What is menopause?

Menopause is a transition into a new phase of life. Once the menstrual cycle ends it continues. Menopause is not a health concern and some view it as a release time. Hormonal fluctuations and other causes can be causing pain, however.

In developing countries, where the average age is 51, menopause typically starts between the ages of 40 and 58. In others, due to a medical condition or procedure, such as removing the ovaries, this may occur sooner.

Many females experience physical symptoms during the time of menopause, such as hot flashes, night sweats, vaginal dryness, and a decreased sex drive. It can lead to anxiety, mood changes and a decreased sex drive as well.

Such symptoms can begin before menstruation is over, and may last for many years. The effect can vary from moderate to serious on a person’s quality of life. There are, however, ways to treat those symptoms.

Every single person experiences menopause differently. Some have complete, healthy lives before and after the process and some feel relaxed by not having to deal with menstruation or birth control any more.

Maintaining a balanced diet and daily exercise will make a person feel healthier in the long run and improve their overall health. Those experiencing signs of menopause will obtain medications and assistance.

Read more about what to expect during menopause, in this article.

What is menopause?

Menopause is the period of life that follows menstrual cycles to their conclusion. Each person can experience menopause differently.

This can last for many years, and there are three stages:

Perimenopause is the transitional phase that starts before menopause and involves the 12 months after the last cycle of a individual.

Menopause occurs about 12 months after the last menstrual, or when menstruation has ceased for a health cause, such as ovarian removal.

Postmenopause refers to the years after menopause, but it may be hard to know when menopause is over and postmenopause starts.

Signs and symptoms

Different physical and mental changes can arise during the menopause, which can cause symptoms. Some of these begin before menopause and some go on after.

The perimenopausal and menopause shifts include:

Lower fertility

As a female reaches the end of the reproductive period but before menopause starts, rates of estrogen begin to decrease. This diminishes the risk of becoming pregnant.

Irregular menstruation

The first indication that menopause is coming is that cycles usually occur less frequently. They may come more or less often than usual, and may be lighter or heavier.

Anyone who has questions regarding menstrual changes should see a doctor, as such changes can also signify pregnancy or health issues.

Vaginal dryness and discomfort

During perimenopause, vaginal dryness, itching, and discomfort can begin and continue into menopause. A person with any of those symptoms during vaginal sex can experience chafing and discomfort. It, too, will increase the risk of infection if the skin splits.

Atrophic vaginitis may also occur during menopause, causing thinning, drying and inflammation of the vaginal wall.

Diverse moisturizers, lubricants, and medicines may reduce vaginal dryness and related problems.

Hot flashes

Hot flashes are popular during the menopause time. They cause a person in the upper body to feel a sudden sensation of heat. The sensation may begin in the face, neck, or chest, and may move up or down.

A hot flash can also cause:

• sweating
• red patches to form on the skin

In addition to or because of hot flashes, some people feel night sweats and cold flashes, or chills.

Hot flashes typically occur after menstruation ends in the first year, but they can persist for up to 14 years after menopause.

Sleep disturbances

Sleep problems can arise during menopause, and they may stem from:

• anxiety
• night sweats
• an increased need to urinate

Having plenty of exercise and avoiding big meals before bedtime will help handle these problems so contact a health care provider if they continue.

Emotional changes

Depression, anxiety and low mood during a menopause are normal. Experiencing moments of irritability and weeping spells isn’t rare.

Hormonal changes and sleep disorders may lead to those problems. A person’s feelings about menopause can also come into play. Distress over low libido or fertility ending, for example, may lead to depression during menopause.

Although feelings of sorrow, irritability, and tiredness during menopause are common, they do not necessarily suggest depression. Whoever experiences a low mood for 2 weeks or longer should see a doctor, who will decide on the best course of action.

Anyone who has sleep problems or any menopause related changes should contact a health care provider.

An article published in 2018 indicates that the connection between menopause and suicide can, in some cases, exist. Anyone contemplating suicide should seek support from a counselor or health care provider. Anonymous hotlines are available too.

