of menopause can make you feel less sexual desire. The symptoms can also affect your sleep and lower your energy — which might make you not so into sex. Vaginal dryness and decreased sensation can also feel like a turn-off. It’s also normal to feel a range of emotions, including anxiety, sadness, or loss while going through menopause.

If you lose interest in sex during this time, it’ll probably come back when your symptoms stop.

A pretty common symptom that can affect your sexual desire is vaginal dryness, which can make sex uncomfortable or even painful.

For symptoms that affect your sex life, trying one or more of these things can help:

  • Use water- or silicone-based lube when you have sex. You can buy lube at most drugstores or online.

  • Give your yourself more time to feel aroused. Moisture from being aroused protects sensitive tissues.

  • Have sex and/or masturbate more often. This increases blood flow to your vagina, which helps keep your vaginal tissue healthy.

  • Practice pelvic floor exercises (aka Kegel exercises). They can make the muscles used in orgasm stronger and can help with bladder leaks. Ask your doctor or nurse about how to do these exercises.

  • Ask about prescription hormone medicines. Estrogen creams, tablets, or rings may help with dryness if you find that lube isn’t enough. These products can help you enjoy sex during menopause and after.

  • Talk with your partner. Being open about your feelings and what menopause is like for you helps you connect more with your partner, and may take the pressure off of you to have sex if you don’t feel like it.

Some people may actually find that they want to have sex MORE after menopause, because they don’t have to worry about getting pregnant. This may give you a sense of freedom to enjoy a renewed and exciting sex life.

Remember that even though you don’t need birth control after menopause, you can still get or pass on STDs. Use condoms and dental dams to protect yourself and get tested regularly if you have new sexual partners.

Menopause is a natural biological process. And while it marks the end of your ability to get pregnant, it definitely doesn’t have to be the end of your sexuality.

What other life changes affect menopause?

Menopause can be a rough time. In addition to the symptoms that may be tough to deal with, a lot of stressful life changes can happen around the same time as perimenopause and menopause.

Some changes you may go through during this time in your life include:

  • anxiety about illness, aging, and death

  • anxiety about the future, getting older, and losing independence

  • anxiety about being disabled

  • changes in family, social, and personal relationships

  • changes in identity or body image

  • children leaving home

  • getting divorced or losing a partner

  • having a partner become ill or disabled

  • more responsibility for grandchildren

  • loss of loved ones

  • changes in your financial situation

  • retirement

These kinds of things can be overwhelming. You may want to talk to a friend, partner, or therapist about what’s going on. And you may want to spend time with some other people who are going through menopause and experiencing the same things. The point is, you’re not alone.

More questions from patients:

What are post menopause symptoms?

Postmenopause is the time in your life after you go through menopause. When you haven’t gotten your period for over 12 months (a year), you’re officially postmenopausal. For most people, many of the symptoms they had during perimenopause/menopause (like hot flashes and mood swings) last a few years — and then they fade once you’re in postmenopause.

But a few common menopause symptoms may continue or get worse when menopause is over — like vaginal dryness and changes in your sex drive. You may also be more at risk for certain health conditions. Most of these happen because your body is making less estrogen.

Here are some things that can happen/continue after menopause:

Vaginal dryness and changes in your sexual function

Your vagina may make less moisture, and your vaginal tissue can get thinner and less stretchy. This can make vaginal sex uncomfortable or painful, and/or cause a little bit of bleeding. Your libido (sex drive) may also go down. And you may have vaginal infections and irritation (like vaginitis) more often.

Over-the-counter vaginal moisturizers and lubricants can help ease dryness and make sex more comfortable. Your doctor may also prescribe a vaginal pill, cream, or ring that has estrogen in it — this is called local estrogen therapy. The estrogen helps restore your vaginal lining and increase moisture.

Incontinence and Urinary Problems

Changes in your pelvic tissue (like your vagina and urethra) can lead to:

  • Frequent, strong urges to pee.

  • Not being able to control or hold your urine (this is called incontinence).

  • Leaking urine when you cough, laugh, or lift something heavy (called stress incontinence).

  • Urinary tract infections (UTIs).

Doing kegel exercises to make your pelvic muscles stronger, and using vaginal estrogen creams can help with urinary problems.

Higher risk of heart attacks/strokes

The estrogen your body makes throughout your life before menopause protects against heart attack and stroke. When your estrogen levels go down during and after menopause, your risk for heart and blood vessel problems goes up. Heart disease is the most common cause of death, so it’s important to take care of your heart health. Get regular exercise, eat well, maintain a healthy weight, and watch your cholesterol and blood pressure. Talk to a doctor or nurse for help managing these risks.

Higher risk of osteoporosis

As people get older, bones are broken down faster than they’re made. After age 35, it’s normal to lose small amounts of bone density over time. But this loss happens faster during the first 4-8 years after menopause because you don’t have as much estrogen in your body. This makes you more likely to get osteoporosis. Osteoporosis makes you more likely to break or fracture bones — your hips, wrists, and spine are usually the most at risk.

