Menopause1 is the time in a woman’s life when her period stops. It usually occurs naturally, most often after age 45. Menopause happens because the woman’s ovaries stop producing the hormones estrogen and progesterone.
A woman has reached menopause when she has not had a period for one year. Changes and symptoms can start several years earlier. They include:
- A change in periods – shorter or longer, lighter or heavier, with more or less time in between
- Hot flashes and/or night sweats
- Trouble sleeping
- Vaginal dryness
- Mood swings
- Trouble focusing
- Less hair on head, more on face
Some symptoms require treatment. Talk to your doctor about how to best manage menopause. Make sure the doctor knows your medical history and your family medical history. This includes whether you are at risk for heart disease, osteoporosis, or breast cancer.
The Centers for Disease Control and Prevention (CDC) has a similar definition of menopause. The CDC also states that menopause2 happens because the woman’s ovary stops producing the hormones estrogen and progesterone.
Menopause, or the “change of life,” is different for each woman. For example, hot flashes and sleep problems may trouble your sister. Meanwhile, you are enjoying a new sense of freedom and energy. And your best friend might hardly be aware of a change at all.
Men should also understand menopause. This quote from Azar Nafisi asks the right question:
“Shouldn’t he want to know about something that has happened to his mother, that will happen to his wife, his sisters, his daughter and, I went on morosely, if ever he has an affair, even to his mistress?”
Menopause is a normal part of life, just like puberty. It is the time of your last menstrual period. You may notice changes in your body before and after menopause. The transition usually has three parts: perimenopause, menopause, and postmenopause.
Changes usually begin with perimenopause. This can start several years before your last menstrual period. Changing levels of estrogen and progesterone, which are two female hormones made in your ovaries, might lead to symptoms. Menopause comes next to the end of your menstrual periods. After a full year without a period, you can say you have been “through menopause,” and perimenopause is over. Postmenopause follows perimenopause and lasts the rest of your life.
The average age of a woman having her last period, menopause, is 51. But, some women have their last period in their forties, and some have it later in their fifties.
Smoking can lead to early menopause. So can some types of operations. For example, surgery to remove your uterus (called a hysterectomy) will make your periods stop, and that’s menopause. But you might not have menopause symptoms like hot flashes right then because if your ovaries are untouched, they still make hormones. In time, when your ovaries start to make less estrogen, menopause symptoms could start. But, sometimes both ovaries are removed (called an oophorectomy), usually along with your uterus. In this case, menopause symptoms can start right away, no matter what age you are, because your body has lost its main supply of estrogen.
Women may have different signs or symptoms at menopause. That’s because estrogen is used by many parts of your body. As you have less estrogen, you could have various symptoms. Here are the most common changes you might notice at midlife. Some may be part of aging rather than directly related to menopause.
Change in your period. This might be what you notice first. Your periods may no longer be regular. They may be shorter or last longer. You might bleed less than usual or more. These are all normal changes, but to make sure there isn’t a problem, see your doctor if:
- Your periods come very close together
- You have heavy bleeding
- You have spotting
- Your periods last more than a week
- Your periods resume after no bleeding for more than a year
Hot flashes. Many women have hot flashes, which can last a few years after menopause. They may be related to changing estrogen levels. A hot flash is a sudden feeling of heat in the upper
part or all of your body. Your face and neck become flushed. Red blotches may appear on your chest, back, and arms. Heavy sweating and cold shivering can follow. Flashes can be very mild or strong enough to wake you from your sleep (called night sweats). Most hot flashes last between 30 seconds and 10 minutes.
Vaginal health and bladder control. Your vagina may get drier. This could make sexual intercourse uncomfortable. Or, you could have other health problems, such as vaginal or bladder infections. Some women also find it hard to hold their urine long enough to get to the bathroom. This loss of bladder control is called incontinence. You may have a sudden urge to urinate, or urine may leak during exercise, sneezing, or laughing.
Sleep. Around midlife, some women start having trouble getting a good night’s sleep. Maybe you can’t fall asleep easily, or you wake too early. Night sweats might wake you up. You might have trouble falling back to sleep if you wake up during the night.
Sex. You may find that your feelings about sex are changing. You could be less interested. Or, you could feel freer and sexier after menopause. After one full year without a period, you can no longer become pregnant. But remember, you could still be at risk for sexually transmitted diseases (STDs), such as gonorrhea or even HIV/AIDS. You increase your risk for an STD if you are having sex with more than one person or with someone who is having sex with others. If so, make sure your partner uses a condom each time you have sex.
Mood changes. You might find yourself more moody or irritable around the time of menopause. Scientists don’t know why this happens. It’s possible that stress, family changes such as growing children or aging parents, a history of depression, or feeling tired could be causing these mood changes.
Your body seems different. Your waist could get larger. You could lose muscle and gain fat. Your skin could get thinner. You might have memory problems, and your joints and muscles could feel stiff and achy. Are these a result of having less estrogen or just related to growing older? Experts don’t know the answer.
You could also talk to your doctor about whether there are any medicines to manage hot flashes. A few drugs that are approved for other uses (for example, certain antidepressants) seem to be helpful to some women.
The National Institute on Aging has a very informative booklet named “Menopause Time for a Change4.” The booklet gives a fairly detailed overview of all aspects of menopause.
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