The Questions

• What is menopause?

• What is perimenopause?

• What symptoms might I have before and after
  menopause?

• How will I know when I am nearing menopause?

• How can I manage my symptoms?

• Does menopause cause bone loss?

• Does menopause raise my chances of getting cardiovascular disease?

• Can menopausal hormone therapy (MHT) help treat my symptoms?

• Who should not take MHT for menopause?
  

• Can MHT prevent heart disease or Alzheimer’s
  disease?

• Are there natural treatments for my symptoms?

• What is “bioidentical” hormone therapy?

• How much physical activity do I need as I approach menopause?

• Do I need a special diet as I approach menopause?

• I’m having a hysterectomy soon. Will this cause
  menopause?

• What if I have symptoms of menopause before age 40?

• Other popular question and answers

• Questions that others have asked
  

What is menopause?

Menopause is the point in time when a woman’s menstrual periods stop. Some people call the years leading up to a woman’s last period “menopause,” but that time actually is perimenopause (PER-ee-MEN-oh-pawz).

Periods can stop for a while and then start again, so a woman is considered to have been through menopause only after a full year without periods. (There also can’t be some other reason for the periods stopping like being sick or pregnant.) After menopause, a woman no longer can get pregnant. It is common to experience symptoms such as hot flashes in the time around menopause.

The average age of menopause is 51, but for some women it happens in their 40s or later in their 50s. Sometimes called “the change of life,” menopause is a normal part of life.

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What is perimenopause?

Perimenopause (PER-ee-MEN-oh-pawz), which is sometimes called “the menopausal transition,” is the time leading up to a woman’s last period. During this time a woman will have changes in her levels of the hormones estrogen (ES-truh-jin) and progesterone (proh-JES-tuh-RONE). These changes may cause symptoms like hot flashes. Some symptoms can last for months or years after a woman’s period stops. After menopause, a woman is in postmenopause, which lasts the rest of her life.

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What symptoms might I have before and after menopause?

The hormone changes that happen around menopause affect every woman differently. Also, symptoms sometimes are not caused by menopause but by other aspects of aging instead.

Some changes that might start in the years around menopause include:

• Irregular periods. Your periods may:
  • Come more often or less often
  • Last more days or fewer
  • Be lighter or heavier
• Hot flashes
  (or flushes). These can cause:
  • Sudden feelings of heat all over or in the upper part of your body
  • Flushing of your face and neck
  • Red blotches on your chest, back, and arms
  • Heavy sweating and cold shivering after the flash
• Trouble sleeping. You may have:
  • Trouble sleeping through the night
  • Night sweats (hot flashes that make you sweat while you sleep)
• Vaginal and urinary problems. Changing hormone levels can lead to:
  • Drier and thinner vaginal tissue, which can make sex uncomfortable
  • More infections in the vagina
  • More urinary tract infections
  • Not being able to hold your urine long enough to get to the bathroom (urinary incontinence)
• Mood changes. You might:
  • Have mood swings (which are not the same as depression)
  • Cry more often
  • Feel crabby
• Changing feelings about sex. You might:
  • Feel less interested in sex
  • Feel more comfortable with your sexuality
• Other changes. Some other possible changes at this time (either from lower levels of hormones or just from getting older) include:
  
  • Forgetfulness or trouble focusing
  • Losing muscle, gaining fat, and having a larger waist
  • Feeling stiff or achy

  
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How will I know when I am nearing menopause?

Symptoms, a physical exam, and your medical history can provide clues that you are in perimenopause. Your doctor also could test the amount of hormones in your blood. But hormones go up and down during your menstrual cycle, so these tests alone can’t tell for sure that you have gone through menopause or are getting close to it.

How can I manage symptoms of menopause?

It is not necessary to get treatment for your symptoms unless they are bothering you. You can learn about simple lifestyle changes that may help with symptoms, and some symptoms will go away on their own. If you’re interested in medical treatments like menopausal hormone therapy (MHT), ask your doctor about the possible risks and benefits.