If you have postmenopause symptoms that bother you, or you’re worried about the risks during and after menopause, talk to your doctor or visit your local Planned Parenthood health center. There are treatments available that can help you stay healthy and feel more comfortable.

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Climax – Health IQ


Women at all times were wary of the approach of menopause and made efforts to delay this process as much as possible. And this is no coincidence: nature has laid down that an individual that cannot reproduce is less viable. The likelihood of premature aging, the development of diseases and mortality increase significantly with menopause, but before menopause a woman has a powerful defense – her estrogens.

Menopause is the date of the last menstrual period, it is not a period, but a specific date.

Estrogens is the general collective name for a subclass of female steroidal hormones, produced mainly by the ovarian follicular apparatus in women.

If men are more susceptible to heart attacks and strokes at a young age, then women are not. However, around the age of 50, the statistical ratio of men and women who have suffered a heart attack or stroke levels off. This is directly related to menopause, which provokes other complications: atherosclerosis, osteoporosis, diabetes mellitus, oncology and others.

When we talk about the hormonal background of patients, we note that many women are afraid to take hormonal drugs, fearing that they will provoke oncology. In fact, the risk of cancer increases, on the contrary, against the background of hormonal deficiency. The situation is aggravated by the use of oral contraceptives, which have a lot of side effects, while the appointment of hormone replacement therapy is ignored.

In fact, it is very important not to miss the moment.According to various sources, in the period from 3 to 8 years – on average within 5 years – from the moment of menopause, receptors and their sensitivity to estrogen fade away. And if this happens, it is too late to take any action. Moreover, the appointment of hormone therapy after the extinction of the receptors can even harm the patient. Therefore, it is very important to consult a doctor in time as soon as you feel the approach of menopause.

A signal that indicates the approach of menopause is menstrual irregularities – delays or, conversely, increased menstruation.If you notice these signs in yourself, this is a reason to go to the doctor and, at least, get tested for hormones.

Procedure for climacteric syndrome:

  • Analysis for FSH and LH (follicle-stimulating and luteinizing hormones of the pituitary gland, which determine the function of the ovaries)
  • Mammography + breast ultrasound
  • Blood clotting test
  • Biochemical blood test
  • Ultrasound of the small pelvis
  • Cervical examination cytology
  • Analysis of saliva and urine for metabolites
  • Taking anamnesis
  • Densitometry – Bone Mineral Density Test
  • Prescribing hormone replacement therapy or other treatment plan

The set of tests is determined by the doctor, based on the individual parameters of the patient.For example, based on the history of a patient who has had cases of breast cancer in the family, the doctor will definitely prescribe an analysis for the genes responsible for breast cancer. The majority of breast cancers are not hereditary. But we remember the example of Angelina Jolie, who had a hereditary predisposition to breast cancer, and she removed her breasts for preventive purposes. Among our patients, there were also similar examples: when passing a genetic test, it was revealed that the likelihood of developing oncology tends to 100%.

It should be noted that not all patients in whose family there were cases of oncological diseases are at risk: it happens that both the mother and grandmother had cancer, but the genetic test is not positive, so the patient is not at risk.

About breast cancer.

Angelina Jolie’s decision was correct, as with breast removal, there is literally nowhere for cancer to develop. After carrying out such an operation, hormone therapy is necessarily prescribed.However, if the patient has already started menopause, and the genes responsible for the development of breast cancer have been identified, hormone therapy is not prescribed, as this can provoke the development of oncology.

Hormonal drugs by themselves do not cause oncology, but if the patient already has a tumor, it will grow at a faster rate when taking hormonal drugs. On average, cancer cells grow for 8-10 years, and for many years they are invisible, since breast cancer has no tumor markers.

However, you can always act on cancer prophylactically.

Breast cancer does not occur against the background of absolute health. Mastopathy, cyst, fibroids, polyps, endometriosis are diseases of accumulation of harmful toxic estrogens that are detected in urine or saliva. By their balance, it is possible to determine whether the patient is at risk, and to act on toxic metabolites – to reduce their accumulation. Cancer at the initial stage undergoes a reverse development. Those at risk are prescribed courses of certain drugs, for example, broccoli extracts, which are drunk in courses for life.

Early ovarian extinction.

In some cases, FSH and LH values ​​may be normal, for example, at the age of 48. Accordingly, the reasons for menstrual irregularities may be different: disruption of the thyroid gland, prolactin juices, – not uniquely menopause. Some women have a chance to preserve their ovaries until a later age.

The prerequisites for late menopause are as follows:

  • Good genetics (the patient’s mother had a late menopause)
  • Caring for your body
  • Leading a healthy lifestyle
  • Timely prevention
  • No fatigue from intense professional activity

It is worth noting that, according to statistics, if menstrual irregularities begin at the age of 48-50, this will be a sign that menopause is beginning, and it is time to consult a doctor for qualified help.

Nowadays, early ovarian extinction is increasingly common – at the age of 35-40 years. If hormone replacement therapy is not prescribed at this age, then the woman will grow old very quickly. Today, among doctors, there is an opinion that it is easier to fertilize a mother than a daughter. Those patients who are now 20-25 years old have big problems in the field of reproductive health. This is evidenced by the growth in the number of IVF clinics. Women aged 45 are now more fertile than girls aged 25-30 because women of the previous generation lived in more environmentally friendly conditions.

