Every woman goes through menopause; it’s not a disease, but a natural process of life. What exactly is menopause and what really happens during the “big change?” Very simply, menopause is when a woman has not had a menstrual period for 12 consecutive months and isn’t fertile any more.
During the time leading up to menopause (called perimenopause) your ovaries produce less estrogen and progesterone (hormones regulating your menstruation and fertility), which causes menopausal symptoms. Usually this process occurs gradually, but in some women their ovulation abruptly stops.
Most women undergo menopause between the ages of 45 and 55 years, and the average age is 51. Woman smokers may experience menopause at an earlier age.
Causes of menopause
There are various causes for menopause. First and foremost is the natural decline of a woman’s reproductive hormones. As you age into your late 30s, your ovaries begin to make less estrogen and progesterone, and your fertility declines. As you reach your 40s, you may experience irregular periods – longer or shorter, more or less frequent, lighter or heavier. By age 51 (on average), your ovaries will have stopped producing eggs and you will be experiencing menopause.
If you have surgery that removes your uterus and both ovaries, you will experience immediate menopause. Your symptoms will include immediate cessation of your periods, hot flashes, and more menopausal symptoms due to the abrupt change in the reproductive system.
During or shortly after chemotherapy and radiation therapy you may also experience menopausal symptoms, such as hot flashes. However, the menopause may not be permanent after chemotherapy and you may want to continue to use birth control measures.
The last cause of menopause is primary ovarian insufficiency, which is when your ovaries don’t produce enough reproductive hormones either from a genetic factor or an autoimmune disease. Most commonly, though, no cause for the insufficiency is found.
During perimenopause, the most common symptom is irregular periods. Your periods usually tend to be on shorter cycles (and closer together), but during this time pregnancy is still possible. Other symptoms you may experience are listed below, but the experience is unique to each woman:
- Irregular periods;
- Vaginal dryness;
- Hot flashes;
- Night sweats;
- Sleep problems;
- Mood changes;
- Weight gain and slowed metabolism;
- Thinning hair and dry skin; and
- Loss of breast fullness.
It goes without saying that menopause can’t be prevented because it’s a natural phase of life. There are, however, various treatment options to help with your specific symptoms.
Depending on what your symptom is, from hot flashes to mood swings and beyond, there are various lifestyle changes you can employ, as well as medications you can try.
If your symptoms are from a hormonal cause, your doctor may prescribe a type of medication called hormone replacement therapy. Essentially these drugs work to replace the depleted estrogen and/or progesterone in your body. They come in various forms, like pills, patches, shots, or even vaginal rings. There are risks associated with these treatments and there have been studies that have indicated that HRT may cause cancer spread.
Here are some of the more commonly prescribed hormone replacement medications used for treating menopausal symptoms:
- Estrogen-only: Climara, Estrace, Premarin, Vivelle, etc.;
- Progestin-only: Prometrium, Provera;
- Combination Estrogen and Progestin: Activella, Prempro, etc.; and
- Combination Estrogen and Hormone: Duavee.
Before deciding to use any of these, you should talk with your physician to be sure you understand the potential risks and benefits.