Here are some ways to deal with symptoms:

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Hot Flashes

• Try to avoid things that may trigger hot flashes, like spicy foods, alcohol, caffeine, stress, or being in a hot place.
• Dress in layers, and remove some when you feel a flash starting.
• Use a fan in your home or workplace.
• Try taking slow, deep breaths when a hot flash starts.
• If you still get periods, ask your doctor about low-dose oral contraceptives (birth control pills), which may help.
• Some women can take menopausal hormone therapy (MHT), which can be very effective in treating hot flashes and night sweats.
• If MHT is not an option, your doctor may prescribe medications that usually are used for other conditions, like epilepsy, depression, and high blood pressure, but that have been shown to help with hot flashes.

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Vaginal Dryness

• A water-based, over-the-counter vaginal lubricant like K-Y Jelly can help make sex more comfortable.
• An over-the-counter vaginal moisturizer like Replens can help keep needed moisture in your vagina.
• The most effective treatment may be MHT if the dryness is severe. But if dryness is the only reason for considering MHT, vaginal estrogen products like creams generally are a better choice.

Problems Sleeping

• Be physically active (but not too close to bedtime, since exercise might make you more awake).
• Avoid large meals, smoking, and working right before bed. Avoid caffeine after noon.
• Keep your bedroom dark, quiet, and cool. Use your bedroom only for sleep and sex.
• Avoid napping during the day.
• Try to go to bed and get up at the same times every day.
• If you can’t get to sleep, get up and read until you’re tired.
• If hot flashes are the cause of sleep problems, treating the hot flashes usually will help.

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Mood Swings

• Try getting enough sleep and staying physically active to feel your best.
• Learn ways to deal with stress. “Stress and Your Health” has helpful tips.
• Talk to your doctor to see if you may have depression, which is a serious illness.
• Consider seeing a therapist or joining a support group.
• If you are using MHT for hot flashes or another menopause symptom, your mood swings may get better too.

Memory Problems

• Getting enough sleep and keeping physically active may help.
• If forgetfulness or other mental problems are affecting your daily life, see your doctor.

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Urinary Incontinence

• Ask your doctor about treatments, including medicines, behavioral changes, certain devices, and surgery.

Does menopause cause bone loss?

Lower estrogen around the time of menopause leads to bone loss in women. Bone loss can cause bones to weaken, which can cause bones to break more easily. When bones weaken a lot, the condition is called osteoporosis (OSS-tee-oh-puh-ROH-suhss).

To keep your bones strong, women need weight-bearing exercise, such as walking, climbing stairs, or using weights. You can also protect bone health by eating foods rich in calcium and vitamin D, or if needed, taking calcium and vitamin D supplements. Not smoking also helps protect your bones. Learn more about bone health in our osteoporosis fact sheet.

Ask your doctor if you need a bone density test. Your doctor can also suggest ways to prevent or treatosteoporosis.

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Does menopause raise my chances of getting cardiovascular disease?

Yes. After menopause, women are more likely to have cardiovascular (kar-dee-oh-VAS-kuh-lur) problems, like heart attacks and strokes. Changes in estrogen levels may be part of the cause, but so is getting older. That’s because as you get older, you may gain weight and develop other health problems that increase your risk of cardiovascular disease (CVD).

Ask your doctor about important tests like those for cholesterol and high blood pressure. Discuss ways to prevent CVD. The following lifestyle changes also can help prevent CVD:

• Not smoking and avoiding secondhand smoke
• Exercising
• Following a healthy diet
  

Learn more about heart health and stroke.

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Can menopausal hormone therapy (MHT) help treat my symptoms?

MHT, which used to be called hormone replacement therapy (HRT), involves taking the hormones estrogen and progesterone. (Women who don’t have a uterus anymore take just estrogen). MHT can be very good at relieving moderate to severe menopausal symptoms and preventing bone loss. But MHT also has some risks, especially if used for a long time.