Suicide prevention

• If you know someone at immediate risk of self-harm, suicide, or hurting another person:
• Call 911 or the local emergency number.
• Stay with the person until professional help arrives.
• Remove any weapons, medications, or other potentially harmful objects.
• Listen to the person without judgment.
• If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours a day at 1-800-273-8255.

Trouble focusing and learning

Two-thirds of women in the lead-up to menopause may have trouble with memory and concentration.

Being active both physically and mentally, adopting a balanced diet, and keeping an active social life will help with these problems. Some people are gaining, for example, from discovering a new hobby or joining a club or social activity.

Physical changes

Various physical changes can develop around the time of menopause.

People may experience:

• a buildup of fat around the abdomen
• weight gain
• changes in hair color, texture, and volume
• breast reduction and tenderness
• urinary incontinence

However, there is not always a direct connection between such changes and menopause. Others can take place separately at the same time as the transition, and age and lifestyle may play a role as well.

Increased risk of some health conditions

After menopause it appears that the risk of such health conditions is rising. Menopause does not cause these problems, but some function may be played by the hormonal changes involved.

Osteoporosis: This is a long-term disease in which bone strength and density are reduced. A doctor can recommend consuming more calcium-rich foods and taking vitamin D supplements to maintain bone strength.

Cardiovascular disease: The American Heart Association (AHA) states that while a reduction in estrogen due to menopause will raise the risk of cardiovascular disease, taking hormone therapy does not minimize this risk.

Breast cancer: Many forms of breast cancer have a greater risk of developing after menopause. Menopause does not cause breast cancer but the risk tends to be elevated by the hormonal changes involved.

LGBTQIA+ and menopause

Most menopause details describes the experiences of heterosexual, cisgender females. Menopause can however impact anyone born with ovaries.

A individual who converts to a male but retains their ovaries can experience menopause when the ovaries stop egg production.

When a person starts to take supplemental testosterone as part of their transition, then they can experience symptoms of menopause. Symptoms of menopause can also occur when a person undergoes surgery to remove his or her ovaries.

If transition requires all of these events, menopause symptoms may be the same as those of cisgender females.

Nevertheless, transgender people can face additional challenges, depending on their care team’s attitude. It is important that people who are transgender have access to health care professionals who understand their needs and are able to handle them effectively.

Treatment

Menopause is a natural process rather than a health issue. It may also entail detrimental physical and mental changes.

Everyone dealing with those changes will seek professional advice. A doctor may recommend one or more of these:

Hormone therapy

By supplying additional estrogen and a synthetic form of the hormone progesterone, this treatment helps regulate the hormone levels in the body.

Hormone treatment comes in various ways from patches of the skin and topical creams. This can help to reduce the occurrence of hot flashes and other symptoms of menopause.

Use it may also raise the risk of contracting other diseases and conditions of health.

A person should not use hormone therapy if they have risk factors for the following health problems or if they have a history of these issues, either personal or family:

• heart disease
• blood clots
• high levels of triglycerides in the blood
• gallbladder disease
• liver disease
• stroke
• breast cancer

It is important to discuss the possible benefits and risks of hormone therapy with a doctor before deciding to use it.

Other treatments

A person may find that the following can also help relieve symptoms:

• over-the-counter gels and other products for vaginal dryness
• prescription pills, creams, and rings for vaginal dryness
• low-dose hormonal birth control pills for hot flashes, vaginal dryness, and mood changes
• low-dose antidepressants for hot flashes, even among people who do not have depression

Lifestyle tips

Tips for managing the challenges of menopause include:

• getting regular exercise
• practicing relaxation and deep breathing exercises
• having a healthful diet that includes plenty of fresh fruits, vegetables, and whole grains
• quitting smoking and avoiding secondhand smoke
• limiting the intake of alcohol
• seeking counseling for anxiety, mood changes, and relationship concerns
• establishing good sleeping habits and getting plenty of rest
• doing Kegel exercises to strengthen the pelvic floor
• talking to friends and family about the experience of menopause
• exploring new ways of enjoying intimacy with a partner
• joining a club, volunteering, or taking up a new hobby

Keeping an active sex life

Menopause can reduce the sex drive of a person and lead to vaginal dryness but it also removes the need for birth control. This can make sex more fun for others.

