Menopause

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What is menopause?

Menopause is a naturally occurring condition in women and is the cessation of menstrual periods. It marks the end of a woman’s reproductive years and is defined medically as the absence of menstrual periods for 12 consecutive months. Menopause typically happens between the ages of 45 and 55. During menopause, a women’s reproductive system changes, resulting in a discontinuation of estrogen production, the menstrual cycle, and egg maturation.

Menopause develops when the female reproductive system begins slowing down, resulting in decreased production of the female hormones estrogen and progesterone. Decreased hormone levels cause a coinciding drop in the production of eggs and in the frequency of menstrual periods. Menopause creates changes in the vagina, vaginal secretions, and outer genitalia. It most commonly develops over a period of one to five years. Surgical removal of the ovaries causes a more abrupt decline in circulating hormones.

The symptoms of menopause are different for every woman. Symptoms of the menopausal transition commonly begin a few years prior to the cessation of menses. The most common symptom of menopause is hot flashes, but a number of other symptoms can occur.

Menopause symptoms can occur frequently or only occasionally. Some women do not experience any symptoms of menopause, while others have sweats, hot flashes, and emotional distress. The symptoms may range in intensity from mild to severe. Fortunately, the symptoms of menopause can be managed with hormone therapy, medications, and lifestyle changes.

Menopause alone is not a disease process. Seek prompt medical care if you are being treated for menopause but mild symptoms recur or are persistent.

What are the symptoms of menopause?

Menopause causes a reduction in the production of the female hormones that can result in a number of symptoms. The symptoms can vary in intensity among individuals.

Common symptoms of menopause

You may experience menopause symptoms daily or only occasionally. Any of these menopause symptoms can be severe:

Other symptoms of menopause

Other symptoms that may occur with menopause include:

Serious symptoms that might indicate a serious condition

Menopause alone is not a serious condition and is a normal aspect of life. Seek prompt medical care if you are being treated for symptoms of menopause but these recur or cause you concern.

What causes menopause?

Menopause is caused by the decreased production of the female hormones estrogen and progesterone. As a result, the female reproductive system begins slowing down the frequency of the menstrual cycle, eventually stopping it completely. Surgical removal of the ovaries causes a more abrupt decline in circulating hormones. Menopause changes the vagina, vaginal secretions, and outer genitalia. It most commonly develops over a period of one to five years.

What are the risk factors for menopause?

Because menopause is a normal function of the female reproductive system, it is not a preventable condition, so there are no risk factors associated with menopause.

How is menopause treated?

Treatment for menopause is not always necessary. It is a normal part of life and not a disease process. However, some of the symptoms may be uncomfortable, and treatment of these symptoms is possible. Some women with menopause may not have any troubling symptoms, but if symptoms do occur, there are several treatment options for reducing or eliminating them. Your health care provider will assess the best treatment options for you based on your age, the severity of your symptoms, and your individual risk for cardiovascular disease, blood clots, breast cancer, and stroke.

Hormone replacement therapy

Hormone therapy with estrogen or, most commonly, with estrogen plus a progestin, may be considered for the short-term relief of symptoms. Hormone therapy may be taken in pill form or may be prescribed as a skin patch, cream, or vaginal suppository.

You and your health care provider should discuss hormone replacement therapy, carefully considering whether the benefits will outweigh the risks for you. If you fall in a low risk category and your symptoms are interfering with your quality of life, your health care provider may use the following guidelines for hormone replacement therapy:

  • Do not prescribe for longer than five years

  • Do not prescribe for women who began menopause several years ago. This does not apply to estrogen creams, which can be used at any stage of menopause.

  • Prescribe as low a dose as possible or use estrogen cream

  • Prescribe only for women who recently started menopause

  • Take baseline measurements before hormone therapy is prescribed. These ensure a low risk of breast cancer, heart disease, or blood clots and stroke.

Other menopause treatment options

If you and your health care provider decide that the risks of hormone replacement therapy are too great, your health care provider may prescribe medications that will decrease the effects of symptoms like mood disorders and hot flashes. Examples include:

  • Bupropion (Welbutrin)

  • Catapres (Clonidine)

  • Fluoxetine (Prozac)

  • Paroxetine (Paxil)

  • Venlafaxine (Effexor)

Complementary treatments

Some complementary treatments may help some women to better deal with menopausal symptoms. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for traditional medical care. Be sure to notify your doctor if you are consuming nutritional supplements or homeopathic (nonprescription) remedies as they may interact with the prescribed medical therapy.

Complementary treatments may include:

  • Acupuncture

  • Massage therapy

  • Nutritional dietary supplements, herbal remedies, tea beverages, and similar products

  • Yoga

What you can do to improve your menopause

Symptoms of menopause may also be decreased by:

  • Avoiding spicy foods

  • Being physically active

  • Consuming soy products

  • Consuming the recommended amount of vitamin D and calcium for menopausal women

  • Meditating or taking deep breaths when a hot flash is coming

  • Practicing daily Kegel exercises to strengthen vaginal muscles

  • Using lubricants during sexual intercourse

  • Wearing light, layered clothing

What are the potential complications of menopause?

You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of menopause include:

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 18
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Menopause. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001896/.
  2. Menopause and menopause treatments fact sheet. WomensHealth.gov. http://www.womenshealth.gov/publications/our-publications/fact-sheet/menopause-treatment.html.
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  4. Tierney LM Jr., Saint S, Whooley MA (Eds.) Current Essentials of Medicine (4th ed.). New York: McGraw-Hill, 2011.