Menopause is the period during which a woman ceases to menstruate. The process usually takes several years, and it is considered complete after a year has passed with no periods. Menopause usually occurs naturally between the early 40s and late 50s, but it can also happen earlier under certain circumstances.

In addition to the end of the body’s menstrual cycle, menopause often causes women to experience hot flashes, vaginal dryness, and other symptoms. Some medications can relieve these symptoms but may increase a woman’s risk of developing certain health problems, such as breast cancer. Always speak to your doctor about the potential risks before taking any medication for menopausal symptoms.

Going through menopause also can increase a woman’s risk of osteoporosis and heart disease. Maintaining a healthy lifestyle can help prevent these conditions, and regular checkups are essential to catch any health problems associated with menopause early.

Menopause Symptoms and Stages

Menopause has three stages, each of which can span a number of years. The signs and symptoms felt by each person can vary widely at each stage.

The first symptoms may appear before the woman ceases menstruating. This is known as perimenopause. Menopause is reached when the period stops, and after a year with no periods, the woman is said to have gone through menopause. The stage after this is called postmenopause, and lasts for the rest of the woman’s life. It is not possible to become pregnant after going through menopause.

Symptoms of Menopause by Stage
Perimenopause
(Before)
Menopause
(During)
Postmenopause
(After)
Usually lasts 3 – 5 years before menopause begins. Symptoms include:

  • Hot flashes
  • Elevated heart rate
  • Insomnia or other sleep disturbance
  • Night sweats
  • Mood changes (irritability, depression, anxiety)
  • Vaginal dryness or discomfort
  • Changing level of interest in sexual activity (decrease or increase)
  • Incontinence
  • Difficulty focusing
  • Bodily changes (e.g., weight gain, hair loss, more facial hair)
Usually lasts about 1 – 3 years:

  • Estrogen levels decrease significantly
  • Ovaries stop producing eggs
  • Period flow changes (become heavier or lighter)
  • Interval between periods becomes irregular until menstruation stops altogether
Occurs after a woman has gone 1 year with no menstrual periods and lasts for the rest of the woman’s life:

  • Higher risk of heart disease or stroke
  • Decreased bone density, possibly resulting in osteopenia or osteoporosis

In addition, many women experience some of the same conditions as they experienced during perimenopause, including:

  • Vaginal dryness or discharge
  • Weight gain
  • Incontinence
  • Insomnia

Managing Menopause Symptoms

If you experience discomfort during your menopause, your doctor can advise you about medication to manage your symptoms. For example, medication is available to help ease the severity of hot flashes. Vaginal discomfort can be combatted with creams and/or medication, and by using a water-based lubricant during sex. Some women who experience heavy periods during perimenopause take oral birth control to ease their severity.

Your doctor may also recommend menopausal hormone therapy (MHT), which is available in various forms, including pills, creams, patches, and gels. While MHT can help reduce menopausal symptoms, it has been linked to an increased risk of various health problems in some women, like blood clots, breast cancer, and strokes. The U.S. Food and Drug Administration (FDA) recommends that when MHT is taken, it should be at the lowest possible dose, and for short periods of time.

Wearing breathable clothing and layers that can easily be removed, sleeping in a cooler room, and drinking cold fluids can help remedy hot flashes.

What Causes Menopause?

Menopause is caused by changes in the body’s estrogen levels. As estrogen levels decrease with age, the body experiences menopausal symptoms. Since estrogen is the hormone responsible for regulating the menstrual cycle, when the ovaries stop producing estrogen and eggs, a woman will stop having her period.

Early Menopause

For most women, menopause changes start to happen sometime between their early 40s and their late 50s. The average age for a woman to go through menopause is 51.

For some women, menopause comes significantly earlier. This is usually caused by surgery on the reproductive organs.

  • Premature Ovarian Failure – When the ovaries decrease or stop their activity. This can be caused by genetic factors, surgery, or cancer treatment (radiation or chemotherapy).
  • Hysterectomy – Surgical removal of the uterus to treat a condition such as uterine fibroids, endometriosis, hyperplasia, or uterine cancer
  • Oophorectomy – Surgical removal of the ovaries, most often to treat certain forms of cancer (such as ovarian cancer or breast cancer)
Learn More About Ovarian Cancer Risks and Treatments

Smoking and inhaling secondhand smoke have also been linked to early menopause. Research conducted by the Roswell Park Cancer Institute in Buffalo found that women who smoke frequently or started smoking at an early age tend to go through menopause nearly two years earlier than nonsmokers. Women exposed regularly to secondhand smoke were also more likely to experience early menopause than others.

Menopause Health Issues and Complications

There is an increased risk of developing certain health problems after undergoing menopause.

Osteoporosis

Osteoporosis is a condition that causes bones to weaken and become more brittle. This increases the risk of fractures, and can cause women to lose height. Since estrogen helps control bone loss, women may lose bone density much faster during menopause, which can lead to the condition.

There are usually no symptoms of osteoporosis. Many women don’t realize they have it until they break a bone. A bone density test can determine your risk of developing osteoporosis, and your doctor can advise you about treatments.

Heart disease

As women age and their estrogen levels decrease, the risk of developing heart disease increases. This is a leading cause of death in women, but can be prevented through diet and exercise. Your doctor can advise you about your risk of heart disease, and getting regular blood pressure and cholesterol tests can help catch the warning signs early.

Urinary incontinence

Some women find that they involuntarily urinate more often during menopause. The urge to urinate can come without warning, or leakage may occur during activities like laughing or coughing. This is caused by the loss of elasticity in the vagina, making it harder to control urine loss.

Although it can be embarrassing, urinary incontinence can be combatted using incontinence pads and by performing Kegel exercises.

Staying Healthy During and After Menopause

Maintaining a healthy lifestyle during and after menopause can help prevent a number of health complications common in later life.

Some women have an increased risk of breast cancer and cervical cancer during this period of life. Getting regular Pap smears, pelvic exams, and mammograms, and checking your breasts regularly for lumps can help catch these cancers in their earlier (and more easily treatable) stages.

While you cannot become pregnant after going through menopause, it is still possible to catch a sexually transmitted disease (STD). This includes the human papilloma virus (HPV), which can cause cervical cause. Practicing safe sex eliminates the risk of STDs.

Since many women gain weight during menopause, maintaining a healthy diet and exercising regularly is very important. To look after your bones, ensure your workout regime includes weight-bearing exercises (such as walking briskly, jogging, or performing lunges), and that you get enough vitamin D and calcium (either through diet, supplements, or sunshine). If you smoke, giving up cigarettes can help slow the progress of bone loss.

Menopause Drug Complications

MHT and various other medications prescribed to treat the symptoms of menopause have been linked to an increased risk of health complications, including breast cancer. For example, a study conducted by the National Institutes of Health found that the drug Prempro (a combination of synthetic estrogen and progestin) increased the risk of breast cancer in women by as much as 26%. Hundreds of thousands of women have taken Prempro since it was approved by the FDA in 1942, and more than 13,000 lawsuits have been filed against its manufacturer, Wyeth, for insufficiently warning women about these risks.

If you are concerned about the risks of any medications prescribed during menopause, speak to your doctor.