Menopause

Two woman huggingMenopause is the time in your life when you naturally stop having menstrual periods. Menopause happens when the ovaries stop making estrogen, the hormone that helps control the menstrual cycle. Menopause marks the end of the reproductive years. The average age that women go through menopause is 51 years.

The years leading up to menopause are called perimenopause. Beginning in your 30s and 40s, the amount of estrogen produced by the ovaries begins to fluctuate. A common sign of perimenopause is a change in your menstrual cycle. Cycles may become longer or shorter than usual. You may begin to skip periods. The amount of flow may become lighter or heavier. Although changes in menstrual bleeding are normal during perimenopause, you still should tell your provider. Abnormal bleeding may be a sign of a problem.

Symptoms

Some women do not have any symptoms of perimenopause or have only a few mild symptoms. Others have many symptoms that can be severe. Common signs and symptoms include:

  • Hot flashes
  • Sleep problems
  • Vaginal and urinary tract changes

Complications

A small amount of bone loss after age 35 years is normal for both men and women. But during the first four to eight years after menopause, women lose bone more rapidly. This rapid loss occurs because of the decreased levels of estrogen. If too much bone is lost, it can increase the risk of osteoporosis. Osteoporosis increases the risk of bone fracture. The bones of the hip, wrist and spine are affected most often.

The estrogen produced by women’s ovaries before menopause protects against heart attacks and stroke. When less estrogen is made after menopause, women lose much of this protection. Midlife also is the time when risk factors for heart disease, such as high cholesterol levels, high blood pressure and lack of physical activity, are more common. All of these combined factors increase the risk of heart attack and stroke in menopausal women.

Treatment

Hormone therapy can help relieve the symptoms of — and prevent complications from — perimenopause and menopause. Hormone therapy means taking estrogen and, if you have never had a hysterectomy and still have a uterus, a hormone called progestin. Estrogen plus progestin is called “combined hormone therapy” or simply “hormone therapy.” If you do not have a uterus, estrogen is given without progestin. Estrogen-only therapy is called “estrogen therapy.”

Estrogen can be given in several forms, including pills, skin patches, and gels and sprays applied to the skin. Progestin can be given separately or combined with estrogen in the same pill or patch. Women who only have vaginal dryness may be prescribed “local” estrogen therapy in the form of a vaginal ring, tablet or cream.

Hormone therapy may increase the risk of certain types of cancer and other conditions.

Life After Menopause

A healthy lifestyle can help you make the best of the years after menopause. The following are some ways to stay healthy during midlife:

  • Nutrition—Eating a balanced diet will help you stay healthy before, during and after menopause. Be sure to include enough calcium and vitamin D in your diet to help maintain strong bones.
  • Exercise—Regular exercise slows down bone loss and improves your overall health. Weight-bearing exercise, such as walking, can help keep bones strong. Strength training strengthens your muscles and bones by resisting against weight, such as your own body, an exercise band or handheld weights. Balance training, such as yoga and tai chi, may help you avoid falls, which could lead to broken bones.
  • Routine health care—Visit your doctor once a year to have regular exams and tests. Dental checkups and eye exams are important, too. Routine health care visits, even if you are not sick, can help detect problems early.

Source: American College of Obstetricians and Gynecologists.