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Menopause

Menopause is a natural part of a woman's life cycle. While menopause symptoms can be frustrating and, at times, overwhelming, the process is natural. Understanding this change better will help women get through the symptoms and choose the right treatments for their needs.

Overview

Menopause is the process a woman goes through that causes her monthly periods to end. During menopause, a woman's ovaries stop producing eggs and produce fewer female hormones. When it is over, she can no longer get pregnant naturally.

Menopause, and specifically the symptoms of menopause, can be challenging, both emotionally and physically. Yet for many women, the change of life is something they welcome, with freedom from menstrual periods and pregnancy.

As you approach mid-life, estrogen levels start to fluctuate and then drop. Most women notice that their periods stop being predictable. They may become shorter, longer, heavier or lighter than usual, and the spacing between periods may change, until a woman starts to skip her periods altogether. Eventually, they will cease.

In the United States, the average age for menopause is 51 for non-smokers and 49 for smokers. The average age range is 47 to 55 years. Those who start menopause before age 45 are considered to have early menopause, while those who begin before age 40 are said to have premature menopause.

The entire transition takes between four and five years, and during this time women can still get pregnant. Typically the process occurs gradually, but women who have lost or damaged ovaries may experience menopause more rapidly.

Menopause Symptoms

Symptoms of menopause will begin when a woman's estrogen levels start changing. The first symptoms many women notice include:

  • Hot flashes
  • Mood swings
  • Mental fogginess

As the process progresses, women will experience additional menopause symptoms, including:

  • Problems with sex
  • Vaginal dryness
  • Low libido
  • Worsening PMS
  • Irregular periods
  • Depression, sadness or anxiety
  • Sudden or frequent urinating
  • Higher risk for bone loss and fractures
  • Higher risk of heart disease

The symptoms of menopause occur due to the changing hormones the woman experiences. As the hormone levels begin to stabilize, and estrogen levels stay consistently low, many symptoms will decrease, and many will disappear altogether. Some, such as a higher risk of heart disease or bone loss, remain a constant through middle age and beyond, as a woman's body adjusts to her new hormone levels. Understanding these symptoms will help you choose the right treatment options as you navigate the changes menopause brings.

Editors:

Kathryn Martin, MD
Massachusetts General Hospital

Cynthia Stuenkel, MD
University of California, San Diego

Last Review: May 2013