Overview

Menopause – all women go through it at some point in their lives. Even though it is not an illness, menopause causes physical and mental changes within your body. If your symptoms become unmanageable, there are many treatments available that offer relief.

Medical experts agree that a woman has reached menopause if she hasn't had a menstrual period for 12 consecutive months and there's no underlying medical condition causing her to stop menstruating. On average, women in Western nations can expect to have their last menstrual period at about age 51. In women who smoke, menstruation may stop a year or two earlier. But it varies widely. Some women have their last period when they're still in their 40s; others not until they are 60. Premature menopause, which takes place before age 40, may result from chemotherapy, radiation treatment, or premature ovarian failure, which sometimes runs in families. Surgical menopause — from removal of the ovaries, often done at the time of hysterectomy — can happen at any age.

Because this process takes place over years, menopause is commonly divided into the following two stages:

• Perimenopause – this is the time you begin experiencing menopausal signs and symptoms, even though you still menstruate. Your hormone levels rise and fall unevenly, and you may not have hot flashes and other symptoms. Perimenopause may last four to five years or longer.
• Postmenopause – once 12 months have passes since your last period, you’re reached menopause. Your ovaries produce much less estrogen and no progesterone, and they don’t release eggs. The years that follow are called postmenopause.

Treatments

Symptoms and treatments of menopause:
Some of the physical and mental changes that occur during menopause mimic the natural consequences of aging and may or may not be contributed to a drop in hormone levels. If your symptoms cause you to seek treatment, keep in mind that just as women’s symptoms vary widely, so do their responses to different treatments. You may need to experiment with different strategies or regiments to find the optimal plan for you. Your physician can provide more information to help you deal with everything from hot flashes and depression to mood swings and irregular uterine bleeding.

Hot flashes
Symptoms of hot flashes include sweating, pink or reddened skin, heart palpitations and feelings of anxiety and tension.

Treating hot flashes. Dress in layers, sleep in a cool room, perform deepbreathing exercises, increase soy in your diet and ask your physician about short term hormone therapy.

Vaginal Changes
Vaginal changes such as decreased estrogen causes the vaginal lining to thin and vaginal secretions to diminish. The vagina also becomes shorter and narrower. The result often is dryness and irritation, which can make sexual intercourse unpleasant. Inflammation of the vaginal wall also may occur.

Treating vaginal changes. A vaginal lubricant or moisturizer can be helpful as well as estrogen treatments applied directly to the vagina in the form of creams, rings and tablets.

Irregular uterine bleeding and irregular periods
Symptoms of irregular uterine bleeding and irregular periods include longer periods, cycles shorter than 21 days, bleeding after intercourse, heavy monthly bleeding and spotting.

Treating uterine bleeding. Treatments vary depending on the underlying cause of thebleeding. Treatments include iron supplements, hormones (such as birth control pills, estrogen or an intrauterine device), endometrial ablation and hysterectomy.

Other physical and mental changes at midlife include:

• Mood swings and depression
• Memory and concentration problems
• Insomnia
• Low sexual desire
• Weight gain
• Urinary incontinence
• Heart palpitations
• Dry skin and hair
• Headaches

Menopause itself requires no medical treatment. Fortunately many of the signs and symptoms associated with menopause are temporary. 

Physicians

	Ashley B. Briggs, MD
	Shelley J. Cole, MD
	Jeanne Hassebroek-Johnson, MD
	Kristin Hermanson, MD
	Laurie B. Landeen, MD
	Thomas L. Looby, MD
	Dean L. Madison, MD
	Miranda Pray-Dede, MD
	Allison Wierda Suttle, MD
	Maria C. Bell, MD, MPH
	Zane Craig, DO
	Pamela M. Ephgrave, MD, FACOG
	Keith A. Hansen, MD
	Meredith Kemper, MD
	Anthony Sierra, MD
	Heather Spies, MD
	Teresa P. Buell, CNM
	Terry M. Engelmann, FNP, CNM
	Janet K. Esterly, WHNP
	Mary Beth Johnson, CNP, WHNP
	Dianna L. Puttmann, CNP
	Tammi K. Stangohr, PA-C
	Jenny L. Torgerson, PA-C
	Mary J. Warner, CNM

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