What causes menopause?
Normal changes in your reproductive and hormone systems cause menopause. As your egg supply ages, your body begins to ovulate less often. During this time, your hormone levels go up and down unevenly (fluctuate), causing changes in your periods and other symptoms. In time, estrogen and progesterone levels drop enough that the menstrual cycle stops.
Some medical treatments can cause your periods to stop before age 40. Having your ovaries removed, having radiation therapy, or having chemotherapy can trigger early menopause.
What are the symptoms?
Common symptoms include:
- Irregular periods. Some women have light periods. Others have heavy bleeding. Your menstrual cycle may be longer or shorter, or you may skip periods.
- Hot flashes
- Trouble sleeping (insomnia).
- Emotional changes. Some women have mood swings or feel grouchy, depressed, or worried.
- Feeling that your heart is beating too fast or unevenly (palpitations).
- Problems with remembering or thinking clearly.
- Vaginal dryness.
Some women have only a few mild symptoms. Others have severe symptoms that disrupt their sleep and daily lives.
Symptoms tend to last or get worse the first year or more after menopause. Over time, hormones even out at low levels, and many symptoms improve or go away.
Do you need tests to diagnose menopause?
You don’t need to be tested to see if you have started perimenopause or reached menopause. You and your doctor will most likely be able to tell based on irregular periods and other symptoms.
If you have heavy, irregular periods, your doctor may want to do tests to rule out a serious cause of the bleeding. Heavy bleeding may be a normal sign of perimenopause. But it can also be caused by infection, disease, or a pregnancy problem.
You may not need to see your doctor about menopause symptoms. But it is important to keep up your annual physical exams. Your risks for heart disease, cancer, and bone thinning (osteoporosis) increase after menopause. At your yearly visits, your doctor can check your overall health and recommend testing as needed.
Do you need treatment?
Menopause is a natural part of growing older. You don’t need treatment for it unless your symptoms bother you. But if your symptoms are upsetting or uncomfortable, you don’t have to suffer through them. There are treatments that can help.
The first step is to have a healthy lifestyle. This can help reduce symptoms and also lower your risk of heart disease and other long-term problems related to aging.
- Make a special effort to eat well. Choose a heart-healthy diet that is low in saturated fat. It should include plenty of fish, fruits, vegetables, beans, and high-fiber grains and breads.
- Eat a nutritious diet and be sure you are getting adequate amounts of calcium and vitamin D to help your bones stay strong. Low-fat or nonfat dairy products are a great source of calcium.
- Get regular exercise. Exercise can help you manage your weight, keep your heart and bones strong, and lift your mood.
- Limit caffeine, alcohol, and stress. These things can make symptoms worse. Limiting them may help you sleep better.
- If you smoke, stop. Quitting smoking can reduce hot flashes and long-term health risks.
If lifestyle changes aren’t enough to relieve your symptoms, you can try other measures, such as breathing exercises and yoga.
If you have severe symptoms, you may want to ask your doctor about prescription medicines. Choices include:
- Low-dose birth control pills before menopause.
- Low-dose hormone therapy (HT) after menopause.
- Alternatives to Hormones
All medicines for menopause symptoms have possible risks or side effects. A very small number of women develop serious health problems when taking hormone therapy. Be sure to talk to your doctor about your possible health risks before you start a treatment for menopause symptoms.