Menopause occurs when a woman stops menstruating, usually between the ages of 45 and 55. The diagnosis is made when a woman has not had a period for 12 consecutive months. The transition from premenopause to postmenopause typically takes about seven years, but can take up to 14 years, according to the National Institute on Aging. The period leading up to this change is called perimenopause. Postmenopausal period. During this time, levels of hormones such as estrogen, progesterone, and testosterone decrease. Menopause can be induced artificially by removing the ovaries or by chemotherapy. Signs and Symptoms of Menopause and Perimenopause Every woman experiences menopause differently. She may have all or just a few of the following symptoms: Symptoms can be relatively mild in intensity or severe enough to affect a woman’s quality of life. Hot flashes and night sweats The main symptoms of menopause are hot flashes and night sweats. This is a sudden sensation of heat from within, redness of the face and upper body, rapid heartbeat, and profuse sweating. If a woman experiences this at night, she may become sweaty enough to have to change her bedding. Afterwards, she may feel chills. Researchers hypothesize that hot flashes are caused by changes in the hypothalamus, the part of the brain that regulates body temperature. However, a study presented at the North American Menopause Society’s 2022 Annual Meeting showed that night sweats and hot flashes are not the same thing. Night sweats cause higher levels of stress than hot flashes, last longer, are more intense, and cause more sweating. Women who have more hot flashes at night than during the day also have a higher risk of depression. Related: Learn more about menopause Night sweats Other symptoms of menopause Depleted and fluctuating hormone levels can also cause symptoms such as: Possible weight gain and slowed metabolism. Mood swings, including symptoms of depression and anxiety, can also be triggered at this stage of life. sleep problems. Hair loss, brittle nails, dry eyes and mouth, and skin problems can occur. According to the summary of “Cureus”, it is a genitourinary syndrome associated with menopause. These include genital dryness, irritation, sexual dysfunction, and urinary problems. Hormonal changes can cause sexual problems such as decreased libido, vaginal dryness, and painful penetration. Memory and Cognition Problems, Research Notes. Hormones are to blame, as well as sleep disturbances, mood changes, and hot flashes. Related: Learn more about the signs and symptoms of menopause and the risk factors that affect the timing of menopause If menopause begins before age 40, it’s considered early onset. The Cleveland Clinic notes that early onset is before age 45. The following factors can affect the timing of menopause: Research shows that women who have had children or who exclusively breastfed for many months may be less likely to experience early menopause. Menopause can occur due to removal of the ovaries (surgical menopause), ovarian failure due to chemotherapy, or genetic or endocrine problems. According to the Cleveland Clinic, women who smoke or have certain medical conditions, such as autoimmune disease, thyroid disease, or Crohn’s disease, are at higher risk for early menopause. length of the menstrual cycle. Women who have a menstrual cycle of less than 25 days may experience early menopause. Traumatic experiences, or your child’s traumatic experiences, can have an impact. Race, ethnicity, and family history may be other factors. education. Women who achieve higher levels of education have been shown to experience menopause later. Extreme weight. Obesity and being underweight can also play a role. RELATED: Pregnancy and Breastfeeding Are Linked to Late Menopause, Study Says Perimenopause and Menopause: What’s the Difference? According to the Cleveland Clinic, perimenopause occurs before full menopause begins, usually when a woman is in her 40s, and for many women, the transition period lasts about four to eight years. Irregular menstruation is common during perimenopause. Spotting between cycles, short cycles, light or heavy cycles, or even lack of cycles can also be part of perimenopause. It is possible to conceive a child during perimenopause, but the chances are low. Related: Perimenopause and Menopause: What’s the Difference? How Is Menopause Diagnosed? Diagnosis Diagnosis of menopause is an afterthought. After a woman passes this milestone, she can confirm that she has reached this milestone. In other words, if you have not had a menstrual period for more than a year (12 consecutive months), you are classified as having reached menopause or being postmenopausal. Most women do not need any kind of testing or diagnosis when they naturally enter this stage in midlife, but PicoAMH Elisa, a diagnostic tool that can reveal menopausal status, can be helpful for women who are concerned about their fertility or who are at risk of premature ovarian failure. Duration of the Menopausal Transition