Causes of early menopause / ovarian failure:

  • Unfavorable ecological situation
  • Abundance of chemical elements and pesticides that inhibit ovarian function
  • Stress
  • Non-compliance with sleep
  • Overly active work
  • Genetics

Cystitis with menopause: description of the disease, causes, symptoms, diagnosis and treatment

According to medical statistics, the onset of menopause in women occurs starting from 45-48 years.The state of health and well-being is noticeably deteriorating. This is due to significant changes in the hormonal background of a woman. There is the appearance of hot flashes, a periodic increase in heart rate, a deterioration in sleep occurs, a woman becomes irritable, and also, the likelihood of developing a chronic form of cystitis increases. Such a disease with menopause is a very common phenomenon, since a violation of the hormonal background contributes to the creation of a favorable environment for the inflammatory process.

Why does the disease


There are a number of traditional anatomical and functional prerequisites that contribute to the more frequent occurrence of cystitis in women than in men. In addition, the climacteric period is complemented by involutive changes in the organs of the female urinary system. The leading role in the development of the atrophic process is assigned to hypoestrogenism, which is observed during menopause.

The main factors that increase the risk of cystitis during menopause include:

  • The mucous membrane of the bladder atrophies.Progressive estrogen deficiency contributes to the thinning of the epithelial layer, smoothing the folds. As a result, the vulnerability of the mucous membranes increases, cracks form, in which pathogenic microorganisms can accumulate.

  • Blood circulation in the genitourinary organs is impaired. The atrophic process contributes to a deterioration in blood flow to the detrusor and urethral canal. Due to the resulting hypoxia, the protective functions of the mucous membranes decrease, as a result of which the inflammatory process develops rapidly.

  • The receptor apparatus changes its activity. Menopause in a woman is characterized by a reduced number of adrenoceptors. In addition, there is a decrease in the sensitivity of acetylcholine receptors, the coordination of detrusor contractions is impaired.

  • Urogenital disorder. Since the vagina and urethra undergo atrophic changes, the primary antibacterial potential of the mucous membrane decreases.Menopause is often accompanied by colpitis and urethritis, which leads to the rapid development of cystitis.

A microbial agent provokes an inflammatory process in the bladder during menopause. In urine or biopsy, in most cases, E. coli is sown. In more rare cases – other nonspecific opportunistic microflora. Namely: Staphylococcus, Streptococcus, Proteus, Pseudomonas aeruginosa, Enterococcus, Candida. With menopause, in contrast to reproductive age, the development of specific forms of the disease occurs much less often, that is, those that are provoked by mycoplasma, ureaplasma, chlimidia, Trichomonas, gonococcus.

How does cystitis


There are the main symptoms of a bladder infection:

  • Painful sensations during urination, which intensify at the end of emptying.

  • Frequent urination (more than 7 times a day)

  • There is a feeling that the bladder has not completely emptied.

  • The appearance of general weakness and increased body temperature.

  • Frequent urge to empty the bladder. A small amount of urine is released during each emptying.

  • Pain localized in the lower abdomen.

  • The urine has a strong unpleasant odor.

  • The color of the urine changes. It becomes cloudy, and sometimes blotches of blood are observed.

  • Purulent discharge from the urethra may appear during urination.

In acute cystitis during menopause, pronounced symptoms are present for 5 to 7 days. After that, the signs fade away. If the symptoms of the disease continue further, this may indicate that a chronic form of cystitis has begun.In such a situation, a comprehensive examination is necessary to accurately establish what exactly is the provoking factor of inflammation.

How is disease


To accurately recognize cystitis, differential diagnostics, laboratory and instrumental studies are performed.

Differential diagnostics. If, after taking antibiotics, the woman’s health returned to normal, we can say that there is an acute form of the disease.If the body does not respond to antibacterial treatment, chronic cystitis is suspected. In such a situation, it is necessary to determine what caused the development of the disease, as well as exclude other possible diseases.

Conducting laboratory diagnostics. This diagnostic method consists of:

  • General blood test. In most cases, the indicators are within the normal range. Sometimes it can be detected that a minor inflammatory process is present.The key study, thanks to which the pathology of the genitourinary system is detected, is the delivery of a general urine test. If a woman’s urine becomes cloudy, this indicates that leukocytes, purulent components, bacteria, epithelium, erythrocytes are present. The appearance of urine also changes under the influence of uric acid salts, protein. If the urine has become a sharply unpleasant odor, this indicates an advanced case of cystitis.

  • Delivery of urine analysis according to Nechiporenko.As a result of such a study, a more detailed designation of the state of the woman’s genitourinary system occurs. Thanks to this analysis, the concentration of elements in 1 ml of urine from the middle portion is revealed. The average portion of urine is examined necessarily if the general analysis of urine showed abnormal indicators.

