MENOPAUSE—WHAT'S IT ALL ABOUT?


MENOPAUSE—WHAT'S IT ALL ABOUT?

As you reach your late forties or early fifties, the hormone levels in your body change, and you start the transition into menopause. You may find that your periods become irregular—sometimes lighter, sometimes heavier. Your periods may also be unpredictable—coming less often. This time of transition is called perimenopause. It can last for several years. When your periods have stopped completely for 1 year, you will have reached menopause. For most women, this occurs at about 51 years of age, but it may happen a few years earlier or later.

What Are the Symptoms of Menopause?

The main symptom of menopause is not having your period. Other symptoms may include the following:

  • Hot flashes—A sudden feeling of warmth on your face or your whole body. Some women sweat with hot flashes.
  • Muscle and joint aches.
  • Insomnia and tiredness—Trouble getting to sleep or staying asleep. For some women, this is caused by hot flashes that wake them up at night. Other women just cannot sleep.
  • Memory problems.
  • Vaginal dryness and loss of flexibility may make having sex uncomfortable and may result in incontinence (leaking urine).

Do the Symptoms of Menopause Last Forever?

Most women have hot flashes or other symptoms for a few years before and after their periods stop. After that, the symptoms may come and go. For most women, hot flashes get better over time. Vaginal dryness can get worse over time.

Can Menopause Cause Other Problems?

Menopause is a normal part of getting older. But the loss of hormones that cause menopause can also cause osteoporosis. Osteoporosis is the loss of bone strength. If you get osteoporosis, your bones can break more easily.

What Can I Do to Help With These Symptoms and Problems?

The best thing you can do is to become as healthy as possible.

  • Daily, moderate exercise helps with hot flashes and insomnia and helps keep your bones strong.
  • A low-fat diet with lots of fresh vegetables and fruit will help you control your weight, avoid stress on your joints, and keep your bones strong.
  • Getting enough calcium (at least 1500 mg) and vitamin D (at least 400 IU) each day will help keep your bones strong.
  • Stopping smoking and not drinking too much alcohol both help keep your bones strong and your heart healthy.
  • Forming and keeping strong family ties and friendships will keep you mentally healthy and reduce stress.
  • Some women choose to take hormones to help with their symptoms. The main hormones that are lost at menopause are estrogen and progesterone. Estrogen helps the most with the symptoms and problems of menopause, but a woman who still has a uterus must not take estrogen alone, because it will increase her chance of getting uterine cancer. A woman with a uterus must take both estrogen and progesterone if she decides to use hormone therapy to treat menopausal symptoms. The reverse side of this sheet has information to help you decide if hormone therapy is for you.

IS HORMONE THERAPY (HT) RIGHT FOR ME?

Hot Flashes, Vaginal Dryness, Osteoporosis, and Colon Cancer

  • HT is the most effective medical treatment for hot flashes, night sweats, and the fatigue that may come with them.
  • HT is the most effective medical treatment for vaginal dryness and the discomfort with sex and leaking urine that may come with these symptoms. For vaginal dryness, you can use estrogen in a cream, tablet, or ring placed in the vagina alone (no progesterone) without worry of increased risk for uterine cancer.
  • HT reduces the risks of osteoporosis and the fragile, broken bones that may come with it.
  • HT reduces the chance that you will get colon cancer.

Heart Disease, Stroke, Blood Clots, and Breast Cancer

  • HT increases the risk of heart disease.
  • HT increases the risk of stroke.
  • HT increases the risk that you will have a blood clot in your leg or lungs.
  • HT increases the risk of breast cancer.

Depression and Alzheimer's Disease

HT may or may not help with depression or Alzheimer's disease. HT may increase the risk for Alzheimer's disease when started in women over 65 years of age.

The risk of serious health problems with HT is small, but important. This table shows the difference in the chance of getting these problems between two groups of 10,000 postmenopausal women—one group taking HT and the other group not taking HT—over a 10-year period.

How to Decide

  • HT is not a good choice if you have had liver disease, breast cancer, ovarian cancer, uterine cancer, heart disease, stroke, blood clots in your legs or lungs, or a strong family history of heart disease or breast cancer.
  • HT may be a good choice if you have a strong family history of osteoporosis and broken bones, and you have symptoms that are making you uncomfortable.
  • If you are having severe hot flashes, you might choose a low dose of HT for a short time.
  • If your main concern is vaginal dryness, a topical (in the vagina) estrogen treatment may be all you need.

Talk with your health care provider about the pros and cons of HT. Together you can make the best decision for you.

FOR MORE INFORMATION

The following Web sites have information on menopause, hormone therapy, natural methods for relieving hormone symptoms, and updates on the most recent research about menopause.

North American Menopause Societywww.menopause.orgConsumers.aspx

Women's Health Initiativewww.nhlbi.nih.govwhi

This page may be reproduced for noncommercial use by health care professionals to share with clients. Any other reproduction is subject to JMWH approval. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JMWH suggests that you consult your health care provider.

 No HTHTRisk/Benefit
Number who will get invasive breast cancer30388 more cases
Number who will have a heart attack30377 more cases
Number who will have a stoke21298 more cases
Number who will have a serious blood clot163418 more cases
Number who will have a hip fracture15105 fewer cases
Number who will get colon cancer16106 fewer cases

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