Period Menopause is divided into two stages. The early stages of menopause are when menstrual cycles begin to become unpredictable. Over a period of several months, your period will begin to arrive a week or more later than your normal cycle. The later stages of perimenopause occur when you begin to have a two-month gap between cycles. According to the Cleveland Clinic, this entire process can begin eight to 10 years before menopause. Once you enter postmenopause, you remain in that phase for the rest of your life. According to the Cleveland Clinic, symptoms are usually less severe, but you may still experience lingering symptoms. Menopause Treatment and Medication Options Treatment Many of the symptoms of menopause can be treated, or at least managed, with medications, complementary and alternative medicine, or lifestyle changes. Your doctor can customize treatment for you. Also, if you’re thinking of trying supplements or vitamins, talk to your doctor, as they may affect the medications you’re currently taking. Medication options Antidepressants Clonidine (Catapres) Dehydroepiandrosterone Gamma-aminobutyric acid (Gabapentin) Hormone therapy, including bioidentical hormones and low-dose estradiol vaginal inserts Ospemifene (Osfena) Complementary and integrative health therapies Acupuncture Hypnotherapy Yoga Mindful meditation Lifestyle changes (Wearing layers of clothing, using vaginal moisturizers, etc.)Lubricants, smoking cessation, exercising more intensely and regularly, and eating foods that contain calcium and vitamin C, which promote bone health.Related: Learn more about how to treat menopausal and perimenopausal symptoms Risk of mood problems increases as you reach middle age Depression during perimenopause hasn’t received much attention until recently. (Mood disorders occur more often during perimenopause than after menopause.) However, data from the National Study of Women’s Health published in the journal Psychological Medicine states that for perimenopausal and menopausal women, the risk of depression is about 28 percent for those who have never had depression, and 59 percent for those who have. In 2018, the North American Menopause Society and the National Depression Center Network’s Women and Mood Disorders Task Force published the first guidelines for the evaluation and treatment of this disorder. The International Menopause Society also endorses these guidelines. Related: Mood Risks in Midlife Controversy Surrounding the Use of Hormone Therapy to Treat Menopausal Symptoms There is a complex relationship between hormone therapy, known as menopausal hormone therapy, and breast cancer. Early results from the Women’s Health Initiative’s hormone therapy trial suggest that women who take a combination of estrogen and progestin have a slightly increased risk of developing breast cancer. However, women without a uterus had a slightly lower risk. After more than a decade and many more comprehensive studies, the nuances are better understood. According to the North American Menopause Society (NAMS), most women can safely use hormone therapy to control moderate to severe symptoms, such as hot flashes, if treatment begins within 10 years after menopause or before age 60. General Hormone Therapy Advice from NAMS: Use the lowest doses and minimum durations for menopausal symptoms. The U.S. Preventive Services Task Force recommends against menopausal hormone therapy to prevent chronic diseases such as heart disease and cancer. Everyone’s risk profile is different. Discuss what is best for you with your health care provider. Exercise and the Menopause Transition: Fitness Recommendations Change as You Reach Midlife Like many other things, your fitness habits should change as you age. At this stage in your life, you may need to adjust your workouts to strengthen and stretch your muscles and move your body better. Check out our cheat sheet for age-related exercise recommendations for menopause and menopause. Fighting menopausal belly fat and midlife weight gain A stubborn spare tire around the middle exists due to a drop in hormones, which slows down your metabolism. The number on the scale will gradually rise and fat will move from your hips and thighs to your stomach. Use the tips below to deal with slides. Exercise regularly. Focus on at least 150 minutes of aerobic exercise per week and strength training at least twice per week. Mix moderate and vigorous activity. If you’re feeling stuck in an exercise rut or starting to feel bored, try different workouts that target different muscle groups or exercise with a friend to stay on track. Reduce the number of times you sit and increase the number of times you stand. Try a standing desk. Adjust the amount of food you eat and try to eat three meals a day. Avoid eating late at night and prepare healthy snacks for late afternoon hunger. Choose healthy unsaturated fats. Cut back on restaurant and takeout foods that are high in unhealthy fats, salt, and sugar. Pay special attention to your carbohydrate