Carrying out instrumental diagnostics. At the initial stage, a woman is shown a cystoscopy. The essence of this diagnostic method is the visualization of the genitourinary organs.For this, a cystoscope is used. The limitation to this procedure is the acute form of cystitis. Otherwise, it is possible not only to cause painful sensations in the patient, but also to injure the organ, as a result of which the intensity of the infectious process will increase.

Such a procedure is indicated only in the presence of a chronic form of cystitis. It is this form during menopause that is most common. In addition to these methods, a woman may be prescribed an ultrasound examination, uroflowmetry, biopsy.

When is the operation indicated?

If the therapeutic treatment did not work, the woman is prescribed an operation. Medical statistics say that about 5-7% of patients diagnosed with chronic cystitis require surgical treatment.

1. Too close location of the urethra to the vagina. During sexual intercourse, the canal is drawn into the vagina, then it is injured and painful.In addition, such an anatomical structure can cause infectious development, which can penetrate the bladder without obstacles. This is how the inflammatory process begins in it. With surgery, the canal opening is displaced, the woman gets rid of the problem. This is a simple surgical procedure, the patient recovers in a short period of time. In the recovery period, the intake of antibacterial drugs is indicated. In addition, it is forbidden to have sexual intercourse at this time.

2. With recurrent cystitis. This form of the disease can be caused by various reasons. One of them may be prolapse or prolapse of the uterus, as well as the replacement of muscle fibers in the bladder neck with connective tissue. Such a site is removed. For this, a special loop is used, which is heated with an electric current. During such an operation, there is no bleeding, since thanks to the loop, not only tissue cutting occurs, but also vascular coagulation.

3. Necrotic form of cystitis. It is characterized by necrosis of the bladder walls. In such a situation, it is necessary to impose an epicystostomy. This is a special tube that will drain your urine. After that, the inflammatory process is eliminated. Removal of the tube is only indicated if the bladder has increased to 150 milliliters.

4. At the onset of the most extreme case, when cystitis threatens the development of dangerous complications, and other methods were powerless, the patient is prescribed a resection of the bladder.A portion of the colon or small intestine serves as a replacement for the bladder reservoir.

Use of homeopathy for cystitis

With menopause, a woman can be prescribed both hormonal therapy and a homeopathic remedy (phytoestrogens). Phytoestrogens have a mild effect on a woman’s body. In addition, they do not pose a hazard with prolonged use. This means that for a long time, a small dose of plant estrogen enters the body, which means that it is gradually and naturally adjusted.The most popular homeopathic remedies include:

  • Remens. It helps to reduce the manifestations of menopause. The woman’s mood stops abruptly, there is no dizziness, she becomes calmer, the hot flashes gradually disappear. Thanks to this drug, the body fades and grows old much more slowly, the body weight does not increase. In addition, women tolerate remens well, it has no contraindications or any complications. The drug is taken three times a day, ten drops.Remens therapy for menopause lasts about six months.

  • “Menopause”. The composition of such a preparation includes plants, minerals, vitamins E, B. Thanks to the intake of such a ladys formula, the bones become less brittle, the lack of vitamins is replenished, the woman is in a stable emotional state.

  • Tsi-klim. Reception of such a remedy reduces irritability, apathy, mood swings, eliminates insomnia, excessive sweating, hot flashes.

How is cystitis treated with menopause

To eliminate involutional inflammation of the bladder, it is necessary to correct the patient’s hormonal background and get rid of the infection. The treatment consists of two stages. At the first stage, when inflammatory symptoms prevail, the doctor prescribes drugs that stop the main manifestations of cystitis. Then the patient is shown long-term hormone replacement therapy.

At the first stage, in the treatment of menopausal cystitis, medications can be prescribed that belong to the following groups:

  • Reception of female sex hormones.With an exacerbation of cystitis, to obtain the best result, the doctor prescribes intravaginal agents and systemic estrogens. Thanks to this combination, the normal vaginal flora is restored, the proliferation of the vaginal epithelium is eliminated, the tissues of the urogenital organs become more elastic.

  • Taking antibacterial drugs. To choose the right antibiotic, you should consider the sensitivity of the pathogen. In most cases, fluoroquinolones, fosfomycins, nitrofurans, cephalosporins and other uroantiseptics are prescribed to eliminate involutional cystitis.

  • Taking non-steroidal anti-inflammatory drugs. Thanks to such drugs, the excretory process of chemical compounds from the cells of the pathogen is suppressed. In addition, the infectious and inflammatory response decreases.

  • Taking medications that improve microcirculation. Purine derivatives and other peripheral vasodilators contribute to the improvement of tissue perfusion, as a result of which the damaged mucous membrane is quickly restored.Sufficient oxygenation helps to reduce the risk of fibrosclerotic process.

  • Taking stimulants and receptor blockers. The patient may be prescribed anticholinergic drugs, adrenomimetics, anticholinergics. To correct detrusor overactivity, the use of nootropics, selective serotonin reuptake inhibitors, is indicated.

Supportive treatment consists of lifelong hormone replacement therapy.At the same time, there is a constant adjustment of the type of drug, its dosage and method of administration. The topical remedy can be taken on an ongoing basis.

