All the things you have to know related to menopause

All the things you have to know related to menopause


Menopause happens when a woman hasn’t got her period for 12 consecutive months which means that she cannot be pregnant anymore. It usually starts between the ages of 45 and 55, but may develop before or after that age span.

Menopause can cause unpleasant symptoms such as weight gain and hot flashes. For most women, no medical treatment is required during menopause.

Read on to find out everything you need to know about menopause.

When does menopause begin and how long it lasts?

Most women start to develop symptoms of menopause about four years before their last period.

In a small number of women, the symptoms of menopause occur up to a decade before the onset of menopause, and 1 in 10 women show menopausal symptoms 12 years after their last period.

The average age for menopause is 51 years, although it can be up to two years earlier for Latin American and African American women on average. Further studies are required in order to understand the onset of menopause among non-Caucasian women.

A lot of factors determine when menopause will occur to you, including ovarian health and genetics. Perimenopause occurs before menopause. Perimenopause is a period when your hormones begin changing in order to be prepared for menopause.

It can take several months to several years. Many women start perimenopause sometime after their mid-40s. Other women skip the perimenopause and suddenly hit the menopause.

About 1 percent of women start menopause before the age of 40, which is referred to as premature menopause or primary ovarian failure. About 5 percent of women undergo menopause between 40 and 45 years. This is called early menopause.

Perimenopause vs. menopause vs. postmenopause

During perimenopause, periods start to be irregular. Your periods may be late or you may skip one or more periods completely. Menstrual flow can also become lighter or heavier.

Menopause is a period in which a woman doesn’t get menstruation for one full year.

Postmenopause refers to the postmenopausal years.

What are the symptoms of menopause?

The menopause of every woman is unique. The symptoms are often more severe if the menopause happens over a shorter period of time or out of the blue.

Conditions that affect the health of the ovary, like smoking, hysterectomy or cancer increase the duration and severity of the symptoms.

Apart from changes in menstruation, the symptoms of perimenopause, menopause and postmenopause are the same generally. The most common early signs of perimenopause are:

  • Vasomotor symptoms, such as night sweats, hot flashes and flushing
  • Less frequent menstruation
  • Lighter or heavier periods than you usually experience
  • An estimated 75 percent of women suffer from hot flashes during menopause.

Other common menopause symptoms are:

  • Depression
  • Anxiety
  • Insomnia
  • Weight gain
  • Vaginal dryness
  • Difficulty concentrating
  • Problems with memory
  • Reduced sex drive or libido
  • Dry mouth, skin and eyes
  • Sore or tender breasts
  • Increased urination
  • Headaches
  • Urinary tract infections
  • Racing heart
  • Painful or stiff joints
  • Reduced muscle mass
  • Less full breasts
  • The reduced mass of the bones
  • Hair loss or thinning
  • Increased growth of hair on some areas of the body like the neck, face, chest and upper back


Some common menopause complications include:

  • Slower function of the metabolism
  • Dyspareunia, or painful intercourse
  • Vulvovaginal atrophy
  • Cataracts
  • Mood swings, or sudden changes of emotions
  • Osteoporosis, or weakened bones with reduced strength and mass
  • Periodontal disease
  • Urinary incontinence
  • Heart or blood vessel disease

Why does menopause occur?

Menopause occurs because the ovaries age produce a smaller amount of reproductive hormones.

The body starts various changes in response to lower levels of:

  • Testosterone
  • Progesterone
  • Estrogen
  • Luteinizing hormone (LH)
  • Follicle-stimulating hormone (FSH)

One of the most striking changes is the loss of active ovarian follicles. Ovarian follicles are structures that produce eggs and release them from the ovarian wall, allowing fertility and menstruation.

A thing that most women first notice is that the frequency of their period decreases while the flow becomes longer and heavier. This usually happens sometime in the middle of the 40s. At age 52, most women from the U.S have had menopause.

In some cases, menopause is induced or caused by surgical removal of the ovaries and pelvic structures or due to an injury.

Some common of an induced menopause are:

  • Pelvic radiation
  • Pelvic injuries that severely destroy or damage ovaries
  • Bilateral oophorectomy, or surgical removal of the ovaries
  • Ovarian ablation, or the shutdown of ovary function done by surgery, hormone therapy, or radiotherapy techniques in women with estrogen receptor-positive tumors

How to diagnose menopause?

Talking with your doctor is something worth doing especially if you have disabling or troublesome symptoms of menopause, or if you experience menopause symptoms and you are in your mid-40s or younger.

A new blood test, known as the PicoAMH Elisa diagnostic test, has recently been FDA approved. This test is used to determine if a woman has entered menopause or is about to enter menopause.

This new test can help women who have symptoms of perimenopause, which can also have negative effects on their health. Early menopause is linked with a higher risk of osteoporosis and fractures, vaginal changes and loss of libido, changes in mood, heart disease and cognitive changes.

Your doctor may also perform a blood test in order to measure the level of certain hormones in your blood, usually FSH and an estrogen called estradiol.

A constantly elevated FSH blood level of 30 mIU/ml or more in combination with a one-year menstrual disorder is usually a confirmation of menopause. Saliva tests and OTC urine tests are also available, but they cost a lot of money and are unreliable.