intake. Your body converts it into sugar. Follow your circadian rhythm and eat within an 8-12 hour window, such as from 7 a.m. to 7 p.m. No late night fridge raids. To improve your night’s sleep, follow proper sleep hygiene. (When you don’t get enough sleep, your hunger hormones wake up.) Weight gain during menopause is associated with disrupted sleep cycles. Reduces stress that can lead to unhealthy eating habits. Please consult your doctor or nutritionist. Related: 12 Ways to Beat Menopausal Belly Fat Complications of Menopause and Menopausal Transition The main feature of perimenopause and menopause is a decline in the levels of hormones such as estrogen, and at the same time, many of the protective effects of estrogen also decline. When estrogen levels drop, other complications can occur. Mood Disorders As previously mentioned, menopausal women are at increased risk for depression, even those who have never experienced this mood disorder. Weight Gain Not only do you tend to gain weight, but the distribution of fat also changes, with most of it deposited in your abdomen. This can increase your risk of type 2 diabetes, high blood pressure, heart disease, and some cancers. Metabolic Syndrome Metabolic syndrome is a combination of symptoms including high blood pressure, abdominal fat, high cholesterol and high blood sugar, which increases by 38% after menopause. Sleep Disorders Menopausal women may have trouble falling asleep or staying asleep once they have fallen asleep. They’re also at risk for obstructive sleep apnea, according to the Johns Hopkins Medicine Society. Research & Statistics: When do women reach menopause? Research & Statistics According to the Mayo Clinic, the average age of menopause in the United States is 51 years. According to a study published in the journal BMC Women’s Health, many women spend a third of their lives postmenopausal. According to an article in the Obstetrics and Gynecology Clinic of North America, women often reach menopause at the same age as their mothers. According to UpToDate, 95% of women experience their last period between the ages of 45 and 55. Related: Predicting How Long the Menopausal Transition Lasts and When You’ll Reach Menopause Racial and Ethnic Disparities in Menopause Race and Ethnicity Every woman experiences menopause differently. You’ll be able to slip through it gently with minimal discomfort. Some people experience extreme hot flashes and mood disorders. Research from the National Study of Women’s Health suggests that race and ethnicity may influence the experience of menopause in the United States. Black women, Native American women, and Latin Americans have higher rates of early menopause and more severe symptoms, an analysis published in the journal Menomenos found. Women of color experience more hot flashes and night sweats than white women, and these symptoms last longer. Black women tend to have heavier menstrual flow, Central American Latinos experience more intense hot flashes, and Puerto Rican Latinos have the most sleep problems. The reasons are complex and not fully understood, but current hypotheses suggest that chronic stress, lifestyle, and socio-economic status may be major contributors. RELATED: Learn more about what experts want BIPOC women to know about menopause Causes of menopause-related symptoms and early menopause-related symptoms According to the Women’s Health Administration, premature menopause can be caused by removal of the ovaries or a hysterectomy with ovarian failure, as well as smoking and certain other medical issues. Research suggests that childbirth and exclusive breastfeeding may help prevent early onset. As you enter the post-menopausal phase, changes in your body aside from a drop in estrogen can increase your risk of developing other serious problems, such as increased blood pressure, LDL (“bad”) cholesterol, and fatty triglycerides in your blood. Heart Disease Osteoporosis To reduce bone loss, your doctor may prescribe osteoporosis medications, calcium, and vitamin D. Urinary Incontinence A new study shows that hormone therapy may help prevent urinary tract infections in older women. Sexual Function Some postmenopausal women experience vaginal dryness and pain during sex. RELATED: 5 health risks women face after menopause Cancer risks as you age and health concerns you can address ahead of time Menopause doesn’t necessarily cause cancer, but the risk of developing cancer increases with age. Women who reach menopause later in life (after age 55) are at increased risk of developing breast and uterine cancer because of their lifelong exposure to estrogen. According to Cancer.net, the risk of ovarian cancer is also slightly increased. Related: Menopause and Cancer Risk Resources We Trust Mayo Clinic: Menopause: Ensuring a Gentle Transition Cleveland Clinic: Menopause North American Menopause Society: Frequently Asked Questions About Women’s Health and Menopause Office of Women’s Health: Menopause Symptoms and Relief Johns Hopkins Medicine: About Menopause