Removal of an attack of cystitis

In the acute form of cystitis, each attack is very painful. The first main rule, thanks to which an attack is facilitated, is the consumption of a large amount of liquid. It promotes the rapid elimination of pathogenic microorganisms from the body, as a result of which, the human condition is facilitated.

In a more severe case, you can use medication. The best solution is antispasmodics. The spasm is eliminated, the tone of the smooth muscles of the bladder decreases. Painful sensations are eliminated not only by antispasmodics, but also by analgesics.

Self-administration of antibiotics is strictly prohibited. This can change not only the picture of laboratory examination, but also complicate the identification of the source and cause of the disease. By self-medication, you can only get rid of the symptoms for a while, while the cystitis will become chronic.

What complications can arise

Self-medication and uncontrolled use of drugs is strictly prohibited.

In the absence of timely treatment, the following consequences will occur:

  • Kidneys are affected. Medical statistics indicate that in almost all cases, with untreated cystitis, pyelonephritis and nephritis develop. A more severe consequence is renal failure.Its formation is associated with excessive poisoning of the kidney tissue with the waste products of the infection.

  • Organic changes in the bladder. Due to epithelial degeneration, the bladder becomes less elastic. In addition, its size decreases, and the ability to regenerate is lost. As a result of this effect, the bladder can rupture.

  • In the absence of timely specific treatment, the likelihood that the disease will acquire a chronic form increases.With chronic cystitis, constant inflammatory processes appear. According to medical records, cystitis is not an isolated pathology. In most cases, nearby organs are affected. If a woman has chronic cystitis, relapses of the disease develop, colpitis worsens, adhesions form in the structure of the uterus. Reproductive function is not only reduced, but can also completely disappear.

  • An immediate complication of cystitis is the appearance of stress and depression.An incurable pathology develops into a chronic form. Cystitis often recurs, up to several times a month. During the illness, the patient succumbs to the strongest psychological pressure.

  • The sphincter of the bladder becomes weak. As a result, urinary incontinence develops. This is mainly observed in elderly patients.

What is the forecast

Early diagnosis and timely complex treatment promotes recovery in most women.It should be noted that the use of an antibiotic must be combined with a hormonal drug. Otherwise, the effect will be only temporary. Basically, the prognosis for cystitis during menopause is favorable.

Climax – ProMedicine Ufa

Climax is a special period in a woman’s life. Today, the average age of a woman is approaching 75. The onset of menopause can be attributed to 48+ – 2 years. The climacteric period lasts about 20 years and is the transition from the extinction of fertility to old age.At this time, the rhythm of menstruation changes – they can be less frequent or several times a month. Blood loss can be more or less profuse.

The process of the extinction of ovarian function is reflected, first of all, in the production of female sex hormones, and therefore on the entire body. Hormones are very important for the body. They provide the female body structure, skin color, hairline, secondary sexual characteristics. Hormones affect all organs.

On average, women reach menopause for about 50 years.But sometimes you can see early and late menopause. If menstruation stops at 38, or at 42, then this is a premature menopause, premature ovarian depletion. Late menopause (persistence of menstruation beyond age 55) may be normal or a sign of illness.

Causes and symptoms

The appearance of menopausal signs is proof that the woman’s health is normal. Changes in menopause are caused by natural changes in hormonal levels.Moreover, each woman suffers menopause in her own way. But some symptoms are natural for the female body, and some are pathologies.

Naturally, what does not bother, does not disrupt a woman’s performance. She may be sadder, less mobile, something aches somewhere, but she may not attach any importance to this. Another woman develops a group of symptoms that are associated with a deficiency of hormones – hot flashes, sweating, sleep disturbances, nervousness, tachycardia.These manifestations are due to estrogen deficiency. This is the climacteric syndrome.

Menopause occurs in 9 out of 10 women. Estrogen deficiency leads to atrophic changes – tissue thinning, which is the cause of problems with urination, position and function of the genitals. A few years after the cessation of menstruation, other atrophic processes begin to appear: dryness in the vagina and soreness with intimacy, decreased skin elasticity, hair loss and brittleness.

During this period, changes in character were observed, manifested by excessive irritability, suspiciousness and vulnerability.

In addition to the above signs, with menopause, irregular periods are observed. For several years before menopause, a woman experiences changes in her cycle. It may decrease or increase, bleeding with menopause may become stronger or weaker every month. Missed cycles are common.

In addition to the above symptoms, with menopause in women, there is a decrease in immunity.As a result, they begin to get sick more often, and chronic diseases are exacerbated.

Diagnostics and treatment

Diagnosis of menopause and climacteric neurosis usually does not present any particular difficulties, given the characteristic complaints and age of patients.

If menopause occurs in mild and moderate form, then it does not require any special treatment. In the case of a severe course, drug treatment is required.It is known that most pathological processes during menopause occur due to a decrease in the production of estrogen.Therefore, the main method of treatment for menopause is replacement therapy, during which the deficiency of female sex hormones is replenished. The doctor tries to select the level of hormones so that with the minimum dosage, the maximum improvement of the condition occurs.

