About Menopause
Menopause Stages
Menopause Symptoms
Menopause and Sex
Menopause is a natural event in every woman's life. It refers to the time when a woman’s menstrual periods stop and she can no longer become pregnant. Most women usually experience their last period around age 51, but it could happen at any time in their 40s or 50s. Women who smoke tend to have their last period at a younger age.
Why does this happen and how?
As a woman gets closer to menopause, her ovaries make less of the female hormones estrogen and progesterone. After some time (usually 3 to 5 years), her ovaries make very small amounts of estrogen and stop making progesterone altogether. A woman reaches menopause when she has not experienced a menstrual period in 12 months.
Perimenopause
During a woman's mid to late 40s, certain indicators hint that menopause is right around the corner. These clues can start a few years before the last menstrual period. This time is called the perimenopause stage, and it happens when the ovary hormone levels begin to slowly decrease. Hormone levels become unbalanced and can fluctuate. Menstrual periods also become irregular. Women may experience hot flashes, night sweats, sleep problems and mood swings. Women should be careful during this stage as pregnancy can still occur.
Menopause
Menopause is the permanent ending of menstrual periods. Women living in the United States typically enter natural menopause at age 51; however, it can occur any time between ages 40-58. Few women enter menopause in their 30s and even fewer in their late 60s. Women usually experience menopause around the same age as their mothers and sisters. Smoking can make women begin menopause as much as 2 years earlier than normal. Some women can begin menopause early because of certain medications they have taken or from surgery to remove their ovaries and/or uterus (hysterectomy).
Postmenopause
This is the period after menopause. During this time, a woman’s body makes very small amounts of estrogen. Some women continue to have symptoms of menopause, such as hot flashes and vaginal dryness. After menopause, a woman’s risk of heart disease and weaker bones ("osteoporosis") increases.
Every woman is unique and experiences menopause differently. A lucky few will have no symptoms while others will experience many symptoms before their menstrual periods stop. It is not always possible to tell whether menopause, the normal aging process or both cause the symptoms. Symptoms that may begin in the months or years before menopause include:
- Irregular periods. A woman's menstrual period cycle will begin to change. Cycles can occur more or less frequently and also result in shorter, longer, heavier or lighter periods. However, a few missed periods does not mean a woman is entering menopause and other health factors should be considered. Women should speak with their doctor to test if they are pregnant, if they would like to stop taking contraceptives, or if there is another medical reason that could result in missed periods. Women should consult their doctor if they experience “spotting” after not having a period for one full year. Spotting could be caused by cancer or another health condition.
- Hot flashes or flushes. This symptom is a sudden feeling of heat in the upper body or throughout. During a hot flash, the face and neck areas may become red, and areas around chest, back, and arms may become blotchy. After the episode, women may experience profuse sweating or become extremely cold.
- Night sweats. Night sweats are hot flashes that occur during sleep and usually result in disrupted sleep.
- Trouble sleeping and night sweats. Women may find it harder to fall asleep and/or stay asleep through the entire night.
- Vaginal and urinary problems. These problems can begin or get worse around menopause. Estrogen helps protect the strength of a woman’s vagina, bladder and urethra (the tube that empties your urine). Lower estrogen levels make vagina walls drier and thinner, cause itching or discomfort and could result uncomfortable or even painful intercourse. Vaginal infections or urinary tract infections may increase. Some women develop urinary urge incontinence (problems holding the urine long enough to get to the bathroom) or urinary stress incontinence (urine leaking out when you sneeze, cough or laugh).
- Changing feelings about sex. Some women find they feel less aroused during menopause and lose interest altogether while others feel more comfortable with their sexuality. Some women lose interest in sex because it may become more physically uncomfortable or even painful.
- Mood changes. Women may experience mood swings, feel irritated, or have crying spells. If mood swings before monthly periods or postpartum depression after giving birth, women may become moodier around the time they go through menopause. Changes in mood can be caused by stress or feeling tired. Mood swings and depression are not the same thing.
- Osteoporosis. This condition occurs when bones become thin and weak. It can lead to loss of height and broken bones. Women with a family history of osteoporosis and fractures might have an increased risk.
- Other changes. Women may experience forgetfulness or have a hard time focusing on everyday things. Weight gain, muscle loss and fat gain may also occur. Joints and muscles may feel stiff and achy.
Women who are close to experience menopause may notice changes in their sex lives. Some women may enjoy sex more frequently since pregnancy can no longer occur. Others lose their desire for sex and may not enjoy it as much as before.
Changes in sexuality during this time of life have several possible causes, including:
- Lower hormone levels that cause vaginal dryness and thinner vagina walls, which can make sex uncomfortable.
- Decreased hormone levels that lower sex drive.
- Night sweats that result in sleep problems and no energy for sex.
- Increased emotions or stress that reduce sexual appetite.
There is no need to seek medical treatment because of a loss of interest in sex. Talk with your doctor or nurse if you have concerns or are upset about these changes.
All menopause information can also be found at www.womenshealth.gov* and www.nia.nih.gov*.
