What are the key facts about menopause. How does menopause occur naturally. What are the common symptoms of menopause. How is menopause diagnosed. What treatment options are available for menopause symptoms. How can lifestyle changes help manage menopause. What are the long-term health considerations for postmenopausal women.

Understanding Menopause: A Natural Life Transition

Menopause marks a significant milestone in a woman’s life, signaling the end of her reproductive years. Occurring typically between ages 45-55, menopause is defined as the point when a woman has not had a menstrual period for 12 consecutive months. This transition is caused by a natural decline in ovarian function and hormonal changes, particularly decreasing levels of estrogen.

Do all women experience menopause at the same age? While the average age of menopause is 51, the timing can vary widely. Some women may enter menopause in their early 40s, while others may not reach this stage until their late 50s. Factors influencing the onset of menopause include genetics, lifestyle, and overall health.

Stages of Menopause

• Perimenopause: The transitional phase leading up to menopause
• Menopause: The point marking 12 months since the last menstrual period
• Postmenopause: The years following menopause

Common Symptoms and Signs of Menopause

As the body adjusts to changing hormone levels, women may experience a variety of symptoms during perimenopause and menopause. These can range from mild to severe and may impact daily life and well-being.

What are the most frequently reported menopausal symptoms? While experiences vary, some of the most common symptoms include:

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

Can menopausal symptoms be severe enough to disrupt daily life? For some women, menopausal symptoms can significantly impact their quality of life, affecting sleep, work performance, and relationships. In such cases, seeking medical advice and exploring treatment options is recommended.

Diagnosing Menopause: When to Consult a Healthcare Provider

Menopause is typically a clinical diagnosis based on a woman’s age, menstrual history, and reported symptoms. However, in some cases, additional tests may be necessary to confirm the diagnosis or rule out other conditions.

How do doctors diagnose menopause? Healthcare providers may use the following approaches:

1. Medical history review and symptom assessment
2. Physical examination
3. Hormone level testing (FSH and estradiol)
4. Thyroid function tests to exclude thyroid disorders

Is hormone testing always necessary for diagnosing menopause? For most women, hormone testing is not required to diagnose menopause. However, it may be recommended for younger women experiencing menopausal symptoms or in cases where the diagnosis is unclear.

Treatment Options for Managing Menopausal Symptoms

While menopause itself does not require treatment, many women seek relief from its associated symptoms. Treatment options range from lifestyle modifications to medical interventions, depending on the severity of symptoms and individual health factors.

Hormone Therapy (HT)

Hormone therapy remains one of the most effective treatments for managing menopausal symptoms, particularly hot flashes and vaginal dryness. It involves supplementing the body with estrogen and, in some cases, progestin.

What are the benefits and risks of hormone therapy? HT can significantly alleviate menopausal symptoms and may offer additional benefits such as bone protection. However, it also carries potential risks, including an increased chance of breast cancer and cardiovascular issues in some women. The decision to use HT should be made in consultation with a healthcare provider, considering individual health history and risk factors.

Non-Hormonal Medications

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

• Selective serotonin reuptake inhibitors (SSRIs) for hot flashes and mood symptoms
• Gabapentin or pregabalin for hot flashes and sleep disturbances
• Clonidine for hot flashes
• Ospemifene for vaginal dryness and painful intercourse

Lifestyle Changes to Manage Menopausal Symptoms

Adopting certain lifestyle modifications can help alleviate menopausal symptoms and improve overall health and well-being during this transition.

How can diet and exercise impact menopausal symptoms? A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help manage weight gain and support overall health. Regular physical activity, including both aerobic exercise and strength training, can improve mood, sleep quality, and bone health.

Additional Lifestyle Recommendations

• Practice stress-reduction techniques such as meditation or yoga
• Maintain a cool sleeping environment to manage night sweats
• Limit caffeine and alcohol intake, especially before bedtime
• Quit smoking to reduce hot flashes and improve overall health
• Stay socially engaged and maintain strong support networks

Alternative and Complementary Therapies for Menopause

Many women explore alternative and complementary therapies to manage menopausal symptoms, either alone or in combination with conventional treatments.

Are herbal remedies effective for managing menopausal symptoms? While some women report benefits from herbal remedies such as black cohosh, red clover, and evening primrose oil, scientific evidence supporting their efficacy is limited. It’s important to discuss any herbal supplements with a healthcare provider, as they can interact with medications and may have side effects.

