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Menopause

 

Definition

Menopause is the time when a woman's menstrual period ends. Menopause is considered complete when a woman has been without her period for one year. Menopause can occur any time between ages 40 and 60. On average, it occurs at age 51.

Menopause is gradual. The period of time leading up to complete menopause is called perimenopause. Premature menopause occurs before the age of 40. Menopause can also be surgically induced when the ovaries are removed.

Menopause is a natural process. Treatment is used to reduce the symptoms associated with menopause.

 

Causes    TOP

Menopause is caused by a gradual decrease in a hormone called estrogen. Estrogen is released by the ovaries. The decrease in estrogen eventually stops the ovaries from releasing eggs.

 

Risk Factors    TOP

Menopause is a natural process associated with aging.

 

Symptoms    TOP

Symptoms may include:

  • Irregular menstrual periods
  • Hot flashes and night sweats
  • Disturbed sleep patterns, which may progress to insomnia
  • Mood changes, which may include irritability, anxiety or depression
  • Vaginal dryness and pain with sexual intercourse
  • Dry skin
  • Decreased interest in sex
  • Frequent urination or leaking of urine
 

Diagnosis    TOP

Your doctor will ask you about your symptoms and medical history. A physical exam will be done.

Natural menopause is diagnosed when a woman has not had a menstrual period for 12 consecutive months. Menopause may need to be confirmed if it was caused by a surgical procedure. A blood test may be done to look for follicle-stimulating hormone (FSH). High levels of FSH may indicate menopause.

 

Treatment    TOP

Menopause is a natural part of life. It does not necessarily require treatment. However, symptoms and health risks associated with low estrogen can be treated. These include hot flashes, vaginal dryness, and osteoporosis, which is a loss of bone mass.

Osteoporosis in Hip

Osteoporosis

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Hormone Replacement Therapy (HRT)

Types of hormone replacement therapies include:

  • Estrogens
  • Progesterone
  • Combinations of estrogen and progesterone
  • Low amounts of male hormones

HRT is available as tablets, gels, skin patches, vaginal rings, vaginal tablets, injections, and pellets inserted into the skin.

There are a number of possible risks associated with HRT, such as:

Healthful Diet

A healthful diet during menopause can improve your sense of well-being. It may also reduce the risk of heart disease, osteoporosis, and certain cancers. The diet should be low in fat. It should include plenty of fruits, vegetables, and whole grains. Your diet should also include enough calcium and vitamin D.

Limit Caffeine and Alcohol    TOP

Caffeine and alcohol may increase your symptoms of anxiety and insomnia. They can also increase your loss of calcium. If you drink alcohol, only drink in moderation. Moderation is 1-2 drinks per day.

Quit Smoking    TOP

Smoking can increase the risk of early menopause, heart disease, and osteoporosis.

Regular Exercise    TOP

Weight-bearing exercises like walking and climbing stairs, and strength exercises may also decrease your risk of osteoporosis, especially in women who are inactive. Aerobic exercise may reduce some symptoms of menopause in women who are inactive.

Stress Management    TOP

Stress management may help ease tension, anxiety, and other menopausal symptoms. Deep breathing, massage, warm baths, and quiet music are examples of relaxation techniques.

Over-the-Counter Products    TOP

Vaginal moisturizers and vaginal lubricants are used to help vaginal dryness.

Nonhormonal Medications for Hot Flashes    TOP

  • Medication may be prescribed to reduce symptoms of hot flashes including:
    • Certain blood pressure medications
    • Antiseizure medications
  • Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs)
 

Prevention    TOP

Menopause is a natural biologic event that does not need to be prevented.

RESOURCES:

Healthy Women
http://www.healthywomen.org

The North American Menopause Society
http://www.menopause.org

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca

Women's Health Matters
http://www.womenshealthmatters.ca

REFERENCES:

Menopause. EBSCO DynaMed website. Available at:
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Updated January 15, 2013. Accessed April 18, 2013.

Menopause. Planned Parenthood Federation of America website. Available at:
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Accessed April 18, 2013.

Menopause 101: A primer for the perimenopausal. North American Menopause Society website. Available at:
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Accessed April 18, 2013.

9/30/2008 DynaMed's Systematic Literature Surveillance. Available at:
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: Jacobson BC, Moy B, et al. Postmenopausal hormone use and symptoms of gastroesophageal reflux.Arch Intern Med . 2008;168:1798-1804.

1/30/2009 DynaMed's Systematic Literature Surveillance. Available at:
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: Borrelli F, Ernst E. Black cohosh (Cimicifuga racemosa ): a systematic review of adverse events. Am J Obstet Gynecol . 2008;199:455-466.

1/30/2009 DynaMed's Systematic Literature Surveillance. Available at:
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: Kaszkin-Bettag M, Ventskovskiy BM, et al. Confirmation of the efficacy of ERr 731 in perimenopausal women with menopausal symptoms.Altern Ther Health Med . 2009;15:24-34.

4/14/2009 DynaMed's Systematic Literature Surveillance. Available at:
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: Archer DF, Dupont CM, et al; Study 319 Investigators. Desvenlafaxine for the treatment of vasomotor symptoms associated with menopause: a double-blind, randomized, placebo-controlled trial of efficacy and safety.Am J Obstet Gynecol . 2009;200:238.e1-238.e10. Epub 2009 Jan 24.

11/4/2013 DynaMed's Systematic Literature Surveillance. Available at:
...(Click grey area to select URL)
: Moilanen JM, Mikkola TS, et al. Effect of aerobic training on menopausal symptoms—a randomized controlled trial. Menopause. 2012 Jun;19(6):691-696.



Last reviewed June 2013 by Andrea Chisholm
Last Updated: 11/4/2013

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