Menopause is a normal physiologic process associated with reduced functioning of ovaries due to aging or surgical removal (induced menopause), resulting in lower levels of estrogen and other hormones. Menopause marks the end of a woman’s fertility and is typically confirmed when a woman has missed her period for 12 consecutive months (in the absence of other obvious causes). Menopause occurs most often between ages 45 and 55. The term “premenopause” refers to the phase of life that precedes menopause.
Every woman’s experience with menopause is unique. Many women that undergo natural menopause report no physical changes at all during the perimenopausal years except irregular menstrual periods that eventually stop when they reach menopause. Other changes may include hot flashes, difficulty sleeping, memory problems, mood disturbances, vaginal dryness, and weight gain. Thankfully not all changes are permanent, such as hot flashes and memory problems, that tend to resolve after menopause. If the changes you’re experiencing are affecting your quality of life, we recommend you talk to your women’s health provider as they are well-equipped in managing your concerns.
It is particularly important to inform your women’s health provider of your progress through menopause as there are long-term complications linked to the decreased levels of estrogen associated with menopause. Osteoporosis, which is thinning of the bones, leads to a decrease in bone mass which may lead to curvature of the spine, fractures and pain. In addition, the risk of cardiovascular disease, such as heart attacks or strokes, is increased in postmenopausal women.
Treatment options should be tailored to specific menopausal signs but include both lifestyle changes and medical treatments. Medical management typically includes hormone replacement therapy, antidepressants and anti-seizure medications. Estrogen replacement is the most effective treatment for menopausal symptoms. While there have been concerns in the past about the safety of hormone therapy, for most healthy women who are seeking help with menopausal symptoms, it is safe, low-risk and effective. Hormone therapy typically is given for up to five years and generally is not recommended for women with a history of breast cancer, heart disease or stroke. Antidepressants and anti-seizure medications are a good option, even in women who are not depressed or experiencing seizures, as some types can reduce the severity of hot flashes and other symptoms. Women should speak to a doctor before taking any natural remedies, as some may not be safe, especially for women who have a history of breast cancer.
Lifestyle changes that are frequently recommended include eating well-balanced, nutritious meals along with calcium or vitamin D supplements to help prevent osteoporosis. Nutrition recommendations include increasing fruits, vegetables and whole grains, especially foods high in vitamin C and carotene, and decreasing foods high in saturated fat, cholesterol, salt and processed sugars. Exercising on a regular basis to prevent menopausal complications such as heart or bone disease is often recommended as well. Smoking has also been shown to intensify hot flashes and is recommended against in menopausal women.