Menopause

Quick look at menopause

Menopause is a natural event in a woman’s life when the ovaries are depleted of eggs and she has not menstruated for 12 consecutive months.

Perimenopause refers to the span of months or years leading up to menopause, during which time many of the symptoms associated with menopause occur.

Symptoms associated with menopause include irregular periods, hot flashes, mood swings, decreased fertility, insomnia and fatigue.

Treatment for symptoms may or may not be necessary depending on their severity and interference with daily life.

What is menopause?

Menopause is defined as the time in a woman’s life when she has not menstruated for 12 consecutive months. The absence of menstrual cycles and periods indicate that a woman’s egg supply is depleted. According to the National Institute on Aging, the average age of menopause for women in the United States is 51.

Much like puberty, menopause is a natural physiological transition involving reproductive hormones and processes. As a woman approaches menopause, her ovaries gradually stop making estrogen and progesterone, which are responsible for ovulation and menstruation.

Certain circumstances can cause women to experience menopause prematurely. These include surgical removal of the ovaries to treat an underlying condition such as endometriosis, and cancer treatments such as chemotherapy and radiation. A small number of women (about 1 in 100) experience premature ovarian failure (POF), which can lead to early menopause if left untreated.

The phases of menopause

When menopause occurs naturally, it is divided into three phases: Perimenopause, menopause and postmenopause.

Perimenopause

Perimenopause is the span of time leading up to menopause in which the ovaries slowly begin to produce fewer eggs and therefore less hormones. It may last anywhere from a few months to several years.

The symptoms of perimenopause usually come on gradually, intensifying as a woman approaches menopause. The symptoms of perimenopause are what many associate with someone “going through menopause.”

Some women experience mild and tolerable perimenopause symptoms, while others may experience them severely, leading them to seek medical treatment. The symptoms of perimenopause include:

• Irregular periods
• Decreased fertility
• Hot flashes and night sweats
• Mood swings
• Painful intercourse
• Reduced sex drive
• Vaginal dryness
• Insomnia
• Fatigue.

A physician can usually identify when a woman has entered perimenopause simply by an evaluation of symptoms. In certain uncommon circumstances, a blood test may be ordered to confirm this diagnosis.

Menopause

The occurrence of menopause is signaled by the absence of menstruation for 12 consecutive months, indicating that the ovaries are depleted of eggs. Medically speaking, menopause itself is not a process but a point in time signifying the transition from perimenopause into postmenopause.

Postmenopause

A woman’s life after menopause is referred to as postmenopause. In most cases, once a woman enters postmenopause, many of the unpleasant symptoms listed above will begin to subside.

Due to the loss of estrogen previously produced by the ovaries, postmenopausal women are at greater risk of certain health complications. Most notably, this hormonal change leads to an increased risk of osteoporosis and heart disease. The best way to lower the risks for postmenopausal complications is to lead a healthy, active lifestyle and maintain regular appointments with a primary care physician and an OB-GYN.

Treating perimenopause symptoms and menopause symptoms

Many women do not need to seek treatment for symptoms during perimenopause or those that continue immediately following menopause. However, in certain cases symptoms may be severe enough to interfere with daily life. Depending on the specific symptoms, there are a number of methods and treatment options available.

Hot flashes and night sweats

Hot flashes, which are called night sweats when they occur just before or during sleep, are commonly experienced by women approaching menopause. The severity and frequency of hot flashes can be reduced by implementing certain lifestyle changes, including:

• Maintaining a healthy body weight
• Not smoking
• Avoiding caffeine and alcohol
• Mindfulness practices such as yoga and meditation.

Women experiencing severe hot flashes may be prescribed medication. Paroxetine, a medication used to treat depression, is sometimes used to treat severe hot flashes. Prescription hormone therapy is also a very effective means of treating hot flashes, though there are some risks associated with hormonal medications. A licensed healthcare provider will discuss these risks with his or her patient before prescribing this type of treatment.

Insomnia and fatigue

A number of factors may cause a woman nearing menopause to struggle to get an adequate amount of rest. As hormones change, brain chemistry is disrupted, and night sweats can make falling and staying asleep particularly difficult. Some tips for battling menopausal insomnia include:

• Exercising regularly (but not right before bed)
• Maintaining a cool bedroom temperature
• Avoiding caffeine and large meals in the evening
• Going to bed and waking up at consistent times.

Vaginal dryness and painful intercourse

Pain during sex commonly occurs with menopause due in large part to vaginal dryness. Women can find relief and continue to engage in intercourse during this time by using water-based lubricants and vaginal moisturizers sold over-the-counter in drug and grocery stores. It is important that lubricants and moisturizers be water-based, as oil-based substances such as petroleum jelly can further irritate the vagina.

In circumstances in which these methods fail to provide relief, prescription medications, including hormone therapy, may be prescribed by a healthcare provider to treat vaginal dryness.

Other menopause symptoms

While hot flashes and difficulty sleeping are the most common symptoms, women may also experience mood swings, depression, irritability, headaches and, rarely, heart palpitations. Women should not hesitate to discuss any concerns about the symptoms associated with menopause with their provider.