Having sex can also increase blood flow in the vagina and help keep the tissues healthy.

Some guidelines during menopause to maintain sexual health and behavior include:

• staying physically active
• avoiding tobacco products, recreational drugs, and alcohol
• taking the time to become aroused, which will improve lubrication
• doing Kegel exercises to strengthen the pelvic floor
• not using any strong soaps around the vagina, as these can worsen irritation

Often, signs of menopause lead some individuals to find acceptable types of sex that don’t include the vagina as much or at all.

It is worth remembering that while a woman can not become pregnant once menopause starts, it is still important to protect against sexually transmitted infections by using barrier protection during penetrative sex.

Sexual partners may also get older at the same time — and may be undergoing menopause. We can feel a decline in sex drive too. Opening up on any issues could help both partners feel better and explore new types of intimacy.

Causes

Menopause is not a disease but a period of life. Most women undergo normal midlife menopause. Earlier though, surgery and other factors can cause menopause to begin.

Natural menopause

The reproductive years of a female last from puberty to menopause-from natural transition to natural transition.

The levels of the hormones estrogen and progesterone in the body fall during menopause as they are no longer needed to help reproduction. Menopause causes those changes.

Surgery and treatment

If an person undergoes surgery to remove their ovaries, menopause may occur. When this occurs before middle age, it can be referred to by physicians as “early menopause.”

A doctor might prescribe hormone therapy to relieve these symptoms, but as always, it is necessary to evaluate the risks and possible benefits of this medication.

Some therapies, such as chemotherapy and radiotherapy, may cause ovaries to either temporarily or permanently stop functioning. The probability of this occurring depends on the age of the person, and the treatment type and venue.

An individual who has a menopause due to a surgical procedure will experience the same symptoms as an individual who has a normal menopause. The signs can occur more unexpectedly, however, because the physical change is more sudden.

An individual may also feel sadness or depression over early fertility loss. Some people plan to freeze eggs before pursuing this form of treatment or seek other choices for having children later in life. Counseling is regularly offered.

Discussing potential health effects with a doctor is also crucial, as women who undergo menopause early may have a higher chance of developing heart disease and osteoporosis.

Premature menopause

For causes other than medical treatments some women undergo menopause earlier than others.

Doctors find menopause to be “premature” if it starts before 40 years of age and if it occurs between 40 and 45 years of age. In around 5 percent of females, early menopause happens naturally.

Menopause often occurs early on when a person has:

• a genetic condition that affects the chromosomes, such as Turner’s syndrome
• an autoimmune disease
• in rare cases, an infection, such as tuberculosis, malaria, or mumps

Anyone who experiences changes in menstrual patterns before the age of 45 should see a doctor.

Diagnosis

Menopause is not a disease but when menstruation begins, many women profit from seeing their doctors.

A doctor will also determine, by asking certain questions, that the cause for this transition is perimenopause or menopause. Researchers can also monitor hormone levels and do certain blood and urine analyzes to rule out health concerns. Nonetheless, no tests will say conclusively that menopause has begun.

People can check their hormone levels with test kits at home, some of which are available for online purchase.

Summary

Menopause is not for many people the only transition that happens during the middle ages. Changes in relationships and working or home life — like moving children away — may also have a huge effect. It can feel daunting when more than one of those changes happens in a short time.

Nevertheless, many women in the menopause and several decades later lead full, safe lives, and midlife may also be the beginning of a new era.

Q:

Do males go through a kind of menopause?

A:

Not quite. The natural aging process for people with male reproductive organs involves a gradual decline in testosterone over a lifetime.

For people with ovaries, menopause is a relatively short period of time during which there is a significant drop in the production of estrogen and progesterone. This may result in the undesired symptoms described in this article. Carolyn Kay, M.D.

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.