Menopause occurs when menstrual periods have stopped for one whole year. It is also called “the change of life.” In general, this occurs between the ages of 45 and 55. It can, though, occur as early as age 35 or as late as age 65. It can also happen when both ovaries are removed.
Signs & Symptoms
Signs and symptoms often occur many years before the last menstrual period. This time period is called peri-menopause. Symptoms vary from woman to woman. They result from hormone changes, the aging process itself, fatigue and stress.
Emotional Signs & Symptoms
Irritability.
Mood changes.
Lack of concentration; memory problems.
Tension, anxiety, depression.
Insomnia; hot flashes can interrupt sleep.
Physical Signs & Symptoms
Hot flashes. These are sudden waves of heat that can start in the waist or chest and work their way to the neck and face and sometimes the rest of the body. They can occur as often as every 90 minutes. Each one can last from 15 seconds to 30 minutes; 5 minutes is average. Heavy sweating during hot flashes may also occur. This is sometimes called night sweats when this happens during sleep. Some women are more bothered by them than others. Sometimes heart palpitations come with hot flashes.
Vaginal dryness. The vaginal wall also becomes thinner. These problems can make sex painful or uncomfortable. Irritation can increase the risk for infection.
Headaches.
Dizziness.
Hair grows on the face, but thins at the temples.
Skin that is prone to wrinkle.
Irregular periods:
Bleeding can occur between periods. This is the most common bleeding pattern in peri-menopause.
Periods get shorter and lighter for 2 or more years.
Periods can stop for a few months and then start up again and are more widely spaced.
Periods occur with heavy bleeding and/or the passage of many small or large blood clots.
Loss of bladder tone. This can result in having trouble holding urine long enough to get to the bathroom. Or, urine can leak when you cough, sneeze, laugh or exercise.
Muscles lose some strength and tone.
Bones become more brittle, which increases the risk for osteoporosis.
Causes
Hormone changes that come with aging cause menopause. The body makes less estrogen and progesterone.
Treatment
Self-care may be all that is needed. Just estrogen can be prescribed. This is estrogen therapy (ET). Estrogen plus progestogen can be prescribed. This is called EPT. The term hormone therapy (HT) is used for both ET and EPT. Hormone therapy is used to treat menopause symptoms and post-menopausal bone loss that can lead to osteoporosis. But side effects of HT may not be safe for some women. Each women should discuss the benefits and risks with their doctor. There are also non-estrogen treatments to consider.
Self-Care
Hot Flashes
Wear lightweight clothes made of natural fibers, such as cotton.
Limit or avoid alcohol. Limit caffeine.
Have cool drinks, especially water, when you feel a hot flash coming on and before and after you exercise. Avoid hot drinks.
Keep cool. Open a window. Lower the thermostat when the heat is on. Use air conditioning and/or fans. Carry a small fan with you.
Try to relax when you get a hot flash. Getting stressed out over one only makes it worse.
Use relaxation techniques, such as meditation, biofeedback or yoga.
Follow your doctor’s advice for taking herbal products, such as black cohosh, vitamin supplements, over-the-counter menopause aids, and soy products.
If you suffer from night sweats (hot flashes that occur as you sleep):
Wear loose fitting cotton nightwear. Have changes of nightwear ready.
Sleep with only a top sheet, not blankets.
Keep the room cool.
Vaginal Dryness & Painful Sex
Don’t use deodorant soaps or scented products in the vaginal area.
Use a water soluble lubricant, such as K-Y Liquid®, Replens®, etc. These make penetration easier during sex. Avoid oils or petroleum-based products. These promote infection.
Ask your doctor about the benefits and risks of using estrogen (pills, patches, vaginal cream, or rings).
Stay sexually active. Having sex often may lessen the chance of having the vagina constrict. It also helps to maintain natural lubrication and pelvic muscle tone. Reaching orgasm with a partner or alone gives these benefits.
If you can, avoid using antihistamines. They dry mucus membranes in the body.
Emotional Symptoms
Exercise regularly. This helps maintain hormonal balance.
Try to get seven to eight hours of sleep.
Talk to other women who have gone through or are going through menopause.
Limit stress. To deal with stress, use relaxation techniques. Examples are meditation, yoga, listening to soft music, and massages.
Avoid or limit alcohol to one drink per day.
Eat healthy. Take vitamins and minerals, as advised.
For More Information:
Office on Women’s Health womenshealth.gov
North American Menopause Society (NAMS) menopause.org
Triage Questions
Question 1
Do you have any of these problems?
Extreme pain during sex. Pain or burning when passing urine. Thick vaginal discharge.
