Menopause

What is menopause?

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Menopause is the point at which a person no longer has menstrual periods, thus inhibiting the body’s ability to produce eggs. The experience occurs when a person has not menstruated in 12 consecutive months. In most people, this change typically occurs between ages 45 and 55, but it can occur both before and after this range. Menopause is known to cause uncomfortable symptoms, but medical treatment is not necessary for most people.

That said, some may experience debilitating menopausal symptoms, or perhaps complications from menopause. In these cases, it is important to visit a doctor. If you’re not sure whether to make an appointment to discuss menopause symptoms, we always recommend erring on the side of caution. To that end, a doctor may be able to prescribe or suggest medication to help mitigate symptoms, such as insomnia, hair loss, and changes in bone density.

What causes menopause?

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Menopause is a process that occurs in all female bodies once they reach a certain age. Menopause is primarily caused by aging ovaries and the changing production of reproductive hormones. Additionally, the loss of ovarian follicles, or the structures that produce and release eggs cells, interferes with menstruation.

The hormones primarily responsible for these changes include:

  • Progesterone
  • Estrogen
  • Testosterone
  • FSH, or follicle-stimulating hormone
  • LH, or luteinizing hormone

In some cases, menopause may be induced. This can happen when the ovaries are surgically removed or during other surgical procedures. This can include bilateral oophorectomy, ovarian ablation, pelvic radiation, or any pelvic injury that may damage the ovaries. Menopause may also occur early in people who have Down’s syndrome or Addison’s disease.

Are there different types of menopause?

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While there are no separate types of menopause, there are various stages of the biological process: perimenopause, menopause, and post-menopause. We’ll explain each stage below.

  • Perimenopause: During this phase, menstrual periods become irregular. For most, this means they may be late or skipped altogether. Additional, menstrual flow may change, becoming either lighter or heavier depending on the individual.
  • Menopause: Menopause is the period after perimenopause. Clinically, the stage is defined as when a person has not experienced menstruation for 12 consecutive months. If a person experiences a period after 11 months, the 12-month countdown begins again.
  • Postmenopause: This stage refers to the years after menopause has occurred. Here, most symptoms will subside.

In some cases, a person may experience early menopause. This term refers to the onset of menopause before age 45. In most cases, early menopause is genetically inherited. However, some lifestyle factors, such as smoking and a low body mass index, can deplete estrogen stores early. Some research suggests that a lack of exercise, a lack of sun exposure throughout a person’s life, and a vegetarian diet may also contribute to early menopause.

Early menopause may also be a symptom of certain autoimmune disease, including thyroid disease and rheumatoid arthritis. Note that no stage of menopause warrants a visit to the doctor on its own. But, if you experience menopausal symptoms early on, you should visit your physician. Similarly, if at any point symptoms become difficult to manage, talking to a doctor can help.

What are the most common symptoms of menopause?

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Every person will experience menopause differently. However, some symptoms are more common than others. Close to 75 percent of people who are menopausal will experience one or more of the following symptoms:

  • Heavier or lighter periods than normal
  • Night sweats
  • Less frequent menstruation
  • Hot flashes
  • Weight gain
  • Insomnia
  • Anxiety and/or depression
  • Vaginal dryness
  • Cognitive changes, like memory problems
  • Reduced sex drive
  • Sore and/or tender breasts
  • Increased heart rate
  • Recurrent urinary tract infections
  • More frequent urination
  • Dry skin, especially around the eyes
  • Reduced bone mass
  • Hair loss or thinning
  • Increased hair growth
  • Reduced muscle mass

Some conditions can impact the severity of these symptoms. This includes a history of cancer or hysterectomy, as well as some lifestyle factors, like a person’s diet and whether they smoke cigarettes.

While none of these symptoms is cause for alarm, debilitating symptoms may be reason enough to visit a doctor. If menopause symptoms severely impact your day-to-day life, or if they are extremely painful, a physician may be able to help. Additionally, severe symptoms may indicate an separate, underlying issue. When in doubt, give your doctor a call.

