Menopause fact sheet
What is menopause?
Menopause is a life transition that happens to every woman. The “change of life,” or the cessation of menstruation, occurs as a woman ages. The exact age at which it will happen to a woman varies, but on average it occurs at age 51.
The gradual transition leading up to the final menstrual period is known as perimenopause. During this time, many women will experience changes in their bodies due to hormonal fluctuations in estrogen and progesterone.
Women who have a hysterectomy to remove their uterus or a bilateral oophorectomy to remove both of their ovaries have undergone an event known as “surgical menopause.” The removal of the ovaries or uterus stops monthly periods immediately and generally results in more intense menopausal symptoms than those felt by a woman who reaches menopause naturally. Surgical menopause also puts the woman at risk for early bone loss and heart disease.
There are other causes of menopause such as radiation treatment, medication used in chemotherapy, autoimmunity or genetic errors. In some cases, women with “premature ovarian failure” will have menopause symptoms before the age of 40. Women with this diagnosis sometimes have ovaries that produce hormones irregularly, can begin to have their menstrual cycles again and can possibly become pregnant after their diagnosis.
Menstrual cycle changes
The first difference that many women notice in perimenopause is a change in their periods, such as:
- Periods that last longer than a week.
- Periods that come very close together.
- Heavy bleeding.
When menstrual cycles are irregular, it makes it more difficult to predict when sexual intercourse could result in a pregnancy. It is recommended that a woman check with her doctor after missing a few periods to make sure she is not pregnant.
If you begin having issues with heavy bleeding during your period, your doctor might suggest a low-dose birth control pill to help regulate the cycle, prevent pregnancy and reduce hot flashes.
Hot flashes & night sweats
Another common symptom during perimenopause is hot flashes. During a hot flash, the face and upper body become hot, and the skin will look flushed. Hot flashes vary in their frequency and severity; they can happen several times an hour, a few times a day or once a week. Night sweats are hot flashes that occur when you are sleeping. They can be mild or strong enough to wake you up in the middle of the night.
Lifestyle changes such as exercise, losing weight and quitting smoking all might lower your risk of hot flashes.
Keeping a written journal of your activities during the day and before bed might help you determine what triggers your hot flashes and night sweats. There are other steps you can take to reduce hot flashes and night sweats, including:
- Sleep in a cool room.
- Dress in layers that can be removed at the beginning of a hot flash.
- Have a cool drink of water when you feel a hot flash beginning.
- Use sheets and clothing that let your skin breath.
- Use relaxing breathing techniques.
- Do not smoke.
Sleep issues & fatigue
Many women report that during their menopause transition they have trouble falling asleep and staying asleep. While it can be common to wake up from a night sweat or to use the restroom, not being able to fall back asleep can cause fatigue. There are steps a woman can take to get a restful night’s sleep.
- Go to bed and get up at the same time every day, even on weekends.
- Avoid naps in the late afternoon and evening.
- Have a bedtime routine that you follow each night.
- Don’t eat a large meal close to bedtime, and avoid caffeine later in the day.
- After turning off the light, give yourself 15 minutes to fall asleep. If you are still awake, get out of bed and only lie back down when you are sleepy.
- Use relaxing breathing techniques.
- Limit fluid intake before bed.
Your skin & tissue
It is normal for skin to change as a women goes through her menopause transition. Fatty tissue and collagen under the skin and in the areas near the vagina and urinary tract start to become thinner and lose elasticity. These changes are likely to make the vaginal tissue drier and can increase the likelihood of tearing and infection.
Due to these changes, sexual intercourse might become painful. If sexual intercourse becomes uncomfortable because of these changes in fatty tissue and collagen, there are methods that can relieve vaginal dryness. Water-based lubricant, vaginal estrogen tablets and estrogen cream all can reduce discomfort. When accompanied with hot flashes, a physician might recommend menopausal hormone therapy (MHT).
Menopause hormone therapy (MHT)
Menopausal hormone therapy (MHT) was formerly known as hormone replacement therapy (HRT). It uses hormones to ease the symptoms of menopause or to prevent osteoporosis. Women who no longer have a uterus might use the hormone estrogen alone for treatment. For women with a uterus, estrogen is combined with progesterone or a progestin (a progesterone-like medicine) to help ease symptoms.
When taking estrogen, progesterone or progestin is needed to protect the lining of the uterus. To reduce the risk of serious health issues, the federal Food and Drug Administration recommends that MHT be used at the lowest dose possible to relieve symptoms for the shortest time needed. While many women find that MHT helps to relieve their menopause symptoms, it is not the right treatment for all women.
After menopause, some women notice changes in their desire to have sex or the ability to become sexually aroused. Medications taken for blood pressure, depression and cholesterol might affect your libido. It is important to practice safe sex even after menopause because sexually transmitted diseases can still be contracted.
Post-menopausal women are at a high risk for contracting HIV because of the fragile tissue of the vulva and the lining of the vagina. These delicate tissues are more susceptible to the HIV virus.
Bone loss speeds up around the time of menopause and slows again a few years later. Maintaining bone density at menopause through exercise and a proper diet can help reduce further bone loss. Regular weight-bearing exercise such as walking, running, stair climbing or using weights at least three or four times a week can help keep bones strong and increase balance. To preserve bone density, it is important to get enough calcium and vitamin D in your diet.
Sources: National Institutes of Health, National Institute on Aging
For further information
Our physicians are on hand to answer your questions and concerns about menopause. Request an appointment online or call 859-257-1000 or toll-free 1-800-333-8874 for more information or to schedule an appointment with a gynecologist.