The doctor selects the treatment regimen and dosage for each patient individually, based on the characteristics of the vital activity of her body. In the treatment of menopause, only natural estrogens are prescribed. To prevent the proliferation of the endometrium, progesterones are prescribed along with estrogens.

For the prevention of osteoporosis, experts recommend taking medications that contain silicon. It improves bone elasticity and prevents calcium leaching.

In addition to medication, a woman is advised to change her lifestyle. It is necessary to give up bad habits, start eating right and playing sports.

Menopause in a woman – first symptoms, methods of improving well-being

Symptoms of menopause in women, how to alleviate the condition

Menopause, or menopause, refers to the physiological processes that indicate old age.During menopause, the uterus and ovaries cease their functionality, the reproductive period ends. Unfortunately, it is impossible to stop or somehow prevent this process. But knowing the symptoms of menopause in women and the recommendations of gynecologists, it is quite possible to alleviate the condition and make the menopause simpler.

What is known about menopause

In gynecology, several types of the physiological process under consideration are distinguished:

  • natural – menopause, which came on time and without any outside interference on the aging process and the extinction of the reproductive function of the body;
  • surgical menopause after removal of the uterus is a normal phenomenon after such an intervention, requiring constant support of the body with drugs;
  • premature menopause;
  • menopause, which occurred against the background of ovarian failure.

At what age do women go through menopause? Doctors determine the period of 40-55 years, but most often menopause is diagnosed at the age of 50.

Symptoms of menopause in women

You can talk about the onset of menopause if the following symptoms are present:

  • a sharp change in mood – this is especially characteristic of the early menopause at the age of 40;
  • sudden onset of fever, hot flashes;
  • a slight increase in body temperature for no apparent reason;
  • too fast weight gain, obesity with the usual diet;
  • Excessive irritability and nervousness;
  • itching, burning and dryness in the intimate area;
  • increased fatigue, drowsiness.

In addition, a woman may be disturbed by dizziness and headaches, and sleep disorder occurs. She is beginning to be disturbed by groundless experiences, the unstable psycho-emotional background is clearly visible to those around her.

Climax lasts for several years and is not characterized by rapid development. A woman will never have all of the above symptoms at once. The latter will grow gradually, alternating with quite “healthy” periods. Vaginal discharge during menopause continues, but becomes brownish-red, denser, viscous.If they acquire an unpleasant odor, then this indicates an inflammatory or infectious process in the organs of the reproductive system. This condition requires the provision of qualified medical care.

Artificial menopause, as a rule, proceeds more easily and quickly. For example, a woman may not experience hot flashes and hot flashes, but will constantly complain of acute headache or dizziness.

What to do at the first sign of menopause? Firstly, you should not use any medications and try to cope with the discomfort with folk methods.First you need to confirm the diagnosis with a gynecologist. Secondly, you need to visit a medical institution and get qualified help, including in the form of doctor’s recommendations on methods of stabilizing your well-being.

Help with the signs of menopause

The physiological process under consideration causes great inconvenience to a woman and not only in terms of well-being. Sweating, dizziness and headaches interfere with the usual active lifestyle, and in some cases even “force” to stop working.To solve the problem, you should heed the recommendations of gynecologists:

  1. How to relieve hot flashes during menopause. It is recommended to wear light clothing, if possible be near a ventilator or in an air-conditioned room, and consume a sufficient amount of liquid (at least 2 liters per day). If hot flashes bother a woman too often (several times a day or every day), then it is worth visiting a doctor and undergoing treatment with hormonal drugs.
  2. If there is excessive sweating at night, the recommendations are as follows: just before going to bed, take a cold shower (cool), cover with a thin blanket, be sure to leave some part of the body open to release heat (for example, you can not cover your lower limbs).Using a heating pad or ice pack is a great option. They are placed under the pillow and periodically turned over at night.
  3. Itching and burning in the intimate area most likely indicates vaginal atrophy. This is also a physiological process. Doctors do not recommend giving up sex during this period, since an active sex life allows you to maintain the vaginal tissue in a normal state. If severe dryness is observed, then it is worth using a special lubricant for intercourse.But there is one caveat – the lubricant should be water-based, which will avoid repeated irritation.
  4. Lose weight. It is the extra pounds that provoke hot flashes, sweating and early atrophy of the vagina. By contacting an experienced nutritionist, you can get advice on how to lose weight with menopause. Banal diets are unlikely to help in this case.
  5. If any chronic pathology of the reproductive system was previously diagnosed, then at the first signs of menopause, you must definitely visit a gynecologist.Many diseases during this period require supportive therapy. For example, endometrial hyperplasia in menopause involves hormone therapy.

The climacteric period is inevitable, so a woman should prepare for it in advance. You can get information about HRT for menopause (hormone replacement therapy), make an appointment with a specialist on our website Dobrobut.com.

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Gynecological Check-up

Care for the elderly, taking into account the physiological characteristics of women

It is impossible to care for the elderly without taking into account the peculiarities of the physiology of the organism, not only during this period, but also in those preceding it.One of the most important signs of the end of maturity and the onset of old age for women is menopause – that is, a condition in which the entire body of a woman is drastically rebuilt in a new way. The climax ends with menopause, that is, the onset of the period when a woman is no longer able to become pregnant.