Other Complementary Approaches

• Acupuncture for hot flashes and mood symptoms
• Mindfulness-based stress reduction techniques
• Cognitive behavioral therapy for sleep disturbances and mood changes
• Pelvic floor exercises for urinary incontinence

Long-Term Health Considerations for Postmenopausal Women

As women transition through menopause, they face an increased risk of certain health conditions due to the long-term effects of reduced estrogen levels.

What are the primary health concerns for postmenopausal women? Key areas of focus include:

1. Cardiovascular health: Increased risk of heart disease and stroke
2. Bone health: Higher risk of osteoporosis and fractures
3. Urogenital health: Increased likelihood of urinary tract infections and vaginal atrophy
4. Cognitive function: Potential increased risk of cognitive decline and dementia
5. Metabolic health: Changes in body composition and increased risk of metabolic syndrome

How can postmenopausal women protect their long-term health? Adopting a healthy lifestyle, including regular exercise, a balanced diet, and routine health screenings, is crucial. Women should work closely with their healthcare providers to develop personalized strategies for maintaining optimal health in the postmenopausal years.

Navigating the Emotional and Psychological Aspects of Menopause

Menopause is not just a physical transition; it can also have significant emotional and psychological impacts. Many women experience mood changes, anxiety, and a sense of loss as they navigate this life stage.

How can women cope with the emotional challenges of menopause? Strategies for emotional well-being include:

• Seeking support from friends, family, or support groups
• Practicing self-care and prioritizing mental health
• Exploring new interests and setting personal goals
• Considering counseling or therapy if mood changes are severe
• Staying informed about the menopausal transition to reduce anxiety

Is it normal to experience depression during menopause? While mood changes are common, clinical depression is not a normal part of menopause. Women experiencing persistent feelings of sadness, hopelessness, or loss of interest in activities should seek professional help.

Embracing a New Chapter

Many women find that menopause offers opportunities for personal growth and renewed focus on health and well-being. By viewing this transition as a natural part of aging and an opportunity for self-reflection and care, women can navigate menopause with confidence and optimism.

Menopause marks a significant transition in a woman’s life, bringing both challenges and opportunities. By understanding the physical and emotional changes associated with menopause, exploring treatment options, and adopting healthy lifestyle habits, women can effectively manage symptoms and maintain their quality of life. Regular communication with healthcare providers and a proactive approach to health can help ensure a smooth transition through menopause and beyond. Remember, every woman’s experience with menopause is unique, and finding the right balance of treatments and lifestyle adjustments may take time and patience.

Menopause

Menopause

• All topics »
• A
• B
• C
• D
• E
• F
• G
• H
• I
• J
• K
• L
• M
• N
• O
• P
• Q
• R
• S
• T
• U
• V
• W
• X
• Y
• Z
• Resources »
  • Fact sheets
  • Facts in pictures
  • Multimedia
  • Publications
  • Questions & answers
  • Tools and toolkits
• Popular »
  • Air pollution
  • Coronavirus disease (COVID-19)
  • Hepatitis
  • Monkeypox
• All countries »
• A
• B
• C
• D
• E
• F
• G
• H
• I
• J
• K
• L
• M
• N
• O
• P
• Q
• R
• S
• T
• U
• V
• W
• X
• Y
• Z
• Regions »
  • Africa
  • Americas
  • South-East Asia
  • Europe
  • Eastern Mediterranean
  • Western Pacific
• WHO in countries »
  • Statistics
  • Cooperation strategies
  • Ukraine emergency
• All news »
  • News releases
  • Statements
  • Campaigns
  • Commentaries
  • Events
  • Feature stories
  • Speeches
  • Spotlights
  • Newsletters
  • Photo library
  • Media distribution list
• Headlines »
• Focus on »
  • Afghanistan crisis
  • COVID-19 pandemic
  • Northern Ethiopia crisis
  • Syria crisis
  • Ukraine emergency
  • Monkeypox outbreak
  • Greater Horn of Africa crisis
• Latest »
  • Disease Outbreak News
  • Travel advice
  • Situation reports
  • Weekly Epidemiological Record
• WHO in emergencies »
  • Surveillance
  • Research
  • Funding
  • Partners
  • Operations
  • Independent Oversight and Advisory Committee
  • WHO’s Health Emergency Appeal 2023
• Data at WHO »
  • Global Health Estimates
  • Health SDGs
  • Mortality Database
  • Data collections
• Dashboards »
  • COVID-19 Dashboard
  • Triple Billion Dashboard
  • Health Inequality Monitor
• Highlights »
  • Global Health Observatory
  • SCORE
  • Insights and visualizations
  • Data collection tools
• Reports »
  • World Health Statistics 2022
  • COVID excess deaths
  • DDI IN FOCUS: 2022
• About WHO »
  • People
  • Teams
  • Structure
  • Partnerships and collaboration
  • Collaborating centres
  • Networks, committees and advisory groups
  • Transformation
• Our Work »
  • General Programme of Work
  • WHO Academy
  • Activities
  • Initiatives
• Funding »
  • Investment case
  • WHO Foundation
• Accountability »
  • Audit
  • Programme Budget
  • Financial statements
  • Programme Budget Portal
  • Results Report
• Governance »
  • World Health Assembly
  • Executive Board
  • Election of Director-General
  • Governing Bodies website
  • Member States Portal
• Home/
• Newsroom/
• Fact sheets/
• Detail/
• Menopause

