Menopause is the time in a woman's life when her menstrual period has stopped. Menopause is caused by a decrease in the ovaries' production of the hormones estrogen and progesterone, which eventually results in the ovaries' ceasing to produce eggs, and the end of menstruation.
A woman has reached menopause when she has not had a menstrual period for at least 12 months. Menopause is a natural process that takes several years. During this time, fertility decreases, and periods often change in duration, frequency, and amount of blood flow. This stage is known as perimenopause, and it is often when symptoms of menopause begin. The average age that menopause occurs is 51, although it may occur prematurely in women who have had total hysterectomies or have received chemotherapy or radiation treatments.
Symptoms of Menopause
The symptoms of menopause can vary, with some women experiencing no symptoms at all and others experiencing multiple severe symptoms. The first phase of menopause often begins with irregular periods, and can include the following symptoms:
- Insomnia
- Hot flashes
- Night sweats
- Fatigue
- Discomfort during intercourse
- Vaginal dryness or itchiness
- Urinary tract infection
- Bladder control issues
- Weight gain
- Thinning hair
- Dry skin
Menopause can also have mental and emotional effects, causing mood swings, depression and irritability.
Diagnosis of Menopause
Menopause is usually diagnosed based on symptoms. In some cases, blood tests are used to make an accurate diagnosis, and rule out any underlying conditions. Two tests are typically used.
Follicle-Stimulating-Hormone Test
A follicle-stimulating-hormone (FSH) test measures the level of follicle-stimulating hormone in the blood. When a woman's estrogen levels begin to decrease, the pituitary gland in the brain causes FSH to be released, stimulating estrogen production by the ovaries. If a woman's levels of FSH are rising, menopause is often the most likely cause.
Thyroid-Stimulating-Hormone Test
A thyroid-stimulating-hormone (TSH) test measures levels of thyroid-stimulating hormone in the blood. It helps to determine whether hypothyroidism is responsible for symptoms; an underactive thyroid can cause symptoms similar to those of menopause.
Vaginal pH testing is also used to help diagnose menopause; pH levels increase to about 6 from the reproductive years' average of 4.5.
Treatment of Menopause
Treatment for menopause varies depending on the individual. One treatment is hormone-replacement therapy (HRT), in which medication containing estrogen or progesterone is prescribed to replace the hormones that are deficient within the ovaries. These synthetic forms of hormones are delivered through pills, patches or creams. However, there are risks associated with HRT, including heart disease, stroke and breast cancer. Risks may vary depending on a woman's health history and lifestyle. Before deciding if HRT is appropriate, a woman should discuss its risks and benefits with her doctor.
Women suffering from depression or mood changes due to menopause may benefit from taking antidepressants or anti-anxiety medications. Low-dose vaginal estrogen, which is available in a pill or cream form, can be prescribed to help reduce dryness within the vagina. Medication is also available to treat the osteoporosis often caused by menopause. Women who maintain a healthy and active lifestyle may experience less discomfort during menopause.
Complications of Menopause
In addition to temporary discomfort and symptoms, menopause can cause long-term health complications for women. The bone disease osteoporosis is a common concern for women who have been through menopause. During menopause, production of estrogen, which supports bone mass, decreases. The drop in estrogen causes bones to become less dense, and prone to fracture and injury. Additional complications of menopause may include the following:
- Cardiovascular disease
- Urinary incontinence
- Sexual dysfunction
Women experiencing menopause should consult with their physicians for effective treatment of symptoms, and recommendations for reducing the chances of complications.