Menopause Symptoms & Treatment

Menopause is a major life change signaling the end of fertility. The types and severity of symptoms associated with menopause vary from woman to woman, but nearly everyone experiences at least some symptoms. A variety of treatment options exist to make the symptoms associated with this process easier to manage.

Identification

• Menopause signals the end of menstruation and fertility. At menopause, the ovaries no longer release eggs each month and production of the hormones estrogen and progesterone decreases. Menopause occurs in most women between the ages of 45 and 55, although some women enter menopause in their thirties.

The Process

• Before you reach menopause, you will experience perimenopause. During this time, your ovaries will gradually produce less and less estrogen. This stage can last as long as 10 years, although the average is 4 years. During perimenopause, you will start to experience many of the symptoms that people associate with menopause, such as hot flashes and irregular menstrual periods. Menopause occurs when you have not had a period for one year.

Symptoms

• In the years leading up to menopause, you may experience a decrease in fertility, hot flashes, trouble sleeping, an increase in fat around your abdomen, increased premenstrual syndrome symptoms, breast tenderness, vaginal dryness, moodiness, decreased interest in sex, thinning hair, and urine leakage or urgency. Your period will most likely become very irregular. It may last longer or shorter than normal and your flow may increase. You may find that you never know quite when to expect your period and may even go several months without having a period before it resumes again.

Risk Factors

• Menopause usually occurs due to the natural aging process, but in some women, medical conditions or surgeries can cause menopause to happen earlier than normal. Chemotherapy and radiation therapies can trigger early menopause, as can premature ovarian failure. This condition affects approximately 1 percent of women younger than 40 and occurs when the ovaries stop working due to an autoimmune disease or genetic problems. In some cases, no cause can be found for premature ovarian failure. While a hysterectomy (a type of surgical procedure used to remove the uterus) will prevent pregnancy and menstruation, it will only cause menopause to occur if you also have your ovaries removed. If your ovaries are still intact after surgery, you will reach menopause around the same age you would have if you hadn't had a hysterectomy.

Treatment

• Treatment is focused on relieving your most troublesome symptoms. Hormone Replacement Therapy (HRT) provides the body with extra estrogen or a combination of estrogen and progesterone. HRT is helpful in relieving vaginal dryness, night sweats, itchy skin, hot flashes and moodiness. It reduces your chances of developing colon cancer and osteoporosis. Risks associated with HRT include a higher risk of endometrial cancer, blood clots, breast cancer and strokes. Long-term estrogen-progestin combination therapy can increase the risk of heart disease in older women, but may decrease the risk in younger women who use this therapy. Doctors prescribe the lowest possible dosage of HRT to try to prevent these diseases from occurring.
  If you would prefer not to use HRT to treat your symptoms, you may find that several drugs may help ease hot flashes. They include gabapentin, a drug normally used to treat seizures, low-dose antidepressants and clonidine, a medication usually used to treat high blood pressure. Estrogen applied directly to the vagina is a safer alternative to HRT and is used to relieve urinary symptoms, pain with intercourse and dryness. Some women find that selective estrogen receptor modulators (SERMs) can help maintain bone density without the risks usually associated with estrogen use.

Managing Menopause

• You can relieve some of the symptoms of menopause without relying on prescription medications. Water-based vaginal lubricants, available at drugstores, can help make sex more comfortable. Increasing your calcium and vitamin D intake may be helpful in preventing osteoporosis and something as simple as dressing in layers can be a good strategy in handling hot flashes. Regular exercise and a healthy diet can also help ensure that you remain healthy and strong during menopause and beyond.