Menopause is a period that marks the end of your menstrual cycle. It is diagnosed after you have not had a period for 12 months. Menopause can occur in 40 or 50 years, but the average age is 51 in the United States.
Menopause is a natural biological process. But physical symptoms, such as fever and menopausal symptoms, can interfere with your sleep, reduce your energy level, or affect your emotional health. There are many effective treatments available, from lifestyle adjustments to hormone replacement therapy.
In the months or years that lead to menopause (perimenopause), you may experience the following signs and symptoms:
- Unusual moments
- Dryness of the vagina
- Hot lights
- Night sweats
- Sleep problems
- Emotions change
- Obesity and decreased metabolism
- Hair loss and dry skin
- Loss of breast fullness
Signs and symptoms, including menstrual changes, may vary among women. Most likely, you will experience some irregularities in your period before it ends.
Missing periods during perimenopause are common and expected. Normally, menstruation will be over a month or so, or it may be several months and then the monthly cycle will begin again for a few months. Periods also occur in shorter cycles, so they are closer together. Despite the rare occurrences, pregnancy can occur. If you have missed a period but are not sure if you have started menopause, consider a pregnancy test.
When to see a doctor
Continue to visit your doctor regularly for preventive health care and any medical concerns. Continue to get these appointments during and after menopause.
Preventive health care as you grow older may include recommended medical tests, such as colonoscopy, mammography, and triglyceride tests. Your doctor may recommend other tests and tests, too, including thyroid tests if your history is elevated, and breast and pelvic tests.
Always seek medical advice if you bleed in the vagina after menopause.
Menopause can be caused by:
Natural deficiency of reproductive hormones.
As you approach the age of 30, your ovaries begin to produce less estrogen and progesterone – hormones that regulate menstruation – and your fertility decreases.
By the age of 40, your menstrual cycle can be longer or shorter, heavier or lighter, and more frequent or shorter, until finally – on average, at 51 years – your ovaries stop releasing eggs, and you no longer have time.
Ovarian surgery (oophorectomy).
Your eggs produce hormones, including estrogen and progesterone, which regulate the menstrual cycle. Surgery to remove your ovaries causes rapid menopause. Your periods are stagnant, and you may experience hot flashes and other signs and symptoms of menopause. Signs and symptoms can be severe, as hormonal changes occur suddenly rather than gradually over a few years.
Surgery to remove your uterus but not your eggs (hysterectomy) usually does not cause premature menopause. Although you no longer have periods, your ovaries still release eggs and produce estrogen and progesterone.
Chemotherapy and radiation therapy.
These cancer treatments can cause menopause, causing symptoms such as hot flashes during or shortly after treatment. Suspension of menstruation (and childbirth) is not permanent following chemotherapy, so birth control measures may be desirable. Radiation therapy only affects ovarian function when radiation is directed at the ovaries. Radiation therapy in other parts of the body, such as breast tissue or head and neck, will not affect menstruation.
About 1% of women experience menopause before age 40 (premature menopause). Premature menopause can cause your eggs to fail to produce normal levels of reproductive hormones (primary ovarian deficiency), which may be due to genetic factors or the immune system. But usually, there is no cause for premature menopause. For these women, hormone replacement therapy is generally recommended at least until the age of menopause to protect the brain, heart, and bones.
After menopause, the chances of developing certain medical conditions increase.
Cardiovascular disease (heart).
As estrogen levels fall, your risk of heart disease increases. Heart disease is the leading cause of death for both women and men. It is therefore important to exercise regularly, eat a healthy diet, and maintain a normal weight. Ask your doctor for advice on how to protect your heart, such as how to lower your cholesterol or blood pressure if you have high blood pressure.
This condition causes the bones to become brittle and weak, leading to an increased risk of fractures. During the first few years after menopause, you may experience rapid bone loss, which increases the risk of osteoporosis. Postmenopausal women with osteoporosis are at greater risk for fractures of the spine, buttocks, and wrists.
Inability to urinate.
As the tissues of your vagina and urethra lose elasticity, you may have a normal, sudden, intense urge to urinate, followed by spontaneous urination (inability to control), or loss of urine through coughing, laughing, or lifting (depression). You may have urinary tract infections often.
Strengthening the pelvic floor muscles with Kegel exercises and the use of private estrogen can help alleviate the symptoms of incontinence. Hormone therapy may also be an effective treatment option for menopause and changes in the vagina that may cause urinary incontinence.
Dryness of the vagina due to decreased moisture production and loss of elasticity can cause discomfort and slight bleeding during sex. Also, a decrease in hearing loss can reduce your desire for sex (libido).
Water-based lubricants and lubricants can help. If the ointment on a woman’s vagina is not enough, many women benefit from using local cream, tablet, or ring.
Many women gain weight during the menopausal transition and after menopause because metabolism slows. You may need to eat less and exercise more, just to maintain your current weight.
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