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Menopause Overview

Updated: Oct 27, 2023


What is Menopause


For me, menopause has been a shocking experience. Perimenopause, the time leading to menopause was nothing. Starting around 48, I would occasionally wake up sweaty in the early hours of the morning and have to toss the covers off and then try to get back to sleep. I didn’t think much of it. But, sometime after my 53rd birthday, things began to change. I started to experience all kinds of symptoms, everything from embarrassing hot flashes in the middle of the day to weight gain, body aches, and even hair loss.


The Science

I began researching menopause and couldn’t find a definitive source to answer all my questions. I was very frustrated because I wanted to know why the symptoms were occurring from a scientific perspective. Eventually, I decided to put all the research into one place and to share it, as well as the products I had tried and found helpful.


Technically, menopause is caused by the release of the last eggs in the ovary. When this occurs, the ovary no longer needs to make the hormones estrogen and progesterone, which regulate the menstrual cycle. A woman reaches menopause officially when she has not had a period for 12 months in a row. Perimenopause, is the transition to menopause and can last between two and eight years before the period stops permanently. For most women, this transition to menopause lasts about four years.


The average age for menopause in the United States is 51, according to the US Office on Women’s Health. But it can occur sooner or later, depending on a woman’s general health and family history. You can have symptoms of menopause for up to 10 years. (Good Lord, I’m hoping it doesn’t last that long!) However, most people experience symptoms of menopause for less than five years. If you know the facts about menopause, you can manage your symptoms and make the transition easier.


The Symptoms

Menopausal symptoms are widespread and significantly impact quality of life. The signs and symptoms usually begin years before the final menstrual period. Perimenopause, as it is known, is the long transition to menopause when the levels of estrogen begin to fluctuate, and symptoms can arise. Irregular periods leading to menopause are common, as well as night sweats, sleep problems, mood swings, heart palpitations, weight gain, memory issues, and vaginal dryness. On average, women are in perimenopause for four years before their periods stop.


Menopausal Symptoms

The following menopausal symptoms are each discussed in depth separately on this site:

  • Hot flashes

  • Night sweats and/or cold flashes

  • Vaginal dryness that causes discomfort during sex

  • Urinary urgency (a pressing need to pee more frequently)

  • Difficulty sleeping (insomnia)

  • Emotional changes (irritability, mood swings or mild depression)

  • Dry skin, dry eyes or dry mouth

  • Breast tenderness

  • Worsening of premenstrual syndrome (PMS)

  • Irregular periods or periods that are heavier or lighter than usual

  • Racing heart

  • Headaches

  • Joint and muscle aches and pains

  • Changes in libido (sex drive)

  • Difficulty concentrating or memory lapses (often temporary)

  • Weight gain

  • Hair loss or thinning

Options

Because I was raised with mostly natural healing as a child, I gravitate toward more natural solutions. There are several ways to raise your estrogen level naturally, which are discussed in depth on this website. However, Western Medicine does offer some options as well. Some people use low-dose hormonal birth control to help in the years leading up to the final period. It is said that these may help stop or reduce hot flashes, vaginal dryness, and mood swings. I did not try this.


For those who are interested in that approach, you should not use hormonal birth control if you smoke. Hormonal birth control, especially the combination of birth control pills and other forms of hormonal birth control like the vaginal ring or skin patch, can raise your risk for blood clots and high blood pressure, and the risk is higher for women who smoke.

Hormone replacement therapy (HRT) is used to treat menopause symptoms after menopause, but it may also increase your risk for blood clots, stroke, and some cancers.

Read more here:


If you decide to take hormone replacement therapy, consider using transdermal HRT, which has recently been shown to be the least dangerous. The two types of HRT include estrogen or combination therapy. Estrogen therapy: In this treatment, you take estrogen alone. Your provider prescribes it in a low dose. Estrogen comes in many forms, such as a patch, pill, cream, vaginal ring, gel or spray. Estrogen therapy isn’t a good treatment for you if you still have a uterus.


Estrogen Progesterone/Progestin Hormone Therapy: This treatment is also called combination therapy because it uses doses of estrogen and progesterone. Progesterone is available in its natural form, or also as a progestin (a synthetic form of progesterone). This type of hormone therapy is for people who still have their uterus.


Again, a complete discussion of both forms of HRT is here:


Two non-hormonal medicines approved by the Food and Drug Administration (FDA) may help treat certain menopause symptoms. One low-dose selective serotonin reuptake inhibitor (SSRI), a type of medicine usually used to treat depression, is approved to treat hot flashes in women who do not already have mood or anxiety problems. But be careful. Serotonin is not always a bed of roses. In the early days of treatment, it has been shown to increase levels of fear and anxiety and even suicidal thinking in some people, including younger people. Too much serotonin causes signs and symptoms that can range from mild (shivering and diarrhea) to severe (muscle rigidity, fever and seizures).


Long term side effects of menopause

Two conditions that affect your health after menopause are osteoporosis and coronary artery disease.


Osteoporosis

Osteoporosis, a “brittle-bone” disease, occurs when the insides of bones become less dense, making them more fragile and likely to fracture. Estrogen plays an important role in preserving bone mass. Estrogen signals cells in the bones to stop breaking down.

People lose an average of 25% of their bone mass from the time of menopause to age 60. This is largely because of the loss of estrogen. Over time, this loss of bone can lead to bone fractures. Your healthcare provider may want to test the strength of your bones over time. Bone mineral density testing, also called bone densitometry, is a quick way to see how much calcium you have in certain parts of your bones. The test is used to detect osteoporosis and osteopenia. Osteopenia is a disease where bone density is decreased and this can be a precursor to later osteoporosis. If you have osteoporosis or osteopenia, your treatment options could include estrogen therapy.


Coronary artery disease

Coronary artery disease is the narrowing or blockage of arteries that supply your heart muscle with blood. As women go through menopause, they may experience multiple symptoms such as hot flashes and night sweats, mood changes (eg, depression and anxiety), and sleep and cognitive disturbances, as well as genitourinary and sexual function changes. Links between many of these symptoms and CVD risk have been found. Other factors influencing the affect of menopause on the risk of cardiovascular disease include: smoking, obesity, cholesterol, age of menopause onset, and depression.


The connection between Hormone Replacement Therapy is discussed in depth here:


Conclusion

Menopause is something every woman experiences to a greater or lesser degree. However, there are many natural remedies discussed on this website. Almost all symptoms have a natural remedy, some of which have been used for hundreds of years. Suffering can be diminished or eliminated by many of them.

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