Hormonal changes in the body during menopause, as a rule, are combined in women and with a difficult life period in psychological terms; it is at this moment that children start their own families, and the woman is left alone with her problems; in addition, many women in menopause are very worried about the fact that their physical attractiveness decreases, new diseases appear, and the body is already apparently aging.All these psychological problems only increase with age, therefore, when caring for the elderly, it is necessary to remember about the presence of these problems and about the age at which they arose in a woman and what they are associated with. But with the proper approach to yourself and the correct perception of the onset of old age as one of the best periods in life that you can devote to yourself completely and completely, depression and loss of energy can be avoided.

Menopause, as a rule, occurs at about 52 years old – this is inherent in the body of any woman.Unfortunately, unfavorable living conditions can significantly shift the onset of menopause to an earlier side; for example, in a Russian woman, menopause occurs at about 45-48 years. After 40 years in the life of any woman, premenopause occurs – a period with irregular menstrual cycles; and a year after the last menstruation, postmenopause occurs, which lasts until about 65 years of age. The climacteric period is premenopause, menopause itself and postmenopause; thus, it continues in the life of any woman for about a quarter of a century.

It should be emphasized that the climacteric period in the life of any woman is characterized by a sharp increase in the risk of cardiovascular diseases and coronary heart disease; during the postmenopausal period, almost half of women develop osteoporosis, which in old age becomes the cause of many fractures; various urogenital diseases also develop.

Private boarding school for the elderly “Nasha Zabota” provides care for the elderly with maximum consideration of the characteristics of human physiology; this is what allows our clients to remain useful and active members of society for as long as possible and lead a fulfilling life to a ripe old age.Caring for the elderly cannot be carried out if one does not take into account the peculiarities of the physiology of the body, not only during this period, but also in those preceding it. One of the most important signs of the end of maturity and the onset of old age for women is menopause – that is, a condition in which the entire body of a woman is drastically rebuilt in a new way. The climax ends with menopause, that is, the onset of the period when a woman is no longer able to become pregnant.

90,000 Menopause, sex drive reduction treatment

In recent years, modern medicine has been actively studying the causes of premature aging in men, as well as the development of effective methods for the prevention and correction of age-related changes, including climacteric disorders.

Partial deficiency of male sex hormones – androgens is male menopause , which manifests itself mainly from 50 to 55 years. During this period, the reproductive function of childbirth is almost complete and for a man his sexual function becomes more relevant, which gradually begins to decline. This phenomenon is determined by a decrease in the main hormone of androgens – testosterone.

Testosterone in the male body: acts on the genitals, prostate gland, seminal vesicles, epididymis, penis, activates the metabolism of fats, proteins, cholesterol, trace elements, etc.regulates normal spermatogenesis, stimulates sexual manifestations and other processes. Testosterone predominantly affects the formation and activation of libido, sexual arousal, and the intensity of orgasm.

Thus, testosterone plays a very important role in the male body at the physical, sexual and emotional levels.

The main changes in the sexual sphere that are observed in men over 50-55 years old can be: weakening (absence) of sexual desire, slow onset of erection, decreased stiffness of the penis during erection, decrease in ejaculate volume, etc.

Studies in recent years have shown quite clearly that a decrease in plasma testosterone concentration causes a decrease in libido, sexual activity and the frequency of sexual fantasies. Clinical manifestations during the climacteric period are multifaceted: increased fatigue, a tendency to depression, a feeling of fear, weakened memory, drowsiness, sweating, a tendency to hypertension, frequent tachycardia, dizziness, migraine, frequent constipation, an increase in adipose tissue, a decrease in the rate of hair growth, atrophy skin, anemia, osteoporosis.

These manifestations of menopausal disorders in men are quite typical, in each case there may be two or three or more manifestations, the full complex of disorders, fortunately, is more rare.

The most common complaint in men with climacteric syndrome: weakening of sexual function, erectile dysfunction, decreased libido, which is aggravated with aging, in the presence of a number of concomitant diseases: depression, heart disease, smoking, diabetes mellitus, coronary heart disease, hypertension, etc. …

Treatment for decreased sex drive

When choosing an adequate therapy, it is necessary to establish the cause of the dysfunction.
The conclusion of the specialist is based on the analysis of the patient’s complaints, on the subjective assessment of his sexual potency. Hormonal examination : determination of testosterone in blood plasma, special tests, dopplerography of the vessels of the penis, ultrasound, etc. It is very important to determine PSA in patients with climacteric syndrome, given their age and significant hormonal changes, which are risk factors for prostate cancer.It also requires an ultrasound scan and, if necessary, a biopsy of the prostate.

Treatment of climacteric disorder requires a versatile and individual approach, it should be a complex and normalizing effect on all mechanisms of the formation of this syndrome.

The main therapeutic measures : pathogenetic therapy with androgens, vitamin therapy, the use of biologically active drugs, methods of physiotherapy and reflexology, correction of erectile dysfunction with special drugs or intracavernous treatment.

