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What is menopause?

Menopause is defined as the stage in a woman's life that happens 12 months after your final menstrual period. After menopause, your body produces much less of the hormones estrogen and progesterone. Your ovaries stop releasing eggs and you can no longer become pregnant.

Uncomfortable symptoms may accompany menopause, but your women’s health provider has treatments and solutions that can make this transition easier.

What are the stages of menopause?

Many women refer to the months or years leading up to their last period as menopause, but menopause actually happens in three stages.

Perimenopause

The years leading up to menopause are called perimenopause or the menopausal transition. For most women, perimenopause begins in their mid to late 40s and lasts about four years, although it can be longer for some.

Menopause

True menopause occurs when you stop menstruating permanently. More specifically, a woman is considered to be in menopause after 12 months with no menstrual cycle. In the US, the average age for a woman to reach menopause is 52.

Postmenopause

After menopause, you enter the postmenopause stage. When postmenopause begins, you may experience fewer symptoms associated with menopause. However, your risk of heart disease and osteoporosis increases, so your years after menopause should focus on taking care of your body by eating well, exercising and seeing your provider regularly.

What are the symptoms of menopause?

Changing levels of estrogen and progesterone during the menopausal transition can cause a wide range of symptoms. Symptoms of menopause include:

  • Anxiety, depression and mood changes
  • Hot flashes
  • Night sweats
  • Irregular periods
  • Memory problems and trouble focusing
  • Sleep problems related to low levels of progesterone
  • Urinary incontinence
  • Vaginal atrophy (dryness and irritation)

When to see a doctor

Your women’s health specialist can help you manage many symptoms of menopause, so don’t feel like you need to handle this transition alone. If menopause symptoms negatively affect your daily life, schedule an appointment to talk about possible treatment options.

What causes menopause?

In most cases, menopause is a natural change that occurs with aging. Some women, however, go through menopause earlier than normal due to health conditions and other factors.

  • Natural menopause

    In most cases, menopause is a natural change that occurs with aging. Some women, however, go through menopause earlier than normal due to health conditions and other factors.

  • Early and premature menopause

    Menopause that occurs before age 40 is called premature menopause. When it happens between ages 40 and 45, it is called early menopause. Both can occur for no obvious reason, but in some cases, medical or other factors play a part, including:

    • Cancer treatment: Chemotherapy and radiation therapy to the pelvic area can damage the ovaries and cause your periods to stop either temporarily or permanently.
    • Family history: If you have a family history of early or premature menopause, you are more likely to experience it yourself.
    • Medical conditions: Certain autoimmune diseases, such as rheumatoid arthritis and thyroid disease, can cause the immune system to attack the ovaries. Women who are living with HIV that is not well controlled, as well as those with missing chromosomes, can also experience early or premature menopause.
    • Smoking: Women who smoke can reach menopause up to two years earlier than those who don’t smoke. They may also have more severe symptoms.
    • Surgery: Having surgery to remove both ovaries, known as a bilateral oophorectomy, causes menopause to begin immediately. If you have a hysterectomy, a surgery to remove the uterus, but still have your ovaries, you will no longer have your period, and you could experience natural menopause earlier than expected.

What long-term health conditions are associated with menopause?

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During and after menopause, women’s bodies go through many changes that can trigger certain long-term conditions. It’s important to know that after menopause, women face a higher risk for some diseases and symptoms. Talk to your provider about ways to lower your risk and monitor your health after menopause.

Cardiovascular disease

Estrogen is linked to heart health, so when levels decline as part of menopause, women are at higher risk for cardiovascular disease. Many women experience atherosclerosis, a buildup of plaque in the arteries. Additionally, hot flashes are linked to high blood pressure.

Changes in sexual function

You may feel less interested in sex around the time of menopause due to dyspareunia (painful sex), vaginal dryness and irritation associated with vaginal atrophy.

Hot flashes

Hot flashes are the most common symptom of menopause. Some women continue to experience hot flashes and night sweats in the years after menopause.

Osteoporosis

Menopause causes the rate of bone loss to increase significantly, leading to a higher risk of osteoporosis. Up to 50% of postmenopausal women are diagnosed with osteoporosis.

Weight gain

Some women gain weight more easily during menopause. Weight gain could be due to changes in your body and side effects from specific treatments.

Menopause diagnosis

In most cases, a formal diagnosis of menopause is not necessary, as women notice the signs and symptoms on their own. However, doctors can do blood or urine tests to measure levels of the hormones follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol to determine if you have started perimenopause or have passed menopause.

Menopause treatment

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Not all women require treatment for menopause. However, if menopause symptoms are severe or interfering with your quality of life, your women’s health provider can recommend options for treatment.

Hormone replacement therapy

Your body produces lower levels of estrogen and progesterone during the menopausal transition. Hormone replacement therapy (HRT) replaces some of these hormones to help ease symptoms such as hot flashes and vaginal dryness. The two types of HRT include:

  • Estrogen therapy: This type of hormone therapy provides estrogen only.
  • Estrogen progesterone/progestin hormone therapy: If you haven’t had a hysterectomy, you also need to take a hormone called progestin along with estrogen. This helps reduce the risk of endometrial cancer that can happen with estrogen alone.

Hormone therapy can be taken as pills, gels, sprays and skin patches. For vaginal dryness, estrogen is available as a tablet, vaginal ring or cream.

Research has shown that HRT can put you at slightly higher risk for breast cancer, endometrial cancer, heart disease and other conditions. Talk to your provider about the risks and benefits of these treatments. 

Medication

Other medications that can address symptoms include:

  • Low-dose birth control pills to regulate hormone levels
  • Low-dose selective serotonin reuptake inhibitors (SSRIs) for hot flashes
  • Over-the-counter lubricants and moisturizers for vaginal dryness and irritation

Lifestyle changes

Making healthy lifestyle changes can help ease or prevent many menopause symptoms.

  • Eat a healthy diet: Eating a heart-healthy diet filled with fruits, vegetables and lean proteins can help prevent heart disease and help you reach or maintain a healthy weight.
  • Don't smoke: Smoking can raise your risk for heart disease, stroke and other conditions.
  • Exercise regularly: Getting regular physical activity is good for your heart and can help you reach or maintain a healthy weight.
  • Increase calcium and vitamin D: Talk to your doctor about ways to increase calcium and vitamin D intake, which helps build strong bones.
  • Strengthen your pelvic floor: Doing pelvic floor exercises like Kegels can help improve urinary incontinence.

Alternative therapies

Some alternative therapies, or integrative medicine, have been proven to help specific menopause symptoms. These therapies can be tried on their own or in combination with other treatments.

  • Acupuncture: Research shows acupuncture can greatly reduce hot flashes for some women.
  • Bioidentical hormones: These are plant-based hormones that mirror those produced by your body. Your provider can discuss these options with you.
  • Yoga: Doing yoga exercises regularly can help with hot flashes and psychological symptoms.

Find specialized care for menopause

We help you manage menopause with services at a location that fits your needs. We offer several locations for your care, including specialized women’s health centers in North and Central Texas.

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Frequently asked questions

  • Can you get pregnant during menopause?

    It is possible to get pregnant during perimenopause. Only when you have gone an entire year without having your period and are officially at menopause can you no longer get pregnant.

  • Does menopause make you tired?

    Many women feel more tired during the menopausal transition due to a lack of quality sleep.

  • Can menopause cause nausea?

    Nausea is not a common symptom of menopause. However, it can sometimes be a side effect of hormonal treatment.

  • Can menopause cause dizziness?

    Dizziness is a common symptom of menopause. Research shows this may be linked to anxiety.