Menopause Frequently Asked Questions
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Are you nearing the change? Do you have any doubts about menopause or considering hormone replacement therapy? Here is some information you might find useful.
What is the Menopause?
Menopause is the time in a woman's life when her periods stop and she can no longer become pregnant. It is a normal change in a woman's body. A woman will know she has reached menopause when she has not had a period for 12 months in a row (and there are no other causes, such as pregnancy or illness, for this change). Most women experience menopause from 40 to 58 years of age, with a median age of 51.4 years.
Menopause is sometimes called, "the change of life." In the years leading up to menopause, a woman’s ovaries ( female sex organs ) slowly make less and less of the female sex hormones estrogen and progesterone. You might not be aware of the changes happening in your body. Or, you might have symptoms as you near menopause. Confusion about menopause can occur because more of the discomforts and difficulties such as menstrual irregularities and sometimes hot flushes occur during the years leading up to menopause, the perimenopausal years. By the time one has experienced a year without periods, often the worst of these problems has subsided. It may take about four years, on average, before menstrual periods stop completely. There is nothing abnormal or diseased about the changes that come with menopause and it does not necessarily require medical attention or treatment.
In some women menopause can be prompted by surgical removal of the ovaries ( female sex organs ). It can also result from severe damage to the ovaries, sometimes caused by chemotherapy or radiation treatments. A hysterectomy (the removal of the uterus) can result in an end to menstruation but will not bring about menopause as long as the ovaries continue to function.
You will feel better by learning all you can about menopause and talking with your doctor about your health and your symptoms. If your symptoms are causing you discomfort or concern, your doctor can teach you about available therapeutic options and help you to make wise choices.
How will I know I have attained menopause?
Menopause affects every woman differently. Your only symptom may be your period stopping or you may have other symptoms, too. Many symptoms at this time of life happen because you are getting older. But some are due to menopause. It’s not always possible to tell if symptoms are related to aging, menopause, or both. Some changes you might notice as you near menopause include :
• Change in pattern of periods (They can be shorter or longer, lighter or heavier, or there may be more or less time between periods.)
• Hot flushes (sometimes called hot flashes), night sweats (sometimes followed by a chill)
• Trouble sleeping through the night (with or without night sweats)
• Vaginal dryness
• Urinary problems – such as leaking, burning or pain when urinating, or leaking when sneezing, coughing, or laughing.
• Less interest in sex and changes in sexual response.
• Mood swings, feeling crabby, or crying spells
• Trouble focusing or forgetfulness
• Hair loss or thinning on your head, or more hair growth on your face
• Changes in texture of your skin and nails.
We don't know exactly what causes hot flushes. It could be a drop in estrogen or change in another hormone. This affects the part of your brain that regulates your body temperature. During a hot flush, you feel a sudden rush of heat move from your chest to your head. Your skin may turn red, and you may sweat. Most hot flashes last 30 seconds to 5 minutes. They usually disappear within a few years after menopause. However, up to 10-15% of women experience hot flashes for number of years.
Both men and women lose bone as they grow older. But dropping estrogen levels around the time of menopause also leads to bone loss in women. Estrogen helps to build and maintain bone. After menopause, bone loss speeds up for several years as estrogen levels rapidly decrease. Bone loss can cause bones to weaken. Weak bones can break more easily. When bones weaken a lot, the condition is called osteoporosis.
How do I manage symptoms of menopause?
Many women do not need any special treatment for menopause. Eating healthy foods and keeping physically fit are important to feeling your best in the years leading up to menopause and beyond. But if you are particularly bothered by some menopausal symptoms, you might want to try treatment. Several treatment options, including menopausal hormone replacement therapy (HRT), are available depending on your symptoms and other factors. Talk to your doctor about the risks and benefits of treatment so you can choose what’s best for you. There is no one treatment that is good for all women.
• Hot flushes.
Some women report that eating or drinking hot or spicy foods, alcohol, or caffeine, feeling stressed, or being in a hot place can bring on hot flushes. Try to avoid any triggers that bring on your hot flushes. Dress in layers, and keep a fan in your home or workplace. If you are bothered by hot flushes or night sweats, ask your doctor about HRT. HRT works best at treating hot flushes and night sweats. If HRT is not an option for you, ask your doctor about trying antidepressant or epilepsy medicine. There is some evidence that these can help relieve hot flushes for some women. Other therapies you may want to try include Vitamin B complex, Vitamin E, Ibuprofen and hormones such as Provera.
• Vaginal dryness.
A water-based, over-the-counter vaginal lubricant (like K-Y® Jelly) can be helpful if sex is painful. A vaginal moisturizer (also over-the-counter) can provide lubrication and help keep needed moisture in vaginal tissues. Really bad vaginal dryness may need HRT. If vaginal dryness is the only reason for considering HRT, an estrogen product like cream for the vagina is the best choice. Vaginal estrogen products (creams, tablet, ring) treat only the vagina.
• Problems sleeping.
One of the best ways to get a good night's sleep is to be physically active. But, don’t exercise close to bedtime. Also avoid large meals, smoking, and working right before bedtime. Caffeine and alcohol should be avoided after noon. Drinking something warm before bedtime, such as herbal tea (no caffeine) or warm milk, might help you to feel sleepy. Keep your bedroom dark, quiet, and cool. Avoid napping during the day, and try to go to bed and get up at the same times every day. If you wake during the night and can't get back to sleep, get up and read until you’re sleepy. Don't just lie there. If hot flushes are the cause of sleep problems, treating the hot flushes will usually improve sleep.
• Mood swings.
Some women report mood swings or "feeling blue" during the menopause transition. Women who had mood swings before their periods or postpartum depression after giving birth may have more mood swings around the time of menopause. These are women who are sensitive to hormone changes. Often the mood swings will go away with time. If a woman is using HRT for hot flushes or another menopause symptom, sometimes her mood swings will get better, too. Also, getting enough sleep and staying physically active will help you to feel your best. Mood swings are not the same as depression.
• Trouble focusing, “fuzzy thinking,” forgetfulness.
Some women complain of these symptoms in midlife. But studies suggest that natural menopause has little effect on memory or other “brain” functions. Also, recent studies suggest that women should not use HRT only to protect against memory loss or brain diseases, including dementia, and Alzheimer’s disease. Getting enough sleep and keeping physically active might help improve symptoms. But if memory problems are really bad, talk to your doctor right away.
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If you have any queries regarding the topics raised within this article please do not hesistate to contact the Women's Health Clinic via the email form at the bottom of the page or by calling our London clinic on 020 8947 9877.