MHT can help with menopause by:

• Reducing hot flashes and night sweats, and related problems such as poor sleep and irritability
  
• Treating vaginal symptoms, such as dryness and discomfort, and related problems, such as pain during sex
• Slowing bone loss
  
• Possibly easing mood swings and mild depressive mood

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For somewomen, MHT may increase their chance of:

• Blood clots
• Heart attack
• Stroke
• Breast cancer
• Gall bladder disease

Research into the risks and benefits of MHT continues. For example, a recent study suggests that the low-dose patch form of MHT may not have the possible risk of stroke that other forms can have. Talk with your doctor about the positives and negatives of MHT based on your medical history and age. Keep in mind, too, that you may have symptoms when you stop MHT. You can also ask about other treatment options. Lower-dose estrogen products (vaginal creams, rings, and tablets) are a good choice if you are bothered only by vaginal symptoms, for example. And other drugs may help with bone loss.

If you choose MHT, experts recommend that you:

• Use it at the lowest dose that helps
• Use it for the shortest time needed

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If you take MHT, call your doctor if you develop any of the following side effects:

• Vaginal bleeding
  
• Bloating
• Breast tenderness or swelling
• Headaches
• Mood changes
• Nausea

Who should not take MHT for menopause?

Women who:

• Think they are pregnant
  
• Have problems with undiagnosed vaginal bleeding
• Have had certain kinds of cancers (such as breast or uterine cancer)
• Have had a stroke or heart attack
• Have had blood clots
  
• Have liver disease
  
• Have heart disease
  

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Can MHT prevent heart disease or Alzheimer’s disease?

A major study called the Women’s Health Initiative (WHI) has looked at the effects of MHT on heart disease and other health concerns. It has explored many questions relating to MHT, including whether MHT’s effects are different depending on when a woman starts it.

Future research may tell experts even more about MHT. For now, MHT should not be used to prevent heart disease, memory loss, dementia, or Alzheimer’s disease. MHT sometimes is used to treat bone loss and menopausal symptoms.

Are there natural treatments for my symptoms?

Some women try herbs or other products that come from plants to help relieve hot flashes. These include:

• Soy.
  Soy contains phytoestrogens (FEYE-toh-ESS-truh-juhns). These are substances from a plant that may act like the estrogen your body makes. There is no clear proof that soy or other sources of phytoestrogens make hot flashes better. And the risks of taking soy products like pills and powders are not known. If you are going to try soy, the best sources are foods such as tofu, tempeh, soymilk, and soy nuts.
• Other sources of phytoestrogens.
  These include herbs such as black cohosh, wild yam, dong quai, and valerian root. There is not enough evidence that these herbs — or pills or creams containing these herbs — help with hot flashes. Also, not enough is known about the risks of using these products.

Make sure to discuss any natural or herbal products with your doctor before taking them. It’s also important to tell your doctor about all medicines you are taking. Some plant products or foods can be harmful when combined with certain medications.

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What is “bioidentical” hormone therapy?

Bioidentical hormone therapy (BHT) means manmade hormones that are the same as the hormones the body makes. There are several prescription BHT products that are well-tested and approved by the U.S. Food and Drug Administration (FDA).

Often, people use the term “BHT” to mean medications that are custom-made by a pharmacist for a specific patient based on a doctor’s order. These custom-made products are also sometimes called bioidentical hormone replacement therapy (BHRT). Despite claims, there is no proof that these products are better or safer than drugs approved by the FDA. Also, many insurance and prescription programs do not pay for these drugs because they are viewed as experimental.

How much physical activity do I need as I approach menopause?

Physical activity helps many areas of your life, including mood, sleep, and heart health. Aim for:

• At least 2 hours and 30 minutes a week of moderate aerobic physical activity or 1 hour and 15 minutes of vigorous aerobic activity or some combination of the two exercises that build muscle strength on two days each week

If you are not able to follow these guidelines, be as physically active as you can. Your doctor can help you decide what’s right for you.

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Do I need a special diet as I approach menopause?

A balanced diet will give you most of what your body needs to stay healthy. Here are a few special points to consider:

• Older people need just as many nutrients but tend to need fewer calories for energy. Learn about eating healthy after 50.
• Women over 50 need 2.4 micrograms (mcg) of vitamin B₁₂ and 1.5 milligrams of vitamin B₆ each day. Ask your doctor if you need a vitamin supplement.
• After menopause, a woman’s calcium needs go up to maintain bone health. Women 51 and older should get 1,200 milligrams (mg) of calcium each day. Vitamin D also is important to bone health. Women 51 to 70 should get 600 international units (IU) of vitamin D each day. Women ages 71 and older need 800 IU of vitamin D each day.
• Women past menopause who are still having vaginal bleeding because they are using menopausal hormone therapy might need extra iron.

