Menopause

Menopause Quiz

Think you may have Menopause? Take our quick assessment to learn more.
The term “menopause” refers to a woman’s final menstrual period. Since most women experience irregular periods leading up to their final period, menopause is only confirmed after a woman experiences 12 straight months without a period. For most women, this occurs naturally between the ages of 45 and 58. For some women, menopause may happen earlier, or as a result of illness, surgery or certain medical treatments, such as chemotherapy.

“Perimenopause” (meaning “around menopause”) is the medical term for the years leading up to menopause and the 12 months after. Many people use “perimenopause” to refer to the years leading up to a woman’s final period, “menopause” to refer to the 12 months following that, and “postmenopause” to refer to all the years beyond menopause. Since it can be difficult for any woman to determine what stage of the process she is in, “menopause” often serves as a useful catch-all term for all stages of the menopause transition.

Most women complete the menopause transition within four years—though for some it may take as little as two years and for others, eight years or longer. The amount of time likely depends on several factors, not all of which are fully understood.

During perimenopause, women may experience a number of symptoms as their ovaries gradually ramp down their production of estrogen and progesterone (female reproductive hormones). Typical symptoms include irregular periods, hot flashes, night sweats and trouble sleeping. Many women also experience a drop in energy levels, mood changes, pain during sex and breast pain. Most of these symptoms can be significantly improved with lifestyle changes or medical treatments such as hormone therapy.
Behavior:
  • Get plenty of sleep. Aim for at least seven to eight hours a night. If night sweats are waking you up at night, reduce the temperature in your bedroom, eliminate excess bedding and try going to bed barefoot.
  • Consider taking a cold shower right before bed to help lower your core temperature.
  • Try metered breathing or meditation.

Diet:
  • Limit your alcohol intake. For some women, alcohol may trigger hot flashes and night sweats.
  • Limit your caffeine intake. Caffeine is dehydrating, and dehydration may also trigger hot flashes and night sweats.
  • Drink plenty of water throughout the day. Aim for 60-80 ounces. Proper hydration can help reduce the amount and severity of your hot flashes and night sweats.
  • Reduce your intake of saturated fat. Saturated fat is found in foods like red meat, dark chicken meat and chicken skin, whole-fat dairy products, ice cream, butter, lard, and tropical oils like coconut and palm oil. Instead, focus on eating lean proteins like chicken and fish, low-fat dairy products, frozen yogurt and vegetable oils like extra virgin olive oil.
  • Limit simple carbohydrates. This includes foods heavy in sugar and starch, like baked goods, desserts, potatoes, white rice and pasta. Load up on fruits and veggies instead, and complex carbohydrates like whole-wheat bread, oats, peas, quinoa and brown rice.
  • Cut down on sugary drinks like soda and fruit juice. These items often end up packing fat around our middles without supplying any essential nutrients.
  • Eat foods with vitamin D (like cereals, egg yolks, milk, yogurt, salmon and tuna) or start taking a vitamin D supplement. Sufficient vitamin D reduces your chances of developing osteoporosis and helps protect against depression.
  • Pay attention to your calcium intake. Women in menopause need 1200 mg a day, which the body may convert into phytoestrogens. Eat calcium-rich foods like dairy products, almond or soy milk, and dark leafy greens (broccoli, kale and bok choy), or consider adding a calcium supplement.
  • If hot flashes or night sweats are a problem for you, consider upping your intake of foods that contain phytoestrogens, or “plant estrogens.” These foods include nuts (almonds, cashews, hazelnuts, peanuts and walnuts), some fruits (apples, avocados, bananas, mangoes, papayas and rhubarb), dark leafy green vegetables and wildflower honey. In addition, soy products contain isoflavones, which the body converts into phytoestrogens during digestion. Bean paste, edamame, soy milk, soy sauce, tempeh and tofu are all good sources of isoflavones.

Exercise:
  • Regular exercise will help you better manage the symptoms of menopause and ward off the weight gain that often comes with menopause. Aim for at least 30 minutes of moderate exercise three times a week.
  • For best results, combine aerobic exercise with stretching and strength training.
  • Aerobic exercise: Aerobics classes, biking, cross-country skiing, dancing, high-intensity interval training, jogging, kickboxing, spin classes, swimming and tennis.
  • Stretching: Ballet, Zumba or other dance classes, Pilates, tai chi and yoga.
  • Strength training: Pushups, pullups, planks, leg squats, Pilates, weight training (with either free weights or weight machines), resistance band or tubing, and yoga.
  • Exercises that strengthen the muscles of the pelvic floor, such as Kegel exercises, can help prevent bladder leaks and protect against pelvic organ prolapse.

