What Is Menopause
Menopause is a biological process that occurs in the female sex when they come to the end of their menstrual cycles. Menopause typically occurs when during the 40s and 50s with the average age being 51. There are a number of signs that are associated with the beginning of menopause.
The WHO has determined the definitions of natural and surgical menopause.
Natural menopause is determined when you have gone 12 consecutive months without a menstrual period (without another reason). Estrogen and progesterone hormone levels change and affect other areas of the body.
Surgical menopause happens when the menses stop due to the removal of the ovaries.
There is known to be a transition period between normal menses and natural menopause; there is no consensus on how long that it or what it actually entails. This is called ‘perimenopause’. Perimenopause may precede menopause by 2 to 8 years.
Early Signs & Symptoms
Early menopause, or perimenopause, signs can begin months to years leading up to menopause. These signs and symptoms begin as hormone levels begin changing.
- Irregular periods
- Vaginal dryness
- Hot flashes
- Night sweats
- Sleep problems
- Mood changes
- Brain fog
- Slow metabolism / weight gain
- Thinning hair and dry skin
During this transition period of perimenopause when these signs begin occurring, skipping periods for one month or several months is very common. Cycles can become very irregular. This is one of the most obvious signs that you are approaching menopause. Pregnancy is still possible during this period as the body is still occasionally releasing eggs, but it is much less common.
Do You Need to See A Doctor?
As the body is going through a difficult albeit natural process it is important to have regular visits with your doctor for preventative care and to look out for any serious conditions that increase in likelihood with the onset of menopause. Health screening tests like colonoscopy, mammography, triglyceride screening, thyroid tests, and pelvic exams are an important part of menopausal and postmenopausal health.
Hormone levels can easily be checked and interpreted if symptoms are not manageable. Up to 80% of women experience hot flashes and these can be disabling. There are a variety of medications used to treat such symptoms ranging from topical estrogen to hormone replacement therapy. Estrogens diminish hot flashes in general. Non-estrogen treatments include clonidine, methyldopa, medroxyprogesterone acetate, and megestrol acetate; megestrol acetate at 20mg each day was shown to reduce hot flashes by 71%.
Depression is quite common with menopause. Up to 45% of those presenting to menopause clinics have depression. The transition to menopause is a huge change to deal with. Depression is especially common in those with a pre-existing history of mood disturbance. Some have attempted to treat this depression with estrogen, but most recommend a full analysis and treatment by a psychiatrist.
If you have significant hot flashes, mood disturbances, bone health questions, a history of heart disease or any other symptoms attributable to menopause, it will be worth it to seek advice from a physician or other provider.