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Understanding Menopause

Menopause

What is Menopause?

Menopause is a normal change in a woman's life when her period stops. It is often called the "change of life." During perimenopause, a woman's body slowly makes less of the hormones estrogen and progesterone. This often happens between the ages of 45 and 55 years old. A woman has reached menopause when she has not had a period for 12 months in a row, and there are no other causes for this change. As you near menopause, you may have symptoms from the changes your body is making. Many women wonder if these changes are normal, and many are confused about how to treat their symptoms. You can feel better by learning all you can about menopause, and talking with your doctor about your health and your symptoms. If you want to treat your symptoms, your doctor can tell you more about your options and help you make the best treatment choices.

Symptoms of Menopause

"My mom never talked to me about menopause. She says her mother never talked about it either. I'm not sad. I'm past menopause. I'm glad those monthly periods are over."

Every woman's period will stop at menopause. Some women have no other symptoms. But many women notice changes in body, mind, and mood at this stage of life. We don’t always know if these changes are related to menopause, aging, or both. Some changes you might notice include:

  • Changes in your period. The time between periods and the flow from month to month may be different.

  • Abnormal bleeding or "spotting." This is common as you near menopause. But if your periods have stopped for 12 months in a row, and you still have "spotting," you should talk to your doctor to rule out serious causes, like cancer.

  • Night sweats. Hot flashes that occur while a woman is sleeping and cause her to perspire. They can make it hard to get a good night’s sleep.

  • Sleeping problems. Lack of sleep can affect your mood, health, and ability to cope with everyday stress.

  • Vaginal changes. The vagina may become dry and thin, and sex and vaginal exams may be painful. You also might get more vaginal infections.

  • Thinning of your bones. This may lead to loss of height and bone breaks (osteoporosis).

  • Emotional changes. May include mood swings, sadness, tearfulness, and irritability. Although menopause does not cause depression, women are at a higher risk of depression in the years leading up to menopause. Some researchers think that the decrease in estrogen levels plays a role in the onset of depression in some women. Also, lack of sleep can strain a woman’s emotional health.

  • Urinary problems. You may have leaking, burning or pain when urinating, or leaking when sneezing, coughing, or laughing.

  • Problems with memory and staying focused. You may notice you are more forgetful or have trouble concentrating.

  • Sex drive decreases. You may have less interest in sex and changes in sexual response.

  • Weight fluctuation. Weight gain or increase in body fat around your waist.

  • Hair loss or thinning. Hair thinning or loss is a problem for some women.

Symptom Relief

"Is it hot in here, or is it me?"

Many women are able to cope with minor discomforts of menopause. Try these tips:

  • Hot flashes. Keep track of when hot flashes happen. You might be able to identify a pattern or triggers, which you can avoid. Dress in layers and keep a fan in your home or workplace. If lifestyle changes don’t seem to help, ask your doctor about menopausal hormone therapy or nonhormonal prescription drugs. Research has found that nonhormonal prescription drugs, such as antidepressants, help hot flashes in some women.

  • Vaginal dryness. Try an over-the-counter water-based vaginal lubricant. Prescription estrogen replacement creams and tablets also can help restore moisture and tissue health. If you have spotting or bleeding while using estrogen creams, you should see your doctor.

  • Problems sleeping. One of the best ways to get a good night's sleep is to get at least 30 minutes of physical activity on most days of the week. But avoid physical activity close to bedtime. Also avoid alcohol, caffeine, large meals, and working right before bedtime. You might want to drink something warm, such as herb tea or warm milk, before bedtime. Keeping your bedroom cool and dark also can help. Avoid napping during the day and try to go to bed and get up at the same times every day.

  • Memory problems. Some women complain about problems with memory and concentration. But there is no proof that menopause causes memory problems. Try to get enough sleep and engage in physical and social activity. If forgetfulness or other mental problems worry you or are affecting your everyday functioning, talk to your doctor.

  • Mood swings. Try to get enough sleep and be physically active. Set limits for yourself, and look for positive ways to ease daily stress. Think about going to a support group for women who are going through the same thing as you, or getting counseling to talk through your problems and fears. Talk to your doctor if mood swings are causing you distress. Medicines might help. For instance, menopausal hormone therapy might help if mood swings are related to disrupted sleep caused by night sweats. Also, your doctor can look out for signs of depression, which is a serious illness that needs treatment.

Two other common health problems can start to happen at menopause, and you might not even notice.

  • Osteoporosis. Day in and day out your body is busy breaking down old bone and replacing it with new healthy bone. Estrogen helps control bone loss. So losing estrogen around the time of menopause causes women to begin to lose more bone than is replaced. In time, bones can become weak and break easily. This condition is called osteoporosis.

  • Heart disease. After menopause, women are more likely to have heart disease. Changes in estrogen levels may be part of the cause. But, so is getting older. As you age, you may develop other problems, like high blood pressure or weight gain, which put you at greater risk for heart disease.

