Menopause
Menopause is a time in a woman's life when her periods (menstruation) eventually stop and the body goes through changes that no longer allow her to get pregnant. A woman has reached menopause when she has not had a period for 12 months in a row. It is a natural event that normally occurs in women age 45 - 55. Perimenopause is a distinctive transitional period that occurs during the years before and the 1 year after the last menstrual period. How many years of perimenopause precede the last menstrual period varies greatly. During perimenopause, estrogen and progesterone levels fluctuate widely. These fluctuations are thought to cause the menopausal symptoms experienced by many women in their 40s. Menopause is considered premature when it occurs before age 40. Premature menopause is also called premature ovarian failure or primary ovarian insufficiency.
Symptoms
During perimenopause, symptoms may be nonexistent, mild, moderate, or severe. Symptoms may last from 6 months to about 10 years.
Other symptoms that may occur around the time of menopause include mood changes, depression, irritability, anxiety, nervousness, sleep disturbances (including insomnia), loss of concentration, headache, and fatigue.
After menopause:
Many of the symptoms that occur during perimenopause, although disturbing, become less frequent and less intense after menopause. However, the decrease in estrogen levels causes changes that can continue to negatively affect health (for example, increasing the risk of osteoporosis). These changes may worsen, unless measures to prevent them are taken.
If you are experiencing any of the symptoms above, please contact Dr. Linda Gedeon for proper evaluation and to discuss the best treatment options for you.
Symptoms
During perimenopause, symptoms may be nonexistent, mild, moderate, or severe. Symptoms may last from 6 months to about 10 years.
- Irregular menstrual periods may be the first symptom of perimenopause. Typically, periods occur more often, then less often, but any pattern is possible. Periods may be shorter or longer, lighter or heavier. They may not occur for months, then become regular again. In some women, periods occur regularly until menopause.
- Hot flashes affect 75 to 85% women. They usually begin before periods stop. Most women have hot flashes for more than 1 year, and more than one half of women have them for more than 4 years. What causes hot flashes in unknown. But it may involve a resetting of the brain's thermostat (the hypothalamus), which controls body temperature. As a result, very small increases in temperature can make women feel hot. Hot flashes may be related to fluctuations in hormone levels and may be triggered by cigarette smoking, hot beverages, certain foods, alcohol, and possibly caffeine. During a hot flash, blood vessels near the skin surface widen (dilate). As a result, blood flow increases, causing the skin, especially on the head and neck, to become red and warm (flushed). Women feel warm or hot, and perspiration may be profuse. A hot flash lasts from 30 seconds to 5 minutes and may be followed by chills. Night sweats are hot flashes that occur at night.
Other symptoms that may occur around the time of menopause include mood changes, depression, irritability, anxiety, nervousness, sleep disturbances (including insomnia), loss of concentration, headache, and fatigue.
After menopause:
Many of the symptoms that occur during perimenopause, although disturbing, become less frequent and less intense after menopause. However, the decrease in estrogen levels causes changes that can continue to negatively affect health (for example, increasing the risk of osteoporosis). These changes may worsen, unless measures to prevent them are taken.
- Reproductive tract: The lining of the vagina becomes thinner, drier, and less elastic (a condition called vaginal atrophy). These changes may make sexual intercourse painful and may increase the risk of inflammation (vaginitis). Other genital organs—the labia minora, clitoris, uterus, and ovaries—decrease in size. Sex drive (libido) commonly decreases with age. Most women can still have an orgasm, but some require more time to reach orgasm.
- Urinary tract: The lining of the urethra becomes thinner, and the urethra becomes shorter. Because of these changes, microorganisms can enter the body more easily, and some women develop urinary tract infections more easily. A woman with a urinary tract infection may feel a burning sensation when she urinates. Urinary incontinence—the unintended passage of urine—becomes more common and severe with age.
- Skin: As estrogen decreases, the amount of collagen (a protein that makes skin strong) and elastin (a protein that makes skin elastic) also decrease. Thus, the skin may become thinner, drier, less elastic, and more vulnerable to injury.
- Bone: The decrease in estrogen often leads to a decrease in bone density and sometimes to osteoporosis because estrogen helps maintain bone. Bone becomes less dense and weaker, making fractures more likely. During the first 2 years after menopause, bone density decreases by about 3 to 5% each year. After that, it decreases by about 1 to 2% each year.
- Fat (lipid) levels: After menopause, levels of lipids, particularly low-density lipoprotein (LDL—the bad) cholesterol, increase in women. Levels of high-density lipoprotein (HDL—the good) cholesterol decrease. These changes in lipid levels may partly explain why atherosclerosis and thus coronary artery disease become more common among women after menopause. Until menopause, the high estrogen levels may protect against coronary artery disease.
If you are experiencing any of the symptoms above, please contact Dr. Linda Gedeon for proper evaluation and to discuss the best treatment options for you.