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

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

 

“,”datePublished”:”2022-10-17T13:00:00.0000000+00:00″,”image”:”https://cdn.who.int/media/images/default-source/health-topics/physical-activity/woman_running.jpg?sfvrsn=f48f6faa_13″,”publisher”:{“@type”:”Organization”,”name”:”World Health Organization: WHO”,”logo”:{“@type”:”ImageObject”,”url”:”https://www.who.int/Images/SchemaOrg/schemaOrgLogo.jpg”,”width”:250,”height”:60}},”dateModified”:”2022-10-17T13:00:00.0000000+00:00″,”mainEntityOfPage”:”https://www.who.int/news-room/fact-sheets/detail/menopause”,”@context”:”http://schema.org”,”@type”:”Article”};

Key facts

• Menopause is one point in a continuum of life stages for women and marks the end of their reproductive years. After menopause, a woman cannot become pregnant, except in rare cases when specialized fertility treatments are used.
• Most women experience menopause between the ages of 45 and 55 years as a natural part of biological ageing.
• Menopause is caused by the loss of ovarian follicular function and a decline in circulating blood oestrogen levels.
• The menopausal transition can be gradual, usually beginning with changes in the menstrual cycle. ‘Perimenopause’ refers to the period from when these signs are first observed and ends one year after the final menstrual period.
• Perimenopause can last several years and can affect physical, emotional, mental and social well-being.
• A variety of non-hormonal and hormonal interventions can help alleviate perimenopausal symptoms.
• Menopause can be a consequence of surgical or medical procedures.

How menopause occurs

For most women, menopause is marked by the end of monthly menstruation (also known as a menstrual period or ‘period’) due to loss of ovarian follicular function. This means that the ovaries stop releasing eggs for fertilisation.

The regularity and length of the menstrual cycle varies across a woman’s reproductive life span, but the age at which natural menopause occurs is generally between 45 and 55 years for women worldwide. 

Natural menopause is deemed to have occurred after 12 consecutive months without menstruation for which there is no other obvious physiological or pathological cause and in the absence of clinical intervention.

Some women experience menopause earlier (before 40 years of age). This ‘premature menopause’ may be because of certain chromosomal abnormalities, autoimmune disorders, or other unknown causes. 

It is not possible to predict when an individual woman will experience menopause, although there are associations between the age at menopause and certain demographic, health, and genetic factors.

Menopause can also be induced as a consequence of surgical procedures that involve removal of both ovaries or medical interventions that cause cessation of ovarian function (for example radiation therapy or chemotherapy).

Many women have already stopped menstruating before menopause, for example those who have had certain surgical procedures (hysterectomy or surgical removal of their uterine lining) as well as those using certain hormonal contraceptives and other medicines that cause infrequent or absent periods. They may still experience other changes related to the menopausal transition.

Changes associated with menopause

The hormonal changes associated with menopause can affect physical, emotional, mental, and social well-being. The symptoms experienced during and following the menopausal transition vary substantially from person to person. Some have few if any symptoms. For others, symptoms can be severe and affect daily activities and quality of life. Some can experience symptoms for several years.