Track Your Symptoms

You can use this chart to keep track of menopausal symptoms that bother you. Take it with you when you visit your doctor, so you both can figure out the best way to handle them.
Track Your Symptoms
Date Symptoms Things I've tried to help them Questions for my doctor New things to try
         
         
         

Additional Resources on Menopause:

Publications

  1. Federal resource  Age Page: Menopause - This fact sheet explains what menopause is, and the different symptoms and health concerns that accompany the different stages. It gives recommendations for what women can do to stay healthy throughout menopause and answers common questions about hormone therapy, phytoestrogens, and other important issues for menopausal women.

    http://www.niapublications.org/agepages/menopause.asp

  2. Federal resource  Frequently Asked Questions - Menopause and Menopause Treatments - This fact sheet discusses menopause symptoms and treatments, including postmenopausal hormone therapy (HT) and the practical steps women can take to alleviate symptoms and prevent diseases like osteoporosis and heart disease.

    http://www.womenshealth.gov/faq/menopaus.htm

  3. Federal resource  Hormones and Menopause: Tips from the National Institute on Aging - This easy-to-read publication presents information and guidelines for women who are troubled by menopausal symptoms.

    http://www.niapublications.org/tipsheets/hormones.asp

  4. Federal resource  Menopause - This interactive tutorial explains the signs and symptoms associated with menopause and how to cope with them. It also explains the health concerns facing women in postmenopause and discusses recent evidence on the risks and benefits of hormone therapy.

    http://www.nlm.nih.gov/medlineplus/tutorials/menopause.html

  5. Federal resource  Menopause & Hormones: Fact Sheet - This fact sheet explains the benefits and risks of treating the symptoms of menopause with hormone therapy. It also explains the Food and Drug Administration's recommendations for menopausal hormone therapy.

    http://www.fda.gov/womens/menopause/mht-FS.html

  6. Federal resource  PDF file  Menopause and Bladder Control - This brochure discusses the effect of menopause on bladder control. It explains the different types of incontinence and how it can be treated.

    http://kidney.niddk.nih.gov/kudiseases/pubs/pdf/menopause_ez.pdf

  7. Hot Flashes: Minimize Discomfort during Menopause (Copyright © MFMER) - This publication explains what hot flashes are and what you can do to alleviate them through diet and lifestyle changes, alternative remedies, hormone therapy, or other prescription medicines. It also discusses the benefits and risks of each option.

    http://www.mayoclinic.com/health/hot-flashes/HQ01409

  8. Menopause and Weight Gain: Reverse the Middle Age Spread (Copyright © MFMER) - This publication provides information on weight gain during menopause, including the causes, complications, and the diet and exercise changes you can make to stay healthy.

    http://www.mayoclinic.com/health/menopause-weight-gain/HQ01076

  9. Menopause Guidebook (Copyright © NAMS) - This guidebook explains the emotional and physical changes that often accompany menopause. It also explains what to expect and how to take care of yourself after menopause.

    http://www.menopause.org/edumaterials/guidebook/guidebook.aspx

  10. The Menopause Years (Copyright © ACOG) - This brochure describes the physical changes that may occur around menopause and what can be done to stay healthy during this time.

    http://www.acog.org/publications/patient_education/bp047.cfm

  11. PDF file  Menopause: A New Beginning (Copyright © NAMS) - This easy-to-read book describes everything about menopause and includes information specifically for women going through menopause following a hysterectomy.

    http://www.menopause.org/edumaterials/easyreadenglish.pdf

  12. PDF file  Menopause: Managing Your Body's Changes (Copyright © Hormone Foundation) - This publication contains helpful information on how the changes of menopause happen and what you can do to help yourself through many common menopause symptoms.

    http://www.hormone.org/Resources/upload/menopause_managing_your_body.pdf

  13. Private Part Smarts: Why Safe Sex is a Menopause Priority (Copyright © NAMS) - This publication explains the importance of practicing safe sex during menopause to reduce the risk of STDs or pregnancy.

    http://www.regardinghealth.com/nam/RHO/2004/06/Article.aspx?bmkEMC=14610

  14. Women and Sleep - Understanding Menopause (Copyright © National Sleep Foundation) - This publication provides information on the connection between sleep quality and menopause. In addition, it briefly discusses some of the common treatments to alleviate menopausal symptoms that can interfere with sleep, and it gives tips on what you can do to sleep better during menopause.

    http://www.sleepfoundation.org/site/c.huIXKjM0IxF/b.2462663/apps/nl/content3.asp?content_id={43125362-4AE0-...

Organizations

  1. Federal resource  National Institute on Aging, NIH, HHS
  2. American College of Obstetricians and Gynecologists (ACOG) Resource Center
  3. American Menopause Foundation
  4. Strong to the Bone
  5. The Hormone Foundation
  6. The North American Menopause Society (NAMS)

Federal resource = Indicates Federal Resources

Content last updated May 29, 2008.

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