Menopause is a natural process that occurs because of a decrease in the function of the ovaries, which also control estrogen production. In addition to a decrease in estrogen levels, menopause results in decreased progesterone levels, meaning that any eggs that are released are less likely to be fertilized.
When Does Menopause Usually Occur?
Menopause usually occurs between the ages of forty-five and fifty-five, although it can occur much later, or much earlier, than that.
What are the Stages of Menopause?
Menopause occurs in a series of stages. While menopause is usually divided into two main stages, perimenopause and postmenopause, it is more accurately divided into the following four stages:
- Premenopause: this refers to the fertile or reproductive stage of woman’s life; it spans from the time of her first period to her last period
- Perimenopause: this stage refers to the years immediately preceding menopause; perimenopause is characterized by hormonal changes which often lead to menopause symptoms and usually occurs between 45 and 60 years of age. It usually lasts for a period of 2 to 6 years.
- Menopause: menopause occurs when a woman has her final period. Menopause is the permanent termination of a woman’s period and her fertility. This stage is confirmed when a woman doesn’t have a period for twelve consecutive months. Most women experience natural menopause, but some may experience artificial, or premature menopause. Natural menopause is caused by aging and occurs after a natural decline in estrogen and progesterone production. Artificial menopause usually follows a medical intervention, such as a hysterectomy, radiation treatment to the pelvic area or the removal of the ovaries. Premature menopause refers to when a woman stops menstruating before she is forty years old and can occur due to smoking, heredity or exposure to chemicals
- Postmenopause: this term refers to the stage after a woman's last period; due to a decline in hormone levels, this stage brings with it a new set of health concerns, including heart disease and osteoporosis.
What are the Symptoms of Menopause?
A woman can experience a variety of menopause symptoms, which occur during the perimenopause stage, including:
- hot flashes and night sweats
- mood swings
- dry skin and hair
- weight gain
- vaginal dryness
- bone density loss
- changes in libido and sexual enjoyment
To be sure a woman is going through menopause, diagnostic testing can be conducted, including an estrogen or follicle-stimulating hormone (FSH) level test, in addition to a blood test.
Menopause: Medical and Natural Treatments
There are a variety of menopause treatments, both natural and medical, that can help alleviate the symptoms of menopause:
- Hot flashes and night sweats: triggered by heavy blankets, caffeine, alcohol, hot water. Dressing in light layers can alleviate hot flashes and night sweats; avoiding caffeine, alcohol and spicy foods can also minimize these symptoms, as can deep breathing
- Insomnia: characterized by fatigue, irritability, waking up during the night, trouble falling asleep, cognitive impairment and decreased memory. Natural treatments for insomnia include: valerian, hops, passion flower and dong quai, all of which are sedative herbs. Vitamin B6 is also helpful because it produces serotonin; exercising during the day, avoiding alcohol, avoiding caffeine before bedtime, relaxing before going to bed (for example, taking a bath) and sleeping in a dark room can also help
- Depression and mood swings: characterized by a decreased interest in life, fatigue, loss of appetite, thoughts of suicide and talk of death. St. John’s wort, magnesium, a vitamin B complex and exercise can help minimize these menopausal symptoms
- Anxiety: symptoms of anxiety include feeling out of control, increased heart rate and difficulty breathing. Herbal menopause treatments include passion flower, valerian root and vitamin B, which boost the nervous system. Aromatherapy is also beneficial, and lavender has a particularly calming effect. Yoga, tai chi and meditation can also help relieve anxiety
- Dry hair and skin: menopause often leads to dry, itchy skin and weak, thin hair that breaks often and that has lots of split ends. Flax seed oil and zinc (found in poultry, dairy, red meat, oysters and whole grains) can help restore your hair and skin’s healthy appearance, as can vitamin E
- Vaginal dryness: menopause decreases vaginal elasticity, leading to vaginal dryness. Vitamin E can help, as can Kegel exercises, which help restore elasticity. Using water-based lubricants during sexual intercourse also minimizes discomfort related to vaginal dryness
- Bone density loss: menopause can lead to osteoporosis. Calcium, magnesium and vitamin D can help restore bone density, which naturally deteriorates after age 30 due to reduced estrogen levels
- Weight gain: menopause and weight gain tend to go together, with weight gain generally occurring in the perimenopause stage. However, studies show that this is due more to lifestyle changes than to the hormonal changes that occur during menopause. The average weight gain is one pound per year. Weight gain during menopause has been conclusively linked to an increased breast cancer risk. Reducing dietary fat intake and exercising regularly can help to combat weight gain during menopause.
