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What is menopause?

Menopause Care Guide

  • Menopause (MEN-oh-pawz) is a normal stage in a woman's life when her monthly period stops. It is also called the "change of life". A woman who has no periods for an entire year after the age of 45 is considered to be in menopause. After menopause, a woman is no longer fertile (able to become pregnant naturally). Going through menopause may take one to two years.

  • Perimenopause (PER-i-men-oh-pawz) is the period of time leading up to menopause. Perimenopause can last from two to eight years. You can have many menopause-like symptoms during perimenopause. These symptoms, such as hot flashes, can be very bothersome for some women.

What causes menopause to start?

Menopause starts when your ovaries (OH-var-ees) slowly stop making the female hormones estrogen (ES-troh-jen) and progesterone (proh-JES-te-rohn). Hormones are special chemicals that your body makes. Hormones act as messengers to help control how your body works. The hormones estrogen and progesterone help control your monthly periods. Menopause usually starts between the ages of 40 to 55. The average age that menopause starts is 51 years old. The age that menopause starts can be affected by:

  • Cigarette smoking. Women who smoke may begin menopause about one year earlier than other women.

  • Family history. Women often go through menopause at about the same age as their mothers did.

  • Medical treatments. Some medical treatments, such as certain treatments for cancer, can cause menopause to start early.

  • Surgery. Menopause may happen suddenly in women of any age if their ovaries are removed during surgery. This is called surgical menopause. A hysterectomy (his-te-REK-toh-mee) is a surgery where the uterus (womb) is removed. Sometimes one or both ovaries are also removed during a hysterectomy. If both ovaries are removed, menopause will start right away. Having a hysterectomy where just the uterus is removed will not usually cause menopause. This is because the ovaries are still inside of the body and able to make hormones. However, monthly periods do stop after the uterus is removed during a hysterectomy. You can no longer get pregnant after having a hysterectomy.

What are the signs, symptoms, and body changes caused by menopause?

The signs and symptoms of menopause can be different from woman to woman. The loss of female hormones may also cause other changes in your body. These changes and symptoms may include one or more of the following:

  • Menstrual period changes. One of the first signs of menopause is a change in your monthly period. You may skip periods or your periods may come closer together. Your flow may be lighter or heavier than normal. Your periods may slowly decrease and then stop. This may happen quickly, but it usually happens over a year or two.

  • Hot flashes. Hot flashes are brief periods of feeling very warm, flushed, and sweaty. Hot flashes can last from a few seconds to several minutes. They may happen many times during the day, and are common at night. Wear cotton clothing if night sweats are a problem. Layer your clothing so that you can easily remove some clothing and cool yourself during a hot flash.

  • Mood changes. Mood changes are common during menopause. You may feel nervous, irritable (easily angered), or depressed (sad for a long time). You may also notice a decrease in your desire to have sex. Talk to your caregiver about any changes in your mood or sex drive that bother you. Talking to your partner or a close friend may also help.

  • Breast changes. Your breasts may change shape or not be as full. You may have breast tenderness, especially during the early stages of menopause.

  • Bone changes. After menopause starts, your bones lose calcium (a mineral needed for strong bones). This causes your bones to become thinner. Thin bones increase your chance of breaking a bone (bone fracture). This risk of bone fractures may increase as you age. Bone thinning may lead to osteoporosis (os-tee-oh-poh-ROH-sis) which is also called "brittle bone disease". You have a greater chance of getting osteoporosis if you smoke, drink too much alcohol, or have poor eating habits. Not exercising, or using certain medicines (such as steroids or thyroid medicine) may also increase this risk.

  • Hair changes. Your hair may become thinner or feel different. This may happen on your head and elsewhere on your body. You may get more hair on your face.

  • Vaginal changes. The lining of your vagina (vah-JI-nah) may get thinner and less elastic (stretchy) because of hormone changes. You may also have vaginal dryness. This may cause you to have pain or discomfort during sexual intercourse (sex). Over-the-counter vaginal creams and lotions can help decrease vaginal dryness and make sex more comfortable. Only use creams and lotions that are made for vaginal use. Do not use petroleum jelly. Talk to your caregiver if over-the-counter products do not help. You may need an estrogen cream to put in and around your vagina. Estrogen cream may help decrease vaginal dryness and lower your risk of vaginal infections (in-FEK-shuns).

  • Urinary changes. After menopause you may be more likely to have urinary problems such as urinary tract infections (UTIs). You may feel the urge to go to the bathroom more often. You may also feel pressure and a feeling that you need to urinate right away (urgency). You may start to wake up at night needing to urinate. You may sometimes leak urine.

  • Other symptoms. You may feel like your heart is pounding at times (heart palpitations). Headaches, trouble sleeping, and tiredness are other symptoms you may have while going through menopause.