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I’m having a hysterectomy soon. Will this cause menopause?

A woman who has a hysterectomy (his-tur-EK-tuh-mee) but keeps
her ovaries does not have menopause right away. Because your uterus is removed, you no longer have periods and cannot get pregnant. But your ovaries might still make hormones, so you might not have other signs of menopause. You may have hot flashes because the surgery may affect the blood supply to the ovaries. Later on, you might have natural menopause a year or two earlier than usually expected.

A woman who has both ovaries removed at the same time that the hysterectomy is done has menopause right away. Having both ovaries removed is called a bilateral oophorectomy (OH-uh-fuh-REK-tuh-mee). Women who have this operation no longer have periods and may have menopausal symptoms right away. Because your hormones drop quickly, your symptoms may be stronger than with natural menopause. If you are having this surgery, ask your doctor about how to manage your symptoms.

Menopause that is caused by surgery also puts you at risk for certain conditions, such as bone loss and heart disease. Ask your doctor about possible steps, including MHT, to help prevent these problems.

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What if I have symptoms of menopause before age 40?

Some women have symptoms of menopause and stop having their periods much earlier than expected. This can happen for no clear reason, or it can be caused by:

• Medical treatments, such as surgery to remove the ovaries
• Cancer treatments that damage the ovaries such as chemotherapy or radiation to the pelvic area — although menopause does not always occur
• An immune system problem in which a woman’s own body cells attack her ovaries

When menopause comes early on its own, it sometimes has been called “premature menopause” or “premature ovarian failure.” A better term is “primary ovarian insufficiency,” which describes the decreased activity in the ovaries. In some cases, women have ovaries that still make hormones from time to time, and their menstrual periods return. Some women can even become pregnant after the diagnosis.

For women who want to have children and can’t, early menopause can be a source of great distress. Women who want to become mothers can talk with their doctors about other options, such as donor egg programs or adoption.

Early menopause raises your risk of certain health problems, such as heart disease and osteoporosis. Talk to your doctor about ways to protect your health. You might ask about menopausal hormone therapy (MHT). Some researchers think the risks of MHT for younger women might be smaller and the benefits greater than for women who begin MHT at or after the typical age of menopause.

Let your doctor know if you are younger than 40 and have symptoms of menopause.

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Other Popular Questions and Answers

How Long Does Menopause Last?

What Menopause Creams Really Work?

Natural Remedies for Menopause?

How to Help Menopause Hot Flashes?

Menopause Weight Gain?

How to Lose Weight During Menopause?

Menopause Vitamins?

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Qigong for Menopause?

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Menopause Headaches and Migraines?

Best Menopause Diet?

Herbs for Menopause?

Menopause and Depression?

Pre-Menopause Symptoms?

Early Signs of Menopause?

HRT – Hormone Replacement Therapy for Menopause?

Bleeding After Menopause?

How Many Years Does Menopause Last?

Weird Symptoms of Menopause

Black Cohosh for Menopause

Calcium Magnesium and Zinc for Menopause?

Average Age Of Menopause?

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Questions That Others Have Asked

Click below to see contributions from other visitors to this page… Maybe your question is already answered here:

Hysterectomy side effects? I had a vaginal hysterectomy 6 years ago (I was 28) and I’ve noticed that over the past 8 months or so that my body has been changing.

Facial hair,…

Still menstruating at age 58 I’m still menstruating at age 58. I did skip 2 cycles, but I just got it again. Should I be concerned? No one else I know is still having periods at my …

Can menopause turn my wife into an alcoholic? For nearly 20 years, my wonderful wife and I were social drinkers and enjoyed alcohol very much.