Although their efficacy in alleviating menopause symptoms has been debated, some experts believe that the following herbal treatments can be effective:
- Black cohosh: a herb that is purported to alleviate depression, night sweats, hot flashes, anxiety and irritability. Black cohosh is part of the buttercup family and is believed to have estrogenic activity. Side effects include nausea, dizziness and headaches
- Phytoestrogens: natural compounds similar to estrogen that helps to alleviate a variety of menopausal symptoms. Phytoestrogens are found in foods such as fruits, sprouts, red clover, yogurt, lentils and spinach
For more information on herbs used for menopause, click here.
Hormone Replacement Therapy (HRT) is another popular option for providing relief from symptoms of menopause. HRT can be administered orally (in pill form), vaginally (as a cream), or transdermally (in patch form). Because it replaces female hormones produced by the ovaries, hormone replacement therapy minimizes menopause symptoms. HRT can minimize hot flashes and night sweats, and reduce vaginal dryness. It can be used before, during and after menopause.
HRT can also help prevent osteoporosis, colon cancer, macular degeneration (vision loss caused by aging) and may delay the onset of Alzheimer’s disease.
Risks associated with HRT include a slight risk of blood clots, ovarian cancer and breast cancer (when used for a period of more than four years). HRT is not recommended for women with liver disease, cardiovascular disease, vaginal bleeding, or a history of uterine or breast cancer.
Menopause and Your Sexuality
Some women experience decreased libido when they reach menopause, while others experience increased enjoyment of sex, due to the fact that they no longer need to worry about pregnancy.
Decreased sex drive during menopause is caused by a variety of factors. These factors can include the following physiological changes:
- hot flashes, which lead to discomfort and irritation
- vaginal dryness, which can lead to discomfort during intercourse
- night sweats, which result in insomnia
- decreased androgen (male hormone) levels including testosterone, which minimizes libido
Menopause also affects sexuality through the physical changes that accompany it, including:
- decreased blood flow to the pelvis, which leads to a smaller and less elastic vagina
- the thinning of the vaginal walls, which also become more tender, making sex more painful
- urinary leakage due to decreased pelvic muscle support
Maintaining a healthy sex life is important, as it will promote vaginal health. HRT minimizes night sweats, hot flashes and vaginal dryness; over-the-counter medications, such as gel lubricants, can also improve your enjoyment of sex after menopause. Trying new sexual techniques is another way to maintain a healthy libido and sex life.
Menopause and Your Health: Menopause Health Risks
Menopause can bring health risks. Osteoporosis is the most common disease associated with menopause, because of the negative impact on bones caused by declining estrogen levels. Bones can become especially brittle in women’s hips, wrists and spine. The risk of developing breast cancer also increases.
Other menopause-related health risks include, heart disease, also due to decreased estrogen levels, and weight gain.
Urinary incontinence can occur due to the loss of elasticity of tissue in the vagina and uterus.
Taking care of your health during menopause is essential in order to ward off the above health dangers. Talk to your doctor about whether you need any calcium or vitamin supplements. Maintain a healthy, well-balanced diet and make sure you exercise regularly.
For additional information about menopause, click here.
Check out our forum on menopause to connect with other women going through this change.