Lifestyle:
  • If you’re a smoker, please quit. This is one of the most positive steps you can take to improve your overall health. Women who smoke experience menopause two years earlier, on average, than those who do not smoke. Smoking can also exacerbate certain symptoms of menopause, including decreased libido, hot flashes, night sweats and incontinence.

Stress Management:
  • Reduce stress through proven strategies like deep breathing, journaling, mindfulness, meditation, qi gong, tai chi and yoga. Many women in perimenopause find that reducing stress is at least as effective as medication in managing their menopause symptoms.
Whether your symptoms are mild or severe, you don’t have to suffer. Our midlife and menopause specialists will help you better understand what’s happening to your body. We can recommend proven treatments that specifically address your symptoms. Treatment may include changes to your diet, increased exercise and hormone replacement therapy.

Treatments for Menopause

Medication:
Antidepressants: Various forms of antidepressants have been shown to relieve symptoms such as hot flashes and night sweats and are prescribed not to treat depression but to relieve the symptoms of menopause.
Hormone therapy (HT): Estrogen and progesterone therapy can be very effective, even in low doses. If you are a good candidate for HT and choose this treatment, your health care provider will adjust your dosage to treat your menopausal symptoms.
Oral contraceptives: Low-dose oral contraceptives (the birth control pill) can relieve hot flashes and night sweats, regulate irregular cycles and even out the emotional rollercoaster for women whose symptoms start early in their menopause transition.
Vaginal estrogen: Available in topical creams, vaginal pills, caplets, suppositories and a three-month ring with slow release, vaginal estrogen can help the tissues of the vagina produce moisture and lubrication as well as maintain elasticity, thereby counteracting vaginal dryness and pain during sex.

Alternative Therapies: Many women have found relief from menopause symptoms with acupuncture, massage and yoga.
What is menopause?
Menopause is a normal and natural life event that all women experience if they live long enough. It is not an illness. Instead, it marks the end of a woman’s reproductive years, much as a woman’s first period marks the beginning.

What causes menopause?
As women age, their ovaries naturally stop producing the hormones estrogen and progesterone, which govern the monthly menstrual cycle. As estrogen gradually decreases, a woman’s periods become more irregular. Once estrogen drops below a certain level, ovulation ceases and periods stop altogether.

What is the average age of menopause?
Most women experience natural menopause between ages 45 and 58, though about 5% of women undergo early menopause between the ages of 40 and 45. The average age of natural menopause for women in developed countries is about 51.

Occasionally, a woman may experience menopause earlier than age 40, often in response to a serious illness, surgery or medical treatment such as chemotherapy. When this occurs, for any reason, it is known as “premature menopause.”

What are the symptoms of menopause?
The most telling symptom of menopause is irregular periods, though many women experience other symptoms first, such as hot flashes and night sweats—both of which are caused by hormonal fluctuations and decreasing estrogen. Other common symptoms of menopause include vaginal dryness, pain during sex, bladder control problems, weight gain, decreased libido and mood swings. About 40% of women have significant symptoms between the ages of 39 and 51.

What causes menopause symptoms?
The underlying cause of menopause symptoms is fluctuating hormone levels, especially estrogen but also progesterone and testosterone. During menopause, estrogen levels gradually decrease, but not in an orderly fashion. Levels may decrease and then spike—sometimes in response to external cues (diet, exercise, stress, etc.), other times for seemingly no reason at all. Sometimes during hormone spikes there can be MORE estrogen present than before perimenopause.

My periods are irregular but I don’t have any other symptoms. Am I in menopause?
Not all women have secondary symptoms during menopause, and for those that do, the experience can vary greatly from woman to woman, and even from day to day. If your periods have become irregular and you are between the ages of 45 and 58, it’s likely you’ve entered perimenopause, but because many other factors can cause irregular periods, you should consult your health care provider for a discussion and evaluation.