Although it is assumed that the likelihood of onset, timing and severity of menopausal disorders in men are genetically determined, the important role of environmental and lifestyle factors is obvious. All measures aimed at eliminating or reducing their negative impact have both preventive and therapeutic value.

It is known that the frequency of climacteric disorders, as well as cases of their early onset, is significantly higher among persons exposed to occupational and household hazards.Irregular working hours, prolonged overstrain, systematic overheating and hypothermia, the action of ionizing radiation, vibration, noise, are additional factors contributing to the development of climacteric syndrome.

Prevention measures male menopause coincide with existing approaches to prevent premature aging.

Age-related decrease in physical activity and the intensity of metabolic processes leads to a decrease in energy requirements.If this does not change the nature of the diet, then the lack of balance between the calorie content of food consumed and the body’s energy consumption will lead to an increase in body weight, and subsequently obesity. In this case, a subcaloric diet is prescribed with a low content of fats and carbohydrates, rich in proteins, complete in terms of the content of mineral salts, trace elements and vitamins. Fasting days should be recommended, without limiting physical activity. It is important to eliminate constipation, to normalize bowel function.

Maintaining sexual activity is essential to the success of all therapeutic interventions. It is necessary to preserve and maximally support the patient’s sexual activity.

Strengthening and maintaining mental and emotional balance seems to be a very important task, given that it is the violations of this area that constitute the leading component of the climacteric syndrome.

Rational psychotherapy should be an obligatory part of the medical complex.It is necessary to make optimal use of the opportunities to normalize interpersonal relations with the wife, the psychological climate in the family, the patient’s attitude to the changes in health and well-being that have arisen. It is necessary to create an optimistic mood in the patient, instill self-confidence.

Thus, it is possible and necessary to fight against menopause !!!

Do not postpone your visit to the doctor!

For more details and make an appointment with a specialist, you can call +7 (495) 292-39-72

Alina Medical Center »Female menopause (menopause)

Menopause – the last independent menstruation due to ovarian function (the date is set retrospectively, namely after 12 months of absence of menstruation)

Allocate the period of the menopausal transition, the actual menopause and postmenopause.The early stage of transition to menopause is characterized by an increase in the variability of the duration of menstrual cycles, which is determined by stable differences of 7 or more days when comparing successive cycles. Stable character means a similar pattern within 10 cycles from the time of the first cycle, increased in duration. The late stage of transition to menopause is characterized by the appearance of amenorrhea with a duration of 60 days or more, characterized by an increase in blood FSH levels of more than 25 IU / L and lasts about 1-3 years.Early postmenopause lasts 5-8 years, followed by a period of late postmenopause.

All people grow old sooner or later and face the problem of menopause.

By about the age of 50, the metabolism slows down, the production of hormones in women decreases, cell renewal is inhibited, diseases and problems arise that are quite rare or do not occur in youth.

Menopause consists of several stages, varying in duration and continuing until the end of life.Feeling unwell, mood swings, “hot flashes”, sweating, pressure drops, rapid heartbeat – this condition can last for quite a long time. To prevent possible concomitant diseases associated with hormonal deficiency (mastopathy, breast cancer, cancer of the female genital organs, prolapse of the genitals, osteoporosis, etc.), you need to contact a specialist (gynecologist, endocrinologist, etc.).

From the point of view of the production of female sex hormones, a woman’s entire life is divided into several stages: premenopause (from the moment of the first menstruation to the end of regular menstruation), perimenopause (the period before and after menopause), menopause (the time of the last menstrual period) and postmenopause (the period, starting twelve months after menopause until the end of life).

Perimenopause, menopause and postmenopause are conventionally combined into menopause – menopause.


This period begins, on average, 4 years before menopause (average age 47.5 years) and lasts for 12 months after the cessation of menstruation.
The first sign of perimenopause is changes in the menstrual cycle, both in duration and in the amount of blood loss.
Perimenopause is a time of great hormonal changes in a woman’s body.The level of estrogens – female sex hormones – begins to fluctuate and decreases steadily. Due to the deficiency of female hormones, a number of unpleasant symptoms develop. The earliest symptoms are hot flashes and night sweats, depression, irritability.


Menopause is the time of the last natural bleeding (menstruation). It can only be established after 12 months without bleeding (amenorrhea). The average age of menopause is 51.3 years, although women who smoke can reach menopause 1.5-2 years earlier.


Twelve months after menopause, women enter the postmenopausal period – a period until the end of life marked by a deficiency of female sex hormones.
As mentioned above, the first symptoms associated with a deficiency of female sex hormones are “hot flashes” and night sweats, mood swings, irritability. They last for at least 2 to 5 years – the early postmenopausal period – and then usually disappear.

Symptoms such as vaginal dryness and itching, loss of sexual desire, pain when urinating, etc., only get worse over time.

In addition, in the first few years after menopause, bone loss occurs very quickly, and vascular changes begin to progress, from which a woman was previously protected by a high level of estrogen hormones. These changes increase the risk for women of osteoporosis (increased fragility of bones, which leads to frequent fractures, the worst of which is a hip fracture), as well as the risk of heart disease.