Symptoms associated with menopause include:

• hot flushes and night sweats. Hot flushes refer to a sudden feeling of heat in the face, neck and chest, often accompanied by flushing of the skin, perspiration (sweating), palpitations, and acute feelings of physical discomfort which can last several minutes;
• changes in the regularity and flow of the menstrual cycle, culminating in cessation of menstruation;
• vaginal dryness, pain during sexual intercourse and incontinence;
• difficulty sleeping/insomnia; and
• changes in mood, depression, and/or anxiety.

Body composition and cardiovascular risk can also be affected. Women’s advantage over men in terms of cardiovascular disease gradually disappears with the significant decline in oestrogen levels after menopause. Menopause can also result in the weakening of the pelvic support structures, increasing the risk of pelvic organ prolapse. Loss of bone density at menopause is a significant contributor to higher rates of osteoporosis and fractures.

There are a variety of non-hormonal and hormonal interventions that can help alleviate symptoms of menopause. Symptoms that impact on health and well-being should be discussed with a health-care provider to identify available management options, with consideration of medical history, values, and preferences.

Pregnancy is still possible during perimenopause. Contraception is recommended to avoid unintended pregnancy until after 12 consecutive months without menstruation. Pregnancy after menopause is unlikely without fertility treatment that involves the use of donor eggs or previously frozen embryos.

During perimenopause and following menopause, it is still possible to acquire sexually-transmitted infections (STIs), including HIV, through unprotected sexual contact, including oral, anal, and vaginal sex. The thinning of the vaginal wall after menopause increases the chances of lesions and tears, thereby increasing the risk of HIV transmission during vaginal sex.

The importance of understanding menopause

It is critical to see menopause as just one point in a continuum of life stages. A woman’s health status entering the perimenopausal period will largely be determined by prior health and reproductive history, lifestyle and environmental factors. Perimenopausal and postmenopausal symptoms can be disruptive to personal and professional lives, and changes associated with menopause will affect a woman’s health as she ages. Therefore, perimenopausal care plays an important role in the promotion of healthy ageing and quality of life.

Menopause can be an important transition from a social perspective, as well as a biological one. Socially, a women’s experience of menopause may be influenced by gender norms, familial and sociocultural factors, including how female ageing and the menopausal transition are viewed in her culture.

The global population of postmenopausal women is growing. In 2021, women aged 50 and over accounted for 26% of all women and girls globally. This was up from 22% 10 years earlier.[i] Additionally, women are living longer. Globally, a woman aged 60 years in 2019 could expect to live on average another 21 years.[ii]

Menopause can offer an important opportunity to reassess one’s health, lifestyle, and goals.

Public health challenges related to menopause

Perimenopausal women need access to quality health services and communities and systems that can support them. Unfortunately, both awareness and access to menopause-related information and services remain a significant challenge in most countries. Menopause is often not discussed within families, communities, workplaces, or health-care settings.

Women may not know that symptoms they experience are related to menopause, or that there are counselling and treatment options that can help alleviate discomfort. Those experiencing menopausal symptoms may feel embarrassed or ashamed to draw attention to their experiences and ask for support.

Health-care providers may not be trained to recognize perimenopausal and post-menopausal symptoms and counsel patients on treatment options and staying healthy after the menopausal transition. Menopause currently receives limited attention in the training curricula for many health-care workers.

The sexual well-being of menopausal women is overlooked in many countries. This means that common gynaecological effects of menopause, including vaginal dryness and pain during intercourse, may go unaddressed. Similarly, older women may not consider themselves at risk of sexually transmitted infections, including HIV[iii], or may not be counselled by their providers to practice safer sex or get tested.

Many governments do not have health polices and financing for the inclusion of menopause-related diagnosis, counselling, and treatment services as part of their routinely available services. Menopause-related services are a particular challenge in settings where there are often other urgent and competing priorities for health funding.

WHO response

WHO considers that social, psychological and physical health support during the menopausal transition and after menopause should be an integral part of health care. WHO is committed to increasing understanding of menopause by:

• raising awareness of menopause and its impact on women at individual and societal levels, as well as on countries’ health and socioeconomic development;
• advocating for the inclusion of diagnosis, treatment and counselling related to management of menopausal symptoms as part of universal health coverage;
• promoting the inclusion of training on menopause and treatment options in pre-service curricula for health workers; and 
• emphasizing a life course approach to health and well-being (including sexual health and well-being), by ensuring that women have access to appropriate health information and services to promote healthy ageing and a high quality of life before, during and after menopause.

