Menopause: Key Q&A

When does menopause usually occur?

Menopause occurs when a woman's body no longer releases eggs, and her ovaries substantially reduce production of the hormones estrogen and progesterone.

A woman is considered to have entered menopause when she goes without a menstrual cycle for 12 consecutive months. In most cases, this happens between the ages of 45 and 55, although sometimes it occurs much earlier or later.

How can I tell if I am in menopause?

If you have not had a period for a year and no other biological or physiological cause can be determined, you are in menopause. To find out if there is another cause, a physician can take several steps such as performing a physical examination, taking a medical history and conducting tests for levels of certain hormones.

What causes early menopause?

Menopause most often occurs as a part of the aging process. Sometimes, however, it may take place prematurely, as with surgical menopause. This occurs when a woman has a hysterectomy (removal of the uterus) and oophorectomy (removal of the ovaries). The symptoms in this case most often occur soon after the surgery and are often more severe than with natural menopause.

Other, less common, causes of premature menopause are genetic predisposition, cancer treatments, smoking, chromosome defects and autoimmune diseases.

What are the most common symptoms of menopause?

Women may experience several symptoms as they enter menopause. The most common include hot flashes (feelings of warmth in the face, neck or chest), night sweats, changes in vaginal tissue (such as thinning, dryness, itchiness or burning), thinning of the bones (osteoporosis), abnormal vaginal bleeding or spotting, mood changes and urinary problems.

The severity of these and other symptoms can vary from one woman to the next. Some problems, such as hot flashes, gradually fade with time.

What is perimenopause?

Perimenopause is the period of transition between your reproductive years and the onset of menopause. The occurrence of perimenopause is usually characterized by a fluctuation in your menstrual cycle.

However, if you experience abnormal vaginal bleeding or spotting and have not had a period for 12 consecutive months, you should notify your doctor. This can sometimes be a sign of a more serious condition such as cancer, or noncancerous growths in the lining of the uterus. It is also a possible side effect of birth control pills or hormone replacement therapy or a result of a hormonal imbalance.

Can I prevent or reduce menopause symptoms?

There is no way to prevent the onset of menopause. However, if you experience severe symptoms, you can take steps to alleviate them. The most common method of achieving this is through hormone replacement therapy (HRT), sometimes called menopausal hormone therapy (MHT).

HRT can be effective at reducing the frequency of hot flashes, relieving vaginal dryness, slowing the loss of bone density and evening out your mood. However, recent studies have identified some health risks with HRT, including increased risk of blood clots and breast cancer. But most studies indicate that women who use HRT to treat severe symptoms as they enter menopause can do so safely. Be sure to consult your physician about the risks and benefits of HRT.

Most women experience some symptoms of menopause to varying degrees. You may also be able to lessen the burden of menopause by exercising regularly, not smoking, eating a healthy diet, avoiding alcohol, staying fit and having regular doctor visits.

Reviewed by Marc Kaufman, M.D., ACOG

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