Pre-menopause set in and my wife turned into an alcohol …

A period after having none for a year? I turn 59 next month. I hadn’t had a period in just over a year. Never had any menopause symptoms, no hot flashes, no night sweats. Figured I just got …

Menopause no period for a year I am in menopause and I have not had a period for over a year, 16 months actually.

I did go through the sweats and hot flushes for a while not extreme …

Unusual symptoms of menopause? I am 43 yrs old and my family has a history of early menopause.

My menstrual cycle has recently stopped but I am experiencing significant pelvic pain,…

Almost two years without a period Can it be possible to get a period after almost 2 years of not having one?

Menopause Sweating I’m turning 51 and my period has stopped for nearly two months. Recently I sweat a lot like face wash, is this one of the symptoms of menopause? I also …

Heart Palpitations and Menopause I keep having palpitations and my heart keeps murmuring and fluttering. Is this normal, or part of menopause? It is a scary feeling and I notice it sometimes …

Youngest Age for Menopause? I’m in my early twenties and I’m worried that I may be starting the menopause phase. What are the signs and is this possible?

Click here to write your own.

Hysterectomy and menopause? I am 31 and I had a vaginal hysterectomy 5 years ago. I am really having a lot of these menopause symptoms. Could I go through menopause after my hysterectomy …

Premature Menopause Signs? I think I may be menopausal. I have IBS symptoms, palpitations, coming over faint, feeling hot and sweaty, periods of feeling light-headed and serious …

No menstruation for 5 months I am 26, almost 27. I think I might be going through early pre-menopause. I have been without a cycle for 5 months. That is not normal for me. Is it possible …

When is it safe to stop using birth control in menopause When is it safe to stop using birth control during menopause? When you haven’t had a period for 2 years, or?

Menopause and Flu-Like Symptoms I am experiencing short breaks between my monthly cycles, when usually I have very regular 28 day cycles. And I’m getting flu-like symptoms each time. Is …

In Menopause do periods just stop? when your going through menopause, do you get your periods, or do they just stop?

Hormone Patch I have been on hormonal patch for about 2 months now. Is there any possibility that a side effect might be that it could dry out my vaginal area?

Cold flashes in menopause? I am having cold flashes – is this a normal part of menopause?

Menopause blood test results? Can early menopause or perimenopause start off but not show up in a your menopause blood test results? I’m having mood swings, hot sweats, irritability …

Postmenapusal bleeding I am a 49-year old woman who stopped menstruating 16 months ago. Should I be concerned that I started a period with associated back pain 2 days ago? I …

At what age does menopause start? I seem to have almost every symptom of menopause. Could i really be going through menopause or perimenpause at age 30???

Facial tingling in menopause? Has anyone else experienced tingling skin as a symptom of menopause or perimenopause? Lately I have been experiencing a tingling sensation on my right …

PeriMenopause body odor smell? During menopause, how do you stop the changes in body odor. Why is it so smelly?

Pre Menopause Periods? I am about to turn 45 and have on a few occasions experienced some pre-menopause symptoms. The first time was 6 years ago, and I believe stress brought …

Menopause alcohol intolerance? During menopause can you have an allergic reaction to alcohol in drinks or when there is alcohol in foods? I have heard about menopause alcohol intolerance …

Pregnancy after Menopause At what age does a women begin to lose the ability to become pregnant? Is there any chance for pregnancy after menopause or not?

Menopause Body Vibration and Tingling I have a weird vibration throughout my body and especially in my lower left leg. I have been told this could possibly be a symptom of menopause. It is …

Menopause loss of libido? I am a man and my girlfriend/fiance is 48 going through pre-menopause. Lately she does not want to kiss or show affection, and has no urges for sex. Is …

Stopping HRT If HRT helps with the diminishing estrogen in the body – what happens when you stop taking it as the estrogen isn’t replaced? Are you only postponing the …

Tinnitus and menopause Is ringing in the ears one of the symptoms of menopause? Is there any connection between Tinnitus and menopause than anyone can tell me about?

Dryness Are there supplements to increase vaginal moisture, and ease the dryness symptoms?

Kliofem 2 mg HRT I have been taking Kliofem 2 mg HRT for just over 1 year.

Lately been feeling more anxious & having worse brain fog than ever.