Notes:

1) Whilst the majority of personal experiences with menopause relate to cisgender women (who were born female and identify as female), transgender men and some people who identify as neither men nor women also experience menopause.

This fact sheet refers to “women” in alignment with the available data, which does not routinely identify gender identity. There is a paucity of readily-available data on trans and gender diverse experiences of menopause. Trans and gender diverse people have unique age-related health needs that clinicians should consider, including referral to specialist services when necessary.

2) Although menopause is not a disease, this fact sheet refers to the perimenopausal and postmenopausal experiences of women as symptoms because they can result in a level of discomfort that affects their quality of life.

---

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

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

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

 

Women’s health 

Sexual and Reproductive Health and Research (SRH)

Ageing

Sexual health

Menopause | NHS inform

Menopause is when a woman stops having periods. Menopause means ‘the last menstrual period’. It’s not only those who identify as women who will experience menopause. Some transgender men, non-binary people and intersex people or people with variations in sex characteristics may also experience menopause.

Menopause is a natural event and transition that women experience, however, the timing and symptoms are different for everyone.  You can look at your family history to get an idea of when you might go through it. It’s likely to be a similar age to when your mother or older sisters started theirs.

Menopause can also occur due to certain surgeries or cancer treatments. This can sometimes cause symptoms to be more sudden and in some cases more severe.

Perimenopause is the time from the start of menopausal symptoms until after a woman has experienced her last period. Periods will usually start to become less frequent over a few months or years before they stop altogether. They might be more irregular and become heavier or lighter. For some women, they can stop suddenly.

Postmenopause is the time after a woman experiences her last period. A woman is said to be postmenopausal when she has not had a period for 12 months.

Perimenopause and menopause are a natural part of a woman’s life course and usually occur between the ages 45 and 55 years of age, as a woman’s oestrogen levels drop (although it can start earlier). In the UK, the average age for a woman to reach menopause is 51.

Life doesn’t have to be put on hold because of menopause. There’s a lot that can be done to help manage symptoms, including making healthy lifestyle choices, trying different treatments and seeking support from healthcare professionals.


Menopause myths
(https://www.youtube.com/watch?v=uol9wrUZwHM)


Symptoms of menopause

Most women will experience menopausal symptoms. Some women will experience few, or no, symptoms. But for some, they can be quite severe and have a significant impact on everyday life.

The first sign of menopause is usually a change in the normal pattern of your periods. You may start having either unusually light or heavy periods.

The frequency of periods may also be affected. They may occur every two or three weeks, or they might not occur for months at a time. Eventually, periods will stop altogether, although for some women other menopause symptoms may continue.

Some women can start experiencing symptoms such as migraines, irritability and low mood especially around the period time, without seeing irregularity in periods.

There are many menopausal symptoms and symptoms can differ between individuals. Some of the most common symptoms include:

• ‘brain fog’ and memory issues
• difficulty sleeping
• fatigue
• hot flushes
• joint aches
• loss of sex drive (libido)
• low mood or anxiety
• migraine
• night sweats
• vaginal dryness or pain

Further information about the symptoms of menopause

Causes of menopause

Menopause is caused by a change in the balance of the body’s hormones, which occurs as you get older. Premature or early menopause can occur at any age and, in many cases, there’s no clear cause.

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

Menopause can also occur when a woman’s ovaries are affected by certain treatments such as chemotherapy or radiotherapy, or when the ovaries are removed, often at the time of a hysterectomy.

Further information about early and premature menopause

Treatments for menopausal symptoms

It’s important to get healthcare advice around menopause treatments so that you can make the decisions that are best for you.

If you or someone you know does need help to manage symptoms, support can be accessed through your GP practice.

Your healthcare professional can talk to you about treatments and work with you to explore lifestyle changes if you have menopausal symptoms that you feel are interfering with your day-to-day life. These include:

• hormone replacement therapy (HRT)
• vaginal oestrogen preparations, lubricants or moisturisers for vaginal dryness
• cognitive behavioural therapy (CBT)
• eating a healthy, balanced diet and exercising regularly
• taking supplements such as vitamin B6 and vitamin D

Further information about treating the symptoms of menopause


Menopause is nothing to fear
(https://www.

youtube.com/watch?v=wXxdbWEjX68)


Menopause and day-to-day life

Menopausal symptoms can sometimes be severe and they could impact day-to-day life. There is help available if you need it.


