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

Periods happen when estrogen and progresterone hormones lower. The ovaries release these hormones. Menopause is a normal part of aging. The ovaries stop releasing eggs when hormones are too low.

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

Risk Factors

This is a normal part of aging. It is most common in women who are 40-58 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

You may not have symptoms.

If you do, they happen in the time leading up to menopause. You may have:

  • Irregular periods
  • Hot flashes and night sweats
  • Disturbed sleep patterns, such as insomnia
  • Vaginal dryness, discharge, itching and pain with sex

Diagnosis

Your doctor will ask you about your periods. Menopause is when a woman has not had a period for 1 year. It is assumed due to age and symptoms.

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

Treatments

Treatment

Menopause is a normal part of life. It doesn't need treatment.

Hormone changes can cause symptoms. Certain treatments and lifestyle changes can help to manage:

  • Symptoms that can occur during transition
  • Your risk of heart disease or osteoporosis

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

HRT can be taken as tablets, gels, skin patches, vaginal rings or tablets, injections, and pellets placed in the skin.

HRT can raise the risk problems like cancer, heart disease, and blood clots. Talk to your doctor about whether the benefits are greater than the risks.

Non-hormone Options

HRT is not a good choice for some women. Here are other options:

  • Certain blood pressure medicines
  • Antidepressant medicines
  • Antiseizure medicines

Lifestyle Changes

A healthful diet may reduce some of your symptoms. It can help you feel better. It can also lower the risk of heart disease and osteoporosis. You should eat:

  • Plenty of fruits, vegetables, and whole grains
  • Low amounts of saturated fats (found in animal products), trans fats, processed foods, and sugars
  • Lean protein options such as chicken, fish, eggs, or nuts

You should also have calcium and vitamin D for healthy bones. Milk and yogurt are high in calcium. Fish is high in vitamin D. Ask your doctor if supplements are needed. Sunlight also raises vitamin D in the body.

Try not to eat spicy or hot foods or drinks. They can make hot flashes worse.

Exercise may lower symptoms, manage weight, and lower stress. Weight-bearing exercises like walking and strength exercises may also help keep bones healthy. A mix of both works best.

Prevention

Menopause is natural. You can’t prevent it.

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

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

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

CANADIAN RESOURCES

Health Canada https://www.canada.ca 

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

References

Menopause. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T114698/Menopause  . Updated March 15, 2018. Accessed April 17, 2018.

Menopause. Planned Parenthood website. Available at: https://www.plannedparenthood.org/learn/health-and-wellness/menopause. Accessed April 18, 2013.

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 April 18, 2013.

Moilanen JM, Mikkola TS, Raitanen JA, et al. Effect of aerobic training on menopausal symptoms: A randomized controlled trial. Menopause. 2012;19(6):691-696.

9/30/2008 DynaMed Plus Systematic Literature Surveillance. Available at:  http://www.dynamed.com/topics/dmp~AN~T114698/Menopause  : Jacobson BC, Moy B, Colditz GA, Fuchs CS. Postmenopausal hormone use and symptoms of gastroesophageal reflux. Arch Intern Med. 2008;168(16):1798-1804.

1/30/2009 DynaMed Plus Systematic Literature Surveillance. Available at:  https://www.dynamed.com/topics/dmp~AN~T128400/Black-cohosh-for-menopausal-symptoms  : Borrelli F, Ernst E. Black cohosh (Cimicifuga racemosa): A systematic review of adverse events. Am J Obstet Gynecol. 2008;199(5):455-466.

1/30/2009 DynaMed Plus Systematic Literature Surveillance. Available at:  http://www.dynamed.com/topics/dmp~AN~T114698/Menopause  : Kaszkin-Bettag M, Ventskovskiy BM, Solskyy S, et al. Confirmation of the efficacy of ERr 731 in perimenopausal women with menopausal symptoms. Altern Ther Health Med. 2009;15(1):24-34.

4/14/2009 DynaMed Plus Systematic Literature Surveillance  https://www.dynamed.com/topics/dmp~AN~T900202/Desvenlafaxine  : Archer DF, Dupont CM, Constantine GD, et al. Desvenlafaxine for the treatment of vasomotor symptoms associated with menopause: a double-blind, randomized, placebo-controlled trial of efficacy and safety. Am J Obstet Gynecol. 2009;200(3):238.