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Menopause


Definition:

Menopause is the time in a woman's life when her periods (menstruation) stop. It is a natural, normal body change that most often occurs between ages 45 - 55. After menopause, a woman can no longer become pregnant.

Menopause is a natural part of a woman's aging process.The correct answer is true. Before and during menopause, the ovaries make less of the hormones estrogen and progesterone. The ovaries also stop releasing eggs. After menopause, you can no longer become pregnant.What is the average age American women reach menopause?The correct answer is 51. Menopause most often occurs slowly between the ages of 45 and 55, but it can also happen when you’re older or younger. You have reached menopause when you have not had a period for 12 months.Perimenopause happens a few years before menopause.The correct answer is true. Perimenopause is the start of menopause. It usually starts 4 years before your last period. During this time, you may notice changes in your monthly flow and the length of your cycle. It most often starts between the ages of 40 and 48.Early menopause is menopause that happens before age ___.The correct answer is 40. Women who have a family history of early menopause are more likely to have menopause early. You might also have early menopause if you have certain medical conditions, use certain cancer treatments, or have your ovaries removed. Hot flashes are the most common sign that menopause is starting.The correct answer is true. A hot flash feels like an intense build-up of body heat. Most often, it lasts 2 to 4 minutes and is most common at night. You also may feel sweaty or have chills after the hot flash. You can reduce hot flashes by avoiding triggers such as hot drinks, spicy foods, caffeine, and alcohol.Some women take medicine for hot flashes and other menopause symptoms.The correct answer is true. Hormone therapy with estrogen and perhaps another hormone can reduce hot flashes. Many women can use this treatment safely. If hot flashes are severe, talk to your doctor about the risks and benefits.Mood swings during menopause are just a myth.The correct answer is false. Mood changes and feeling irritable are real symptoms of menopause. Getting regular exercise, not smoking, reducing stress, and getting enough sleep may help you feel better. If you’re having severe mood swings, talk to your doctor.Before menopause your periods will get:The correct answer is either A or B. In the years before menopause your periods will change. But how they change depends on your body. Your bleeding may get heavier or lighter and your cycles may get longer or shorter -- or you may have a mixture of these. If you have any concerns, talk to your doctor.Many women have trouble sleeping during menopause.The correct answer is true. You may have sleep problems because of hot flashes or changes in hormones. Getting regular exercise, keeping a regular schedule, and avoiding caffeine late in the day may help. See your doctor if sleep problems are affecting your life.Pain during sex is one sign of menopause.The correct answer is true. During menopause your body makes less estrogen. This can make your vaginal walls dry and can cause pain and itching during sex. Using lubricants that dissolve in water such as KY Jelly, Replens, and Astroglide can help reduce dryness and pain.Menopause can make you gain weight.The correct answer is true. Changes in hormone levels can make you more likely to gain weight. Getting more exercise and reducing the amount of calories you eat can help you keep off extra pounds. Staying at a healthy weight may also help reduce hot flashes.You should still use birth control even if you are having symptoms of menopause.The correct answer is true. You can still get pregnant even if you have symptoms of menopause. So you should continue to use birth control until you have not had a period for 12 months. If you have any questions about using birth control while you are going through perimenopause, talk with your doctor.
Alternative Names:

Perimenopause; Postmenopause

Possible Complications:

Some women have vaginal bleeding after menopause. This is often nothing to worry about. However, you should tell your health care provider if this occurs. It may be an early sign of other health problems, including cancer.

Decreased estrogen levels have been linked with some long-term effects, including:

  • Bone loss and osteoporosis in some women
  • Changes in cholesterol levels and greater risk of heart disease
When to Contact a Medical Professional:

Call your health care provider if:

  • You are spotting blood between periods
  • You have had 12 consecutive months with no period and vaginal bleeding or spotting begins again suddenly (even a small amount of bleeding)
Prevention:

Menopause is a natural part of a woman's development. It does not need to be prevented. You can reduce your risk of long-term problems such as osteoporosis and heart disease by taking the following steps:

  • Control your blood pressure, cholesterol, and other risk factors for heart disease.
  • Do NOT smoke. Cigarette use can cause early menopause.
  • Eat a low-fat diet.
  • Get regular exercise. Resistance exercises help strengthen your bones and improve your balance.
  • Talk to your doctor about medicines that can help stop further bone weakening if you show early signs of bone loss or have a strong family history of osteoporosis.
  • Take calcium and vitamin D.
References:

The 2012 hormone therapy position statement of the North American Menopause Society. Menopause. 2012;19(3):257-271.

Lobo R. Menopause and care of the mature woman. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Mosby Elsevier; 2012:chap 14.

American College of Obstetricians and Gynecologists Committee on Gynecologic Practice. ACOG Committee Opinion No. 420, November 2008: hormone therapy and heart disease. Obstet Gynecol. 2008;112:1189-1192.

Management of osteoporosis in postmenopausal women: 2010 position statement of the North American Menopause Society. Menopause. 2010;17:25-54.

Col NF, Fairfield KM, Ewan-Whyte C, Miller H. In the clinic. Menopause. Ann Intern Med. 2009;150:ITC4-1-ITC4-15.

Brunner RL, Aragaki A, Barnabei V, et al. Menopausal symptom experience before and after stopping estrogen therapy in the Women's Health Initiative randomized, placebo-controlled trial. Menopause. 2010;17:946-954.

Freeman EW, et al. Efficacy of escitalopram for hot flashes in healthy postmenopausal women. JAMA. 2011;305:267-274.


Review Date: 8/5/2013
Reviewed By: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

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