Living with the menopause
(https://www.youtube.com/watch?v=BbP8Eel5Uu0)


Mental wellbeing

Menopause can have an effect on your mental health and wellbeing. Some of the symptoms might include irritability, depression and anxiety. Lack of sleep caused by menopause can also have an impact on a person’s mood and how they feel.

If you or someone you know is suffering from any of these symptoms and it’s having an impact on day-to-day life, discuss it with someone from your local GP practice and they can help you get the support you need.

Further information about mental wellbeing during the menopause

Workplace

Some people find it hard to manage menopause symptoms at work. It’s important to remember that the menopause is a normal time in women’s lives and that support should be available to help you feel comfortable at work.

Further information about menopause in the workplace

Sex and relationships

Menopause symptoms such as vaginal dryness or pain, reduced sex drive or discomfort during penetrative sex might have an impact on your sex life and relationships.

There are treatment options available that might help ease or manage some of these symptoms. It might also be helpful to discuss how menopause is affecting you with your partner. By helping them have an understanding of what you’re experiencing, they’ll be more aware of how they can support you.

Further information about sex and intimacy during menopause

Supporting someone through menopause

If you know someone around you is going through menopause, you can let them know that you’re there to support them. Ask them what you can do to help, or just ask them how they’re feeling. People might not always feel comfortable discussing all of their symptoms, but it’s still important to let them know you’re there for them. 

Further information about how to support someone through menopause


Source:
Scottish Government – Opens in new browser window


Last updated:


29 November 2022


How can we improve this page?




Help us improve NHS inform



Don’t include personal information e.g. name, location or any personal health conditions.



Email Address



e.g. [email protected]





Message



Maximum of 500 characters






Other languages and formats


العربية
 |  简体中文
 |  Polski
 |  ਪੰਜਾਬੀ
 |  اردو
 |  Easy Read
 |  British Sign Language (BSL)



Community content from Health Unlocked – This will open in a new window.


Ministry of Health of the Republic of Tatarstan

July 15, 2022, Friday

Every year on July 15, the All-Russian Day of the Gynecologist is celebrated. On the eve of this holiday, we met with the head of the gynecological department, obstetrician-gynecologist of the Mamadysh Central District Hospital, Valiullina Milyausha Razinovna, and frankly talked with her on one of the topical issues of women’s health. The topic of our conversation is the menopause.

– Milyausha Razinovna, please explain what menopause is?

– Menopause is the time when a woman’s hormonal system ceases to consider reproductive function as its main task. This is mainly expressed in a decrease in the level of sex hormones estrogen and progesterone. Normally, they are produced by the ovaries and directly affect the ability to become pregnant and give birth to a child. When the ovaries cease to cope with their main task, a woman stops menstruating, otherwise this process is called menopause.

Usually this happens around the age of fifty, however, the harbingers of menopause can appear as early as 40 years. This is referred to as “premenopause”. The first year without menstruation is just the period of menopause itself. The state after this year is called postmenopause. On average, 40% of a woman’s life is during menopause.

Let’s talk about ways to mitigate the transition period and support the body in a new state.

– Good. How to understand that a woman begins menopause?

– Menopause makes itself felt with non-specific signs. Moreover, depending on the menopause, these symptoms may differ. So, from about 40 to 50 years old, a woman can experience daytime hot flashes and excessive night sweats, heart palpitations and pressure drops, mood swings and decreased sexual desire. Many of these symptoms will go away with established menopause.

In the first three years after the cessation of menstruation, excessive dryness of the mucous membranes and skin may appear. This is usually manifested by wrinkles, brittle nails, pain during sex or when urinating. Weight can change, both up and down.

The further into the post-menopause, the more serious changes in a woman’s body can be. Hormonal changes create the prerequisites for the development of atherosclerosis and osteoporosis, muscle weakness and memory loss.

– Please tell me how you can support the body during this period? Should I try to “treat” menopause?

– Despite the unpleasant symptoms, menopause is a natural state of a woman in adulthood. It does not require treatment in the sense that we treat diseases. Menopause cannot be “cured” or prevented. But menopause can be delayed, facilitate its course and take care of the prevention of diseases, which are promoted by a long-term reduced level of sex hormones.

