Menopause: What to Expect When Your Body is Changing

What is menopause?

Menopause is when a woman’s menstrual periods permanently end. It is a normal part of a woman's life and it happens because, as a woman ages, her ovaries make less of the female hormones estrogen and progesterone. Estrogen and progesterone are the hormones that regulate your menstrual cycle.

Perimenopause is the term for the 3 to 5 years around the time of menopause and before your final period.


When does menopause occur?

The timing of actual menopause is different for each woman. The average age for women to have their last period is about 51. But it's normal for menopause to occur any time from age 40 to 59. A woman often goes through menopause at about the same age as her mother. If you stop having periods early (before age 40) your doctor can do a blood test to see if you're actually going through menopause or if there is another cause for your missed periods.

Menopause is a gradual process that can take several years. You're not really through menopause until you haven't had a period for 12 months. (During this time, keep using birth control if you don't want to become pregnant.)

Women who have both ovaries removed during surgery will go through "surgical menopause" at the time of their surgery. If the uterus is taken out but the ovaries are not, a woman will stop having periods, but she will not go through surgical menopause.


Talk to your doctor if you have:

A change in your monthly cycle
Heavy bleeding
Bleeding that lasts longer than usual
Bleeding more often than every 3 weeks
Bleeding after sexual intercourse
Any blood spotting between periods


What are the common signs and symptoms of menopause?

Some women just stop having periods. Most women experience some symptoms, such as the following:

A change in your menstrual cycle. This is one of the first signs of menopause. You may skip periods or they may occur closer together. Your flow may be lighter or heavier than usual.

Hot flashes. Hot flashes are the most common symptom of menopause.

When you have a hot flash, you'll feel warm from your chest to your head, often in wave-like sensations. Your skin may turn red and you may sweat. You may feel sick to your stomach and dizzy. You may also have a headache and feel like your heart is beating very fast and hard.

Vaginal dryness. During and after menopause, the skin of your vagina and vulva (the area around your vagina) becomes thinner. Your vagina also loses its ability to produce as much lubrication (wetness) during sexual arousal. These changes can lead to pain during sex.

You can use an over-the-counter water-based sexual lubricant (such as K-Y Jelly) or moisturizers for the vaginal area (such as Vagisil) to make sex less painful. You can also talk to your doctor about the benefits and risks of using prescription estrogen cream for vaginal changes.

Urinary tract problems. You're more likely to have bladder and urinary tract infections during and after menopause. Talk to your doctor if you have to go to the bathroom often, feel an urgent need to urinate, feel a burning sensation when urinating or are not able to urinate.

Headaches, night sweats, trouble sleeping and tiredness are other symptoms. Trouble sleeping and feeling tired may be caused by hot flashes and night sweats that keep you from getting a good night’s rest.

Weight gain. Many women gain weight during menopause. A healthy diet and exercising most, if not all, days of the week will help keep you fit.
HeIlp for hot flashes

Turn your thermostat down. Sleep in a cool room.
Dress in layers, so you can remove clothing when you get too warm.
Wear cotton and other natural fabrics that "breathe" so you don't get overheated. Use cotton sheets on your bed.
Drink cool water or other beverages when a hot flash starts.
Get plenty of exercise.
Find out what triggers your hot flashes and avoid them. Spicy foods, alcohol, tight clothing and hot humid weather are some common triggers.


Does menopause have emotional symptoms?

Many women experience emotional symptoms during menopause. These symptoms may include sadness, anxiety and mood swings. For some women, symptoms can be severe. If you find that you're having emotional problems, talk to your family doctor.


What is hormone replacement therapy?

Hormone replacement therapy (HRT) is a treatment for menopause symptoms that involves taking synthetic hormones (which are made in a laboratory rather than by the body). HRT can be estrogen taken alone or estrogen combined with another hormone, progestin. Some women have found that HRT can relieve symptoms such as hot flashes, vaginal dryness and some urinary problems. However, HRT is not for everyone. New information from recent studies suggests that for most women, the risks of using HRT may outweigh the benefits. Talk to your doctor about the risks and benefits of HRT.


Are other treatments available?

Yes. Medicines such as estrogen cream, low-dose antidepressants, soy products and certain herbal supplements may help ease some menopausal symptoms. Discuss these options with your doctor.