Can I ask for a stronger …

Loss of memory during menopause? I have been menopausal for almost two years now. This past 12 months my memory has been getting very bad.

I can remember clearly things from years ago …

Menopause sleep disorders? Sometimes while trying to go to sleep I have a feeling of blood rushing through my head.

It feels as though I am going to faint. I open my eyes and …

Can ovaries functioning be restarted? Can ovaries functioning be restarted? I am 40-yrs old and I have lost estrogen production. I am wondering if medicines can be given to help my cycles return …

Menopause high blood pressure Can menopause cause high blood pressure and cause your cholesterol readings to go higher?

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Night sweats even though I am on HRT I was diagnosed with Premature Ovarian Failure 13 years ago and have been taking HRT.

Recently I have begun to have bad night sweats even though my …

Hair loss in menopause I noticed that during menopause my hair at the front is going very thin, I can see my scalp. Will my hair grow back after menopause is over?

Early menopause at age 20? I’m only 20 years old and it has been 1 year and 2 weeks since I last had a monthly period!

Could this be early menopause?

And will I ever be able …

Itching during menopause? I am 48 and just wondering about itching during menopause.

Is one of the symptoms like your whole body just itches all the time?

I just feel like …

Peri menopause and using estrogen pessaries Hello,

I am 46 and have had peri menopause symptoms for 5 years – irregular periods, etc.

Then 3 years ago, whilst still having irregular periods …

Pelvic Pain and Pressure in Menopause Is constant pain and/or pressure in the pelvic area with no menstrual cycle, a common sign of menopause?

Menopause mood swings Mood swings and feelings of depression are the menopause symptoms I am facing. Also, my menstrual bleeding has stopped completely. Are these normal symptoms?…

Suppressed ovaries in menopause? I have been told by my doctor that I am in the early stages of menopause.

He also told me that my ovaries were suppressed.

What exactly does this …

Menopause and Libido I am 52 years old and have been menopausal for many years. I also had a complete hysterectomy about 5 years ago. I have been on different types of HRT …

Pregnancy During Pre-Menopause? Can you get pregnant while going through the early stages of pre-menopause or peri-menopause?

Early age for menopause? I started my menstrual cycle at a very early age. Does that mean I will start menopause sooner, at a younger age than the average woman?

Menopause age spots? Does Menopause create changes to your complexion, such as brown blotches and age spots on the face?

Early menopause pregnancy test? This may sound silly but I am 41 and I suspect I may be pregnant – but I am also having hot flushes and mild menopausal signs. Can early menopause hormone …

Menopause bleeding between periods? Is it OK if you see a light menopause bleeding between periods, even after you stop? Like you bleed on and off now and then?

Missed Periods in Menopause? I missed a period towards the end of last year and although my husband had had a vasectomy the doctor insisted that I do a pregnancy test. All was fine …

Menopause Irregular Cycles While reading all the symptoms of menopause, I am wondering if I am already into it since I have most of the symptoms except that my cycle has started …

Menopause After Hysterectomy? I had a partial hysterectomy 10 years ago. Shortly after, the doctor had to remove one of my ovaries. I recently turned 40 but seem to have many of the …

Menopause Age 40? Isn’t menopause possible for women at age 39 or early 40?

Night Sweats and HRT Why do I still experience major night sweats every evening despite taking the hormone replacement? I used to have terrible hot flashes, and insomnia, but …

Menopause after partial hysterectomy? Is it possible to begin menopause after a vaginal partial-hysterectomy which did not remove ovaries?

Periods and Menopause My physician confirmed that I was going through menopause. Now it is a couple of months later and I am having a light period when I thought I was done …

Menopause Husband? How do talk with my wife about how I believe she is going through early menopause? She has many symptoms but seems to be in denial. I want to be a supportive …

Could i be going through menopause? I didn’t get my period this month. I am 50 years old, could I be going through menopause?

Earliest age of menopause? Can you go through menopause at the age of 27? What is the earliest age menopause can begin in women?

No period for a year then it returns? I had not had my period for a year then all of the sudden it started again and it is very heavy. What is going on? Is this a menopause symptom?

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