– In what ways can menopause be facilitated? What advice would you give to our readers?

– There are three non-exclusive ways to relieve the symptoms of menopause. The first is to take care of nutrition, motor mode and proper sleep. The second is to turn to hormone replacement therapy. And the third is to add phytoestrogens and estrogen-like bioregulators to the diet.

For women whose menopause begins with unexpressed signs, careful attention to their body can already ease the course of menopause.

OB/GYN recommends

• Track down what causes hot flashes and avoid these triggers. Hot flashes can be provoked by spicy foods, smoking or alcoholic beverages.
• Prefer layered clothing for better temperature control.
• During hot flashes, apply an ice pack to the wrist or back of the neck.
• Sleep in a cool room.
• Choose bedding and pajamas that absorb moisture well.
• Practice yoga and breathing exercises.
• Keep your weight under control.
• Good sleep.
• Maintain physical activity to reduce the risk of osteoporosis.
• Taking hormone replacement therapy.

Hormone replacement therapy (HRT) is considered a reliable way not only to get through menopause easier, but also to delay it. Hormonal pills with estrogen and progesterone allow you to receive sex hormones from the outside, which the ovaries can no longer produce in the right amount.

HRT relieves unpleasant menopausal symptoms after just a few weeks of use and helps prevent the negative effects of menopause on the musculoskeletal and cardiovascular systems. On the recommendation of a doctor, you can start taking HRT at the very beginning of premenopause and thereby delay the onset of menopause, as well as make this transition process easier for a woman’s physical and emotional state.

Of course, hormone therapy has contraindications and side effects. It is assumed that long-term use of HRT, more than 10 years, may increase the risk of developing breast or ovarian cancer.

• Use phytoestrogens.

Phytoestrogens can become an alternative to hormonal preparations. Phytoestrogens, in fact, are also replacement therapy, only not with synthetic hormones, but with non-steroidal plant compounds. It is believed that plant estrogens are found in excess in soy, flax seeds, beans, red grapes and other plants.

Plant isoflavones, substances similar to human estrogen, bind to hormone receptors in the body and act like sex hormones.

– Thanks to Milyausha Razinovna for detailed answers. I wish you success!

Share:

READ ALL NEWS

Menopause in women: causes, symptoms, diagnosis of menopause

Women’s menopause (menopause) is a complex of mental, vegetative-vascular and metabolic-endocrine disorders that occur against the background of the decline of reproductive function. This is a natural stage in the life of every woman, which, on average, occurs by the age of 48–50. Perhaps a more rapid development of menopause against the background of genetic predisposition, ovarian pathology, depletion of the ovarian reserve, chemotherapy and a number of other factors.

In many cases, the onset of menopause affects the psychological state of a woman. There is irritability or depression, depressive mood. In addition, diseases that were not in the reproductive age begin to develop faster. To avoid this and minimize adverse reactions, menopausal hormone therapy is used. In this case, the patient receives the missing hormones from the outside, which significantly reduces the severity of psychological and somatic disorders, and according to some sources, it reduces the likelihood of developing cervical cancer by 2 times.

Symptoms of menopause

The decline of sexual function and related changes in the body occur gradually. Therefore, the symptoms of menopause are divided into early, medium and late.

• early – hot flashes, night sweats, chills, irritability, decreased interest in life, depression, sleep disturbance, decreased attention, emotional lability, weight gain;
• medium-term – sexual dysfunction, prolapse of the genital organs, deterioration of the skin, nails, hair, urinary incontinence, itching and dryness in the vagina, pain during intercourse;
• late – osteoporosis, non-insulin-dependent diabetes mellitus, arterial hypertension, cognitive impairment, visual and hearing loss, dyslipidemia.

Early manifestations of menopause are very variable in severity, set of symptoms and time of their existence. Most often, the first signs of menopausal syndrome appear from the moment of the last menstruation and are noted for several years after it. The STRAW +10 system is used to determine the stage of reproductive aging. The time of onset of late manifestations of menopause in women depends on the initial state of the body and the presence of chronic diseases. As a rule, there are certain changes already 6-10 years after menopause.