During perimenopause, FSH and estrogen levels fluctuate on a daily basis, so healthcare providers end up diagnosing this condition based on menstrual data, medical history and symptoms.

Depending on your medical history and symptoms, your doctor may also conduct further blood tests to rule out any other underlying conditions that may be causing your symptoms.

Additional blood tests usually performed to confirm menopause include:

  • Kidney function tests
  • Liver function tests
  • Thyroid function test
  • Blood lipid profile
  • Testosterone, prolacin, estradiol, progesterone and chronic gonadotropin (hCG) tests


You may need to be treated if your symptoms are severe or affect the quality of your life. Hormone therapy may be effective in treating women under 60, or within 10 years of menopause onset in order to reduce the management of:

  • Flushing
  • Osteoporosis
  • Hot flashes
  • Night sweats
  • Vaginal atrophy

The usage of medications may be required in order to treat symptoms of menopause, such as vaginal dryness and hair loss.

Additional medications that are sometimes used for menopausal symptoms are:

  • Eflornithine hydrochloride topical cream for unwanted hair growth
  • Topical minoxidil 5 percent, used only once a day for hair loss and thinning
  • Antidandruff shampoos, such as ketoconazole 2 percent and zink pyrithione 1 percent used for preventing hair loss
  • Selective serotonin reuptake inhibitors (SSRIs) such as paroxetine, for treating depression, anxiety and hot flashes
  • Low-dose estrogen-based vaginal lubricants in a form of a ring, tablet or cream
  • Nonhormonal vaginal lubricants and moisturizers
  • Prophylactic antibiotics for recurrent UTIS
  • Ospemifene for painful intercourse and vaginal dryness
  • Sleep medications for treating insomnia
  • Teriparatide, raloxifene, denosumab, or calcitonin for postmenstrual osteoporosis

Lifestyle changes and home remedies

There are various ways to reduce minor to moderate menopause symptoms in a natural way by using alternative treatments, home remedies and lifestyle changes.

Here are some tips to make at home to better manage menopause symptoms:

Keeping cool and staying comfortable

Dress in layered and loose clothes, especially at night and during warm or moody weather. This can help you manage hot flashes.

If you want to reduce night sweating, you should also avoid heavy blankets and keep your bedroom cool at night. You can also use a waterproof sheet under your bedding in order to protect your mattress if you experience night sweats regularly.

If you feel flushed, using a portable fan is a good way to cool yourself down.

Exercise and manage your weight

You can manage your weight by reducing your daily calorie intake by 400 to 600. Exercising for around half an hour a day is also very important. This can help:

Communicating about your needs

Talk to a psychologist or a therapist about any feelings you experience related to, depression, anxiety, identity changes, isolation, sadness and disturbed sleep.

You also need to speak with your loved ones, family about your depression, anxiety or mood changes so they better understand your situation and needs.

Add supplements to your diet

Supplement your diet

Take magnesium, calcium and vitamin D supplements in order to improve your sleep and energy levels and also to reduce your risk of osteoporosis. Ask your doctor about supplements that can help your individual health needs.

Practice relaxation techniques

You can practice breathing techniques to promote relaxation such as:

  • Meditation
  • Box breathing
  • Yoga

Take care of your skin

Apply moisturizers daily to reduce the dryness of the skin. You should also avoid excessive swimming or bathing, as this may irritate or dry out your skin.

Cope with sleep problems

Use OTC Sleep Medications to relieve your insomnia temporarily, or consider talking to your doctor about natural sleep aids. Talk to your doctor if you have regular sleep problems so that he or she can help you cope with these problems and sleep better.

Stop smoking and limit alcohol consumption

Quit smoking and avoid exposing yourself to secondhand smoke. Cigarette exposure can aggravate your symptoms.

You should also limit your alcohol intake to reduce aggravating symptoms. Heavy drinking during the onset of menopause can increase the risk of health problems.

Other remedies

Herbal remedies are recommended by some limited studies for menopausal symptoms caused by a deficiency of estrogen.

Natural supplements and nutrients that can help limit the symptoms of menopause are:

  • Flax seed
  • Vitamin E
  • Isoflavone
  • Melatonin
  • Soy

Some people claim that black cohosh can relieve some symptoms, such as night sweats and hot flashes. However, in a recent review of studies, little evidence has been found to support these allegations. Further research is needed.

Similarly, 2015 research has found no evidence to support the claim that omega-3 fatty acids can improve vasomotor symptoms linked with menopause.


Menopause marks the end of fertility because it stops a woman’s menstrual cycle. Most women experience menopause at the age of 52, but damage to the ovaries or pelvis can lead to menopause even earlier in life. Some underlying conditions or genetics can play a role in getting menopause earlier than expected.

Many women experience menopausal symptoms in the pre-menopausal years, most commonly flushing, night sweats and hot flashes. Symptoms can persist for four years or more after menopause.
If your symptoms are severe or affect the quality of your life, you can benefit from treatment like hormone therapy. In general, menopausal symptoms can be treated or reduced by natural means and lifestyle changes.

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Sholem Berkowitz
Sholem Berkowitz

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