Does menopause cause any complications?

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Some people will experience menopause complications. While not common, these complications can be severe. Most commonly, they will include one or more of the following conditions.

  • Osteoporosis, caused by weakened bones and/or reduced bone density.
  • Heart or blood vessel disease, caused by estrogen loss.
  • Mood swings or sudden emotional changes, caused by hormonal changes.
  • Painful intercourse, known as dyspareunia, caused by vaginal dryness or vaginitis.
  • Slower metabolic function and subsequent weight gain, caused by hormonal changes.
  • Vulvovaginal atrophy, a thinning of the vaginal walls caused by changes to estrogen levels.

If you suspect you are experiencing menopause complications, make an appointment with your doctor. In some cases, these symptoms may point to a different underlying condition. Only a physician can help determine what is causing your symptoms and prescribe treatment to cure or mitigate them.

Is there any diagnosis for menopause?

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Menopause does not often receive or require a diagnosis. However, if you are experiencing disabling menopause symptoms, or if you are experiencing symptoms and are under 45 years old, you may need to seek out a physician’s help. The Food and Drug administration recently approved a diagnostic test known as the PicoAMH Elisa. The test works by measuring the amount of a specific hormone –Anti-Müllerian Hormone (AMH) – in the blood. These hormone levels are an indicator for clinicians to determine whether a person is approaching or experiencing menopause.

This test can help determine whether a person is experiencing menopause. The results can be used to rule out other conditions that may cause similar symptoms. It can also help patients receive proper care if they are perimenopausal. Early menopause is often associated with a higher risk of certain conditions, including heart disease, osteoporosis, and cognitive changes, and early diagnosis can allow doctors to properly care for their patients.

Additionally, estrogen, follicle-stimulating hormone, and thyroid-stimulating hormone levels can be used to diagnose menopause, either early, peri-, or post-menopause.

Are there any treatments for menopause?

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If menopause symptoms are severe and/or debilitating, you may require medical treatment. Many see symptom improvement through hormone therapy. This type of treatment is most effective in people under 60 years old, and it can aid in the reduction of night sweats, vaginal atrophy, hot flashes, osteoporosis, and flushing.

Most often, menopause is treated symptomatically. A doctor may prescribe or recommend certain medications to address symptoms like hair loss and vaginal dryness. Prophylactic antibiotics may also be used to prevent recurring urinary tract infections. Sleep medications are common, as are medications to mitigate osteoporosis.

Are there any ways to mitigate menopause symptoms at home?

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Most people experiencing menopause can find relief in home remedies and certain lifestyle changes. For example, wearing loose clothing and carrying a portable fan can help address hot flashes. Moderate daily exercise can also promote better sleep and improve mood, as can communicating your needs to your doctor, a spouse, and/or your family. Importantly, vitamin supplements – specifically calcium, vitamin D, and magnesium – can improve sleep and energy levels while also reducing the risk of osteoporosis.

In addition to a healthy diet, vitamin supplements, and daily exercise, many will find that limiting alcohol use and quitting smoking decrease symptom severity. Applying moisturizers can reduce skin dryness. Practicing meditation and/or yoga can help address any emotional symptoms you may experience. If you’re curious about how you can alleviate menopause symptoms at home, check with your doctor to see what they recommend for your body.

Should I see a doctor for menopause?

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If you are experiencing menopause symptoms that significantly disrupt everyday life, you should see a doctor. Your physician will be able to provide guidance and medication to address specific symptoms. Similarly, if you suspect you are experiencing a complication from menopause, make an appointment with your doctor as soon as possible.

While most folks won’t need medical support through menopause, staying connected to a physician can be helpful – both physically and emotionally. If you are experiencing menopause, or if you suspect you are perimenopausal, we encourage you to make an appointment with your doctor or gynecologist. They can help you understand what to expect in the coming years, and – in many cases – provide support to manage symptoms.

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