Stages of menopause

The development of menopause occurs in several stages:

1. Menopausal transition. It starts at the age of 40-45 and ends with the onset of menopause. It is characterized by an irregular cycle and a decrease in the production of sex hormones. During this period, the first symptoms appear.
2. Menopause. Last menstruation. It is determined retrospectively, 12 months after its onset. The period of menopausal transition and the first year after menopause is called perimenopause.
3. Postmenopausal. Occurs one year after menopause. It is subdivided into the period of early postmenopausal transition (5–8 years) and late postmenopausal phase.

As the stages change, there is a gradual weakening of vasomotor symptoms, which are replaced by signs of somatic aging.

Methods of diagnosis

Diagnosis is usually based on symptoms and physical examination. At the first meeting with the patient, the gynecologist finds out how long ago the disturbing manifestations arose and how pronounced they are. Most women report several symptoms from the list above. By the presence of characteristic changes, it can be assumed which stage of menopause takes place. It is mandatory to assess the stage of aging of the reproductive system according to STRAW +10. The exceptions are women with premature ovarian failure syndrome who have undergone surgical removal of the uterus or ovaries, endometrial ablation, and those who are using combined oral contraceptives at the time of the survey.

The physical examination necessarily includes a bimanual vaginal examination and visual assessment of the genitals. This is especially important for postmenopausal women who have complaints characteristic of the menopausal urogenital syndrome. On examination, tissue atrophy, dryness of the mucous membranes, smoothing of folds, loss of elasticity, and sometimes areas of ulceration and fibrosis can be detected. To exclude the pathology of the mammary glands, their palpation or instrumental examination is performed. Determination of height, body weight, BMI and measurement of waist circumference are shown.

Laboratory tests for hormones are also used to determine the stage of reproductive aging. Manifestations of urogenital syndrome are an indication for determining the acidity of the vagina and testing for genital infections. All patients, without exception, undergo a cytological examination of a smear from the cervix and PCR for oncogenic strains of the human papillomavirus. Once every two years, postmenopausal women are prescribed mammography in two projections, at the first visit and then at each medical examination – ultrasound of the pelvic organs. In the presence of risk factors for the development of osteoporosis, densitometry is required – the determination of bone mineral density.

Treatment and prevention

Menopausal hormone therapy is the mainstay of menopausal syndrome treatment. Its essence lies in the introduction into the body of the missing hormones in tablet form. Drugs are prescribed in the early stages of menopause.

Goals of MHT:

• weakening of vasomotor manifestations of menopause;
• prevention of urogenital syndrome and sexual dysfunction;
• prevention of severe late manifestations of menopause and reduction of female mortality from cardiovascular diseases.

Hormonal preparations are prescribed in the minimum effective doses, taking into account contraindications. Their reception is carried out for a long time, for several years. With aging, the doses of medications are reduced until they are completely canceled. This allows you to ensure a smooth hormonal restructuring of the body and minimize the adverse effects associated with it. PGT is not prescribed for unclear bleeding from the genital tract, hormone-dependent tumors, a tendency to thrombosis, as well as in the complete absence of objective and subjective manifestations of menopausal syndrome.

To date, the only reliably effective way to combat the manifestations of menopause is menopausal hormone therapy. However, due to the high prevalence of hormonophobia (fear of taking hormones) on the part of women, alternative means can also be used to relieve the symptoms of estrogen deficiency – serotonin reuptake inhibitors, bovine pineal polypeptides, isoflavones, and others. Locally, long-acting lubricants and moisturizers are used to combat vaginal dryness. Possible cognitive-behavioral therapy, hypnosis, acupuncture, but the effectiveness of such methods has not been proven.

Specific measures for the prevention of menopausal syndrome have not been developed. The following interventions are recommended during perimenopause to help relieve symptoms and reduce the need for medications:

• adequate physical activity – 150 minutes of low-intensity or 75 minutes of moderate-intensity aerobic exercise per week is recommended;
• correction of body weight with excess weight – a decrease in the thickness of the fatty layer has been proven to improve well-being during menopause, reduces the risk of diabetes, hypertension, cardiovascular accidents;
• diet correction – you should eat more fruits and vegetables, limit salt intake, give preference to vegetable fats, seafood, lean meats;
• smoking cessation – menopause in women who smoke occurs earlier, and menopause is more difficult.

Moscow Academic IVF Clinic invites you to visit our doctors for examination and individual selection of therapy for menopause.