What is Menopause?

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Simply put, Menopause is when periods stop for good. It's diagnosed after 12 months without a menstrual period, vaginal bleeding or spotting. Menopause can happen in the 40s or 50s, but the average age is 51. Menopause is a natural part of aging and marks the end of your reproductive years. But the physical symptoms, such as hot flashes, and the emotional symptoms of menopause may disrupt sleep, lower energy or affect mood. There are many treatments, from lifestyle changes to hormone therapy. 

The three stages of menopause

Menopause happens gradually, and in three stages:

• Perimenopause or “menopause transition:” The transition phase before menopause is often referred to as perimenopause. During this transition time before menopause, the supply of mature eggs in a woman's ovaries diminishes and ovulation becomes irregular. At the same time, the production of estrogen and progesterone decreases. It is the big drop in estrogen levels that causes most of the symptoms of menopause. It usually starts when you’re in your 40s. You can be in perimenopause for several months or several years. Many people begin feeling symptoms like irregular periods, hot flashes and mood swings in perimenopause.
• Menopause: Menopause is the point when you no longer have menstrual periods. At this stage, your ovaries don’t release eggs, and your body doesn’t produce much estrogen. A healthcare provider diagnoses menopause when you’ve gone without a period for 12 consecutive months. Unlike the other stages, menopause itself is a defined moment, so you don’t stay in this stage.
• Postmenopause: This is the time after menopause. You stay in postmenopause for the rest of your life. While most symptoms of menopause ease up in postmenopause, you can continue to have mild menopausal symptoms for several years in postmenopause. People in the postmenopausal phase are at an increased risk for osteoporosis and heart disease due to low estrogen levels.

How long does Menopause last?

Menopause is more like a point in time, so you don’t stay in menopause. You reach it when you have not had a menstrual period for one year. Immediately after you reach menopause, you move into postmenopause. This stage lasts for the rest of your life.

What are the signs & symptoms of menopause? What is really happening to my body?

You may be transitioning into menopause if you begin experiencing some or all of the following symptoms:

• Irregular periods or periods that are heavier or lighter than usual
• Hot flashes, also known as vasomotor symptoms (a sudden feeling of warmth that spreads over your body)
• Night sweats and/or cold flashes
• Vaginal dryness that causes discomfort during sex
• Urinary urgency (a pressing need to pee more frequently)
• Difficulty sleeping (insomnia)
• Emotional changes (irritability, mood swings or depression)
• Dry skin, dry eyes or dry mouth
• Worsening premenstrual syndrome (PMS)
• Breast tenderness

Some people might also experience:

• Racing heart
• Headaches
• Joint and muscle aches and pains
• Changes in libido (sex drive)
• Difficulty concentrating or memory lapses (often temporary)
• Weight gain
• Hair loss or thinning

These symptoms are caused by changes in your hormone levels. Symptoms of menopause can range from mild to severe or intense. Not everyone will have the same symptoms as they transition to menopause. Contact your provider if you’re unsure if your symptoms are related to menopause or another health condition.

So you think you're having hot flashes?

Hot flashes or flushes are, by far, the most common symptom of menopause. About 75% of all women have these sudden, brief, periodic increases in their body temperature. Usually hot flashes start before a woman's last period. For 80% of women, hot flashes occur for 2 years or less. A small percentage of women experience hot flashes for more than 2 years. These flashes seem to be directly related to decreasing levels of estrogen. Hot flashes vary in frequency and intensity for each woman.

In addition to the increase in the temperature of the skin, a hot flash may cause an increase in a woman's heart rate. This causes sudden perspiration as the body tries to reduce its temperature. This symptom may also be accompanied by heart palpitations and dizziness.

Hot flashes that happen at night are called night sweats. A woman may wake up drenched in sweat and have to change her night clothes and sheets.
What can I do about hot flashes?Hot flashes occur from a decrease in estrogen levels. In response to this, your glands release higher amounts of other hormones that affect the brain's thermostat, causing your body temperature to fluctuate. Hormone therapy has been shown to relieve some of the discomfort of hot flashes for many women. However, the decision to start using these hormones should be made only after you and your healthcare provider have evaluated your risk versus benefit ratio.

Practical suggestions for coping with hot flashes include:

• Dress in layers, so that you can remove clothing when a hot flash starts.
• Avoid foods and beverages that may cause hot flashes, like spicy foods, alcohol, coffee, tea, and other hot beverages.
• Drink a glass of cold water or fruit juice when a hot flash starts.
• Reduce your stress level. Stress may worsen hot flashes.
• Keep a thermos of ice water or an ice pack next to your bed during the night.
• Use cotton sheets, lingerie, and clothing that allow your skin to breathe.
• Keep a diary or record of your symptoms to find what might trigger your hot flashes.