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Menopause Overview
This webpage is for information purposes only and is not a substitute for professional medical advice.
Menopause is the gradual end of menstruation. It’s a normal and gradual period of change when a woman’s body goes from a reproductive to a non-reproductive state.
The word menopause is used to describe this period of change. It’s also frequently called the "Change of Life" for female.
Cause
Menopause is caused by a large drop in estrogen levels over time.
A hormone called Follicle Stimulating Hormone (FSH) is released by the pituitary gland in the brain. Normally FSH causes an ovum or egg to mature and be released by an ovary, which causes menstruation.
During menopause the ovaries don’t respond to FSH. An egg isn’t released, and changes (a decrease in the amount of estrogen and progesterone) occur in the female body which gradually stop menstruation.
Average Age
The average age for menopause is 51 years, but it can happen anytime between the ages of approximately 40 and 58 years. If it occurs before age 40, it is called premature menopause.
Women can undergo sudden menopause at any age if their ovaries are surgically removed or damaged through radiation or chemotherapy. Sudden menopause generally has more severe symptoms.
Signs & Symptoms
Menopause doesn’t happen instantly. Most women experience symptoms that happen over a period of months or years that tell them menopause is taking place.
Menstrual cycle changes, hot flashes, and reduced vaginal secretions (vaginal dryness) are the three most common signs.
Menstrual Cycle Changes
Menstrual cycle changes…
- Are usually the first signs of menopause.
- Can vary a great deal.
- Cause your periods to become irregular and your bleeding patterns to change.
- Cause the amount of bleeding to vary or cause very heavy periods.
Fluctuating hormone levels can lead to heavy bleeding, but there are other serious conditions that can cause this as well. See a doctor if heavy bleeding continues.
Hot Flashes
Hot flashes…
- Are harmless.
- May be just a feeling of warmth spreading over your face and upper body or a drenching sweat.
- Might be accompanied by feelings of anxiety, nausea, dizziness or even heart palpitations.
- Are called "night sweats" when they happen at night, and can interfere with sleep.
- Can last for a few seconds or a few minutes.
- Might occur once an hour or more, or once a week.
- Can start when your periods are still regular, or they may start later.
- Can last for a few months or a few years.
Reduced Vaginal Secretions
As estrogen levels fall, the vaginal walls will become thinner and less elastic. Vaginal secretions will decrease and become less acidic, which increases the chance of developing a vaginal or bladder infection.
You might also notice that vaginal lubrication during sexual activity may be slower.
Additional Symptoms
Other symptoms of menopause include:
- Aching muscles and joints
- Chin hair
- Fatigue
- Insomnia
- Thinning hair
- Weight gain
- Wrinkles
Menopause Testing
Your body will let you know that you’re starting menopause.
There is a test which measures the blood level of FSH. You might need to be tested more than once since FSH levels can fluctuate from month to month.
Considering Hormone Replacement Therapy (HRT)
There are two types of hormone therapy: Hormone Replacement Therapy (HRT), a combination of estrogen and progesterone, or Estrogen Replacement Therapy (ERT), which is estrogen only.
Estrogen production doesn’t stop completely at menopause. While the ovaries produce very little estrogen, they still make a hormone called androgen. The adrenal glands also make androgen. This hormone is converted into a form of estrogen, called estrone, by the fat cells in a woman’s body.
The extra weight that females’ gain during mid-life may be natures’ way to make sure that sufficient estrogen is made by her body in the post-menopausal years.
Take your personal history, your menopausal symptoms and your doctor's advice into account as you decide whether or not to take hormones.
Inform yourself and look at all your options before you to take Hormone Replacement Therapy. Take your personal history, your menopausal symptoms and your doctor's advice into account before you make your decision.
Advantages of Hormone Replacement Therapy
Relief From Common Menopause Symptoms
HRT and ERT relieve common menopause symptoms such as hot flashes, night sweats and insomnia.
They also may improve your mood and general state of mind.Reduced Risk of Osteoporosis
Osteoporosis (ah-stee-o-por-o-sis) is a disease where bone deteriorates over time. The bones become thin, brittle and break easily. HRT and ERT reduce the risk of osteoporosis by slowing down bone loss.
Estrogen must be taken for a long time to prevent bone loss. Slowing down bone loss doesn’t necessarily prevent you from fracturing a bone. Research shows that you need to take estrogen for at least seven years for it to have a long-term effect on bone density - any beneficial effect is lost after age 75.
Reduced Risk of Heart Disease
HRT and ERT protect against heart disease by lowering levels of low-density lipoproteins, the "bad" cholesterol.
Ten to fifteen years after menopause, females have the same risk of heart disease as males. Estrogen seems to give protection against heart disease, many believe that taking artificial hormones after menopause will continue to supply this protective effect.
Having high levels of low-density lipoproteins is associated with a higher risk of heart disease. Evidence suggests that estrogen alone does raise high-density lipoproteins (the “good” type of blood cholesterol) and lowers the low-density lipoproteins.
There are no long-term studies that provide evidence that long-term estrogen use benefits females who are not at a high risk for heart disease.
Reduced Vaginal Dryness
Loss of estrogen can lead to the drying and thinning of your vaginal wall. The estrogen in HRT and ERT relieves this vaginal dryness. (You can also treat chronic vaginal dryness with estrogen creams.)
Disadvantages of Hormone Replacement Therapy
Increased Risk of Certain Cancers
- Endometrial Cancer
ERT increases your risk of getting cancer of the endometrial lining of the uterus. For this reason, you should take estrogen plus progesterone if you still have your uterus (womb). When estrogen and progesterone are both necessary, some women find they experience a return of their monthly periods. Sometimes the hormone regimen can be changed to stop this bleeding.
- Breast Cancer
Taking hormone therapy (HRT or ERT) for over 10 years increases your risk of breast cancer by 30-40%.
This is especially true if you have a family history of breast cancer.
Unpleasant Side Effects
- HRT can cause:
- Bloating
- Irritability
- Sore breasts
- Headaches
- Fatigue
- Weight gain
- ERT may be dangerous to women with blood clots.
- HRT increases the risk for high blood pressure and gallstones in some women.
