Menopause

Overview

Definition

Menopause is when a woman has not had a menstrual period for 1 year. It is called early menopause when it happens before age 40.

Causes

Menopause happens when estrogen and progesterone hormones become lower. The ovaries stop releasing eggs when hormones are too low.

Surgery to remove the uterus or ovaries can also cause menopause. Cancer treatments can also cause it.

Risk Factors

Menopause is a normal part of aging. It is most common in women who are 40 to 58 years of age.

When it happens early, risk factors are:

  • Smoking
  • Cancer treatments
  • Surgery to remove the uterus or ovaries
  • Contact with arsenic
  • Use of oral birth control
  • Low body fat
  • Having a mother who was given diethylstilbestrol (DES) when pregnant

SymptomsandDiagnosis

Symptoms

There may not be symptoms. Women who do have symptoms may have them in the time leading up to menopause. Problems may be:

  • Irregular periods
  • Hot flashes and night sweats
  • Problems sleeping, such as insomnia
  • Vaginal dryness, discharge, itching, and pain with sex

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. The doctor will ask about your periods. This is often enough to make the diagnosis.

A blood test may be done to look for follicle-stimulating hormone (FSH). High levels of FSH suggest menopause. It can confirm the diagnosis.

Treatments

Treatment

Menopause is a normal part of life. It does not need treatment.

Hormone changes can cause symptoms. These can be managed with medicine and general care.

Female Reproductive Organs
Osteoporosis
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Hormone Replacement Therapy (HRT)

HRT can be used for a short time. Here are some options:

  • Estrogens
  • Progesterone
  • A blend of estrogen and progesterone
  • Low amounts of male hormones

Non-hormone Options

HRT is not a good choice for some women. Medicine that may help include:

  • Certain blood pressure medicines
  • Antidepressant medicines
  • Antiseizure medicines

Managing Symptoms with Home and Self Care

Taking care of general health may ease the impact of changes due to menopause. Steps that may help include:

  • Balanced diet—plenty of vegetables, fruits, and whole grains
  • Regular exercise—some movement every day
  • Relaxation tools to ease impact of stress
  • Good sleep habits
  • No smoking
  • Moderate or no alcohol

Other steps can help to manage specific problems:

  • Vaginal lubricants can help with dryness.
  • Dressing in layers, cool drinks, and cooling towels can help manage hot flashes.

Prevention

Menopause is a normal part of aging that cannot be prevented.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

RESOURCES

The North American Menopause Society http://www.menopause.org 

Office on Women's Health https://www.womenshealth.gov 

CANADIAN RESOURCES

Health Canada https://www.canada.ca 

Women's Health Matters—Women's College Hospital http://www.womenshealthmatters.ca 

References

American College of Obstetricians and Gynacologists (ACOG). Practice Bulletin No. 141: management of menopausal symptoms. Obstet Gynecol. 2014 Jan;123(1):202-216, reaffirmed 2016, correction can be found in Obstet Gynecol 2016 Jan;127(1):166.

Menopause. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/menopause . Updated December 5, 2019. Accessed July 22, 2020.

Menopause. Planned Parenthood website. Available at: https://www.plannedparenthood.org/learn/health-and-wellness/menopause. Accessed July 22, 2020.

Menopause 101: A primer for the perimenopausal. North American Menopause Society website. Available at: http://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/menopause-101-a-primer-for-the-perimenopausal. Accessed July 22, 2020.