Menopause

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Menopause is defined as occurring 12 months after your last menstrual period and marks the end of menstrual cycles. Menopause can happen in your 40s or 50s.

Menopause is a natural biological process. Although it also ends fertility, you can stay healthy, vital and sexual. Some women feel relieved because they no longer need to worry about pregnancy.

Don’t hesitate to seek treatment for symptoms that bother you. Many effective treatments are available, from lifestyle adjustments to hormone therapy.

Symptoms

In the months or years leading up to menopause (perimenopause), you might experience these signs and symptoms:

  • Irregular periods
  • Vaginal dryness
  • Hot flashes
  • Night sweats
  • Sleep problems
  • Mood changes
  • Weight gain and slowed metabolism
  • Thinning hair and dry skin
  • Loss of breast fullness

When to see a doctor

Starting at perimenopause, schedule regular visits with your doctor for preventive health care and any medical concerns. Continue getting these appointments during and after menopause.

Preventive health care can include recommended screenings at menopause, such as a colonoscopy, mammography, lipid screening, thyroid testing if suggested by your history, and breast and pelvic exams.

Always seek medical advice if you have bleeding from your vagina after menopause.

Causes

  • Natural decline of reproductive hormones
  • Hysterectomy
  • Chemotherapy and radiation therapy
  • Primary ovarian insufficiency

Complications

  • Heart and blood vessel (cardiovascular) disease
  • Osteoporosis
  • Urinary incontinence
  • Sexual function
  • Weight gain

Tests and diagnosis

Tests typically aren’t needed to diagnose menopause. But under certain circumstances, your doctor may recommend blood tests to check your level of:

  • Follicle-stimulating hormone (FSH) and estrogen (estradiol), because your FSH levels increase and estradiol levels decrease as menopause occurs
  • Thyroid-stimulating hormone (TSH), because an underactive thyroid (hypothyroidism) can cause symptoms similar to those of menopause

Treatments and drugs

Menopause requires no medical treatment. Instead, treatments focus on relieving your signs and symptoms and preventing or managing chronic conditions that may occur with aging. Treatments may include:

  • Hormone therapy
  • Vaginal estrogen
  • Low-dose antidepressants
  • Gabapentin
  • Medications to prevent or treat osteoporosis