Menopause
What is menopause?
Menopause is when women stop having periods (stop menstruating) and can no longer get pregnant.
Menopause usually happens after age 40. In the United States, the average age for menopause is about 52.
Menopause doesn't happen all at once. Over time, your periods happen less often. Menopause is complete when you haven’t had a period for a full year. It is possible to get pregnant before then. If you don't want to get pregnant, use birth control until you've gone a year without any periods.
What causes menopause?
Menopause is normal and happens as your body ages.
For several years before menopause, your body gradually makes less estrogen and progesterone. These are sex hormones that are needed for menstruation (getting your period) and pregnancy. With less of these hormones, your ovaries stop releasing eggs, and your periods stop.
Menopause that happens before age 40 is called premature menopause. Premature menopause is uncommon and can be caused by many different medical problems.
What are the symptoms of menopause?
Menopause doesn't happen all of a sudden. At first you may notice:
At the same time, many women also have symptoms like:
These symptoms often go on for a year or more. Eventually your periods stop completely, and the symptoms usually get better. Sometimes hot flashes go on longer.
Symptoms after menopause are due to lower levels of sex hormones. You may have:
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A dry vagina
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Less interest in having sex
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Painful sex, because of a drier and thinner vagina
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Difficulty having an orgasm
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More urinary tract infections (UTIs)
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A need to urinate (pee) more urgently or incontinence (peeing without meaning to)
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Thinner, drier, more delicate skin
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Weaker bones
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Higher levels of bad cholesterol (LDL)
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Higher chance of heart disease
How can doctors tell if I have menopause?
How do doctors treat menopause?
Understanding menopause may help you cope with your symptoms. Talking with other women who have gone through menopause or with your doctor may also help you decide what treatment can work for you.
Because your symptoms are caused by low hormone levels, taking hormones (hormone replacement therapy) is the most effective way to relieve symptoms. However, hormone replacement has risks so doctors usually try other things first.
Hot flash treatments may include:
Incontinence treatments may include:
Dry vagina treatments may include:
Some women take medicinal herbs and other supplements to relieve symptoms. There are many different supplements. Most of them don’t work well, and none are reviewed for safety the way prescription medicines are. Also, some herbs and supplements can interfere with other medicines you take. If you’re thinking about taking supplements, discuss them with your doctor.
Hormone therapy
If other treatments don't work, hormone therapy may help. However, hormone therapy has benefits and risks. Talk to your doctor about whether these treatments are right for you.
Hormone therapy can include:
Hormone therapy can be given as:
Benefits of hormone therapy include:
Risks of hormone therapy include:
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Blood clots in your lungs or legs (with progestin alone)
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Stroke
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Higher chance of getting endometrial cancer (with estrogen alone)
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Higher chance of getting breast cancer (after 3 to 5 years of taking combination therapy or 10+ years of taking estrogen)
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Urinary incontinence (with estrogen alone)
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Lower levels of the "good" (HDL) cholesterol (with progestin alone)
Taking lower doses may lower these risks.
Generally, women who have breast cancer, coronary artery disease, or blood clots in the legs, who have had a stroke, or who have risk factors for these disorders shouldn't use estrogen therapy.
