It May Not Be The Summer Heat Causing Those Hot Flashes!
For most women, menopause happens around age 50. But every woman's body has its own time line. Some women stop having periods in their mid-40s. Others continue well into their 50s. Perimenopause is the process of change that leads up to menopause. It can start as early as your late 30s or as late as your early 50s. How long perimenopause lasts varies, but it usually lasts from 2 to 8 years. You may have irregular periods or other symptoms during this time. Menopause is a natural part of growing older. You don't need treatment for it unless your symptoms bother you. But it's a good idea to learn all you can about menopause. Knowing what to expect can help you stay as healthy as possible during this new phase of your life.
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.
In the months or years leading up to menopause (perimenopause), you might experience these signs and symptoms:
- Irregular periods
- Vaginal dryness
- Hot flashes
- Night sweats
- Sleep problems
- Mood changes
- Weight gain and slowed metabolism
- Thinning hair and dry skin
- Loss of breast fullness
Symptoms, including changes in menstruation, are different for every woman. Most likely, you'll experience some irregularity in your periods before they end. Skipping periods during perimenopause is common and expected. Often, menstrual periods will skip a month and return, or skip several months and then start monthly cycles again for a few months. Periods also tend to happen on shorter cycles, so they are closer together. Despite irregular periods, pregnancy is possible. If you've skipped a period but aren't sure you've started the menopausal transition, consider a pregnancy test.
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 may 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 may 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.
When to see a doctor
Keep up with regular visits with your doctor for preventive health care and any medical concerns. Continue getting these appointments during and after menopause.
Preventive health care as you age may include recommended health screening tests, such as colonoscopy, mammography and triglyceride screening. Your doctor might recommend other tests and exams, too, including thyroid testing if suggested by your history, and breast and pelvic exams.
Always seek medical advice if you have bleeding from your vagina after menopause.
If you have severe symptoms, you may want to ask your doctor about prescription medicines. Choices include:
- Birth control pills before menopause.
- Hormone therapy (HT).
- A medicine called clonidine (Catapres) that is usually used to treat high blood pressure.
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.
Remember, it is still possible to become pregnant until you reach menopause. To prevent an unplanned pregnancy, keep using birth control until you have not had a period for 1 full year.
Menopause can result from:
- Natural decline of reproductive hormones. As you approach your late 30s, your ovaries start making less estrogen and progesterone — the hormones that regulate menstruation — and your fertility declines. In your 40s, your menstrual periods may become longer or shorter, heavier or lighter, and more or less frequent, until eventually — on average, by age 51 — your ovaries stop producing eggs, and you have no more periods.
- Hysterectomy. A hysterectomy that removes your uterus but not your ovaries usually doesn't cause immediate menopause. Although you no longer have periods, your ovaries still release eggs and produce estrogen and progesterone. But surgery that removes both your uterus and your ovaries (total hysterectomy and bilateral oophorectomy) does cause immediate menopause. Your periods stop immediately, and you're likely to have hot flashes and other menopausal signs and symptoms, which can be severe, as these hormonal changes occur abruptly rather than over several years.
- Chemotherapy and radiation therapy. These cancer therapies can induce menopause, causing symptoms such as hot flashes during or shortly after the course of treatment. The halt to menstruation (and fertility) is not always permanent following chemotherapy, so birth control measures may still be desired.
- Primary ovarian insufficiency. About 1 percent of women experience menopause before age 40 (premature menopause). Menopause may result from primary ovarian insufficiency — when your ovaries fail to produce normal levels of reproductive hormones — stemming from genetic factors or autoimmune disease. But often no cause can be found. For these women, hormone therapy is typically recommended at least until the natural age of menopause in order to protect the brain, heart and bones.
After menopause, your risk of certain medical conditions increases. Examples include:
- Heart and blood vessel (cardiovascular) disease. When your estrogen levels decline, your risk of cardiovascular disease increases. Heart disease is the leading cause of death in women as well as in men. So it's important to get regular exercise, eat a healthy diet and maintain a normal weight. Ask your doctor for advice on how to protect your heart, such as how to reduce your cholesterol or blood pressure if it's too high.
- Osteoporosis. This condition causes bones to become brittle and weak, leading to an increased risk of fractures. During the first few years after menopause, you may lose bone density at a rapid rate, increasing your risk of osteoporosis. Postmenopausal women with osteoporosis are especially susceptible to fractures of their spine, hips and wrists.
Urinary incontinence. As the tissues of your vagina and urethra lose elasticity, you may experience frequent, sudden, strong urges to urinate, followed by an involuntary loss of urine (urge incontinence), or the loss of urine with coughing, laughing or lifting (stress incontinence). You may have urinary tract infections more often. Strengthening pelvic floor muscles with Kegel exercises and using a topical vaginal estrogen may help relieve symptoms of incontinence. Hormone therapy may also be an effective treatment option for menopausal urinary tract and vaginal changes which can result in urinary incontinence.
- Weight gain. Many women gain weight during the menopausal transition and after menopause because metabolism slows. You may need to eat less and exercise more, just to maintain your current weight.