Can I still get pregnant while going through menopause?

It is possible to get pregnant while you are going through menopause. Continue to use birth control if you do not want to have a baby. You may need to use birth control until you have gone about a year without having a period. Ask your caregiver about when you can stop taking birth control to avoid pregnancy.

What are the health risks of menopause?

Your bones may weaken and break more easily after menopause. Your blood cholesterol (koh-LES-ter-ol) level may increase also. High cholesterol (fat in your blood) increases your risk of heart and blood vessel problems. You may be more likely to have a heart attack, blood clots, or a stroke (blood clot to the brain). Menopause also increases your chance of having sleep-disordered breathing (SDB). SDB is a condition that causes your breathing to stop for a few moments during sleep.

What are the risks and benefits of hormone replacement therapy (HRT)?

  • HRT replaces one or more female hormones in your body. HRT is used to help decrease menopausal symptoms, such as hot flashes and vaginal dryness. HRT also has some health benefits. The risk of bone fractures due to osteoporosis is much lower if you take HRT. HRT may also help protect you from some kinds of cancer, including colorectal (koh-loh-REK-tal) cancer. Colorectal cancer is cancer of your colon (intestines) and rectum (rear end).

  • HRT may cause serious problems in some people. Other health problems, such as a history of blood clots or certain cancers, may increase the risks of taking HRT. Talk to your caregiver about whether HRT is right for you. If you need HRT, it is best to take it for a short period of time. It is also best to take just enough medicine to control your menopause symptoms. Ask your caregiver for the most up-to-date information about the benefits and risks of HRT. It may take as long as a month on HRT before you notice your symptoms improving.

How can I live a healthy lifestyle during and after menopause?

  • Control other health problems you may have. Your risk of new or worsening health problems after menopause is increased if you have certain other medical conditions. Work with your caregiver to control other problems, such as high blood pressure or diabetes.

  • Prevent bone loss. You may need extra calcium and vitamin D to help prevent osteoporosis. Special medicines may also help decrease your bone loss. Ask your caregiver about the ways to prevent bone loss that are right for you.

  • Lower your heart disease risk. Your risk of heart disease, blood clots, and stroke increases after menopause. The following are ways to decrease your heart disease risk.

    • Exercise: Getting regular exercise can help to slow down bone loss and improve your mood. Exercise makes the heart stronger, lowers blood pressure, and keeps you healthy. Talk to your caregiver before you start exercising. Together you can plan the best exercise program for you. It is best to start slowly and do more as you get stronger.

    • Eat a healthy diet: Eat a healthy variety of foods. Your diet should include fruits and vegetables, breads, dairy products, and protein (such as meat, beans, and fish). Hot flashes may be helped by avoiding spicy foods, and things that contain caffeine or alcohol. Caffeine may be found in coffee, tea, soda, sports drinks, chocolate, and food bars.

    • Quit smoking: It is never too late to quit smoking. You are more likely to have a heart attack, lung disease, blood clots, and cancer if you smoke. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.

    • Control your cholesterol and weight: Lose weight if you are overweight. Check with your caregiver before you start any weight loss program. Decrease your cholesterol level if it is too high. Ask your caregiver for more information about a low cholesterol diet. You may need medicine if diet changes and exercise do not lower your cholesterol.

  • Have unusual vaginal bleeding checked by a caregiver. It is normal for your periods to slowly taper off while you go through menopause. Tell your caregiver if your vaginal bleeding is heavier than normal or happens too often. Medicines such as birth control pills can help make your periods more regular, decrease bleeding, and decrease hot flashes. If you start having vaginal bleeding after menopause, tell your caregiver right away.

  • See a caregiver every year for a checkup. Have a physical exam at least once a year. You may also need a pelvic exam at least once a year. During a pelvic exam, your caregiver checks your vagina, cervix (SER-vicks), and uterus for problems. Other tests you may need include blood tests, a breast exam, a mammogram, and bone density testing. A mammogram is a special x-ray that may help your caregiver find and treat breast cancer early. Bone density testing uses sound waves or special x-rays to check your bone thickness.

Coping with menopause:

It may be hard for you to accept that you are going through menopause. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Let them help you. Encourage those close to you to talk to your caregiver about how things are at home. Your caregiver can help your family better understand how to support a person going through menopause. You can also contact one of the following national organizations for more information about menopause.

  • The National Women's Health Information Center
    8270 Willow Oaks Corporate Drive
    Fairfax , VA 22031
    Phone: 1- 800 - 994-9662
    Web Address: http://www.womenshealth.gov
  • North American Menopause Society (NAMS)
    PO Box 94527
    Cleveland , OH 44101
    Phone: 1- 440 - 442-7550
    Web Address: http://www.menopause.org

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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