Menopause

The menopause transition period, which is also known as perimenopause, is the period of time during which a woman moves beyond her childbearing years and enters menopause. Menopause itself is when a woman has not had a menstrual period for more than one year.

During menopause transition, women often experience a change in menstrual cycles, vaginal dryness, hot flashes or flushes and sleeping problems. The experience of the symptoms can vary greatly from mild to unbearable and can cause severe interference with daily activities and sleep.

Perimenopause usually lasts around five years. The symptoms are often treated with lifestyle changes and hormonal therapies. Although the symptoms should eventually peter out as one enters the menopause, troublesome symptoms which persist can be managed, and should be discussed with a doctor.

Menopause is a time when a woman's body is losing the ability to become spontaneously pregnant. The ovaries stop releasing eggs and producing the hormones necessary for the menstrual cycle, estrogen, and progesterone. For these reasons, a woman stops having menstrual periods. The menopause is confirmed once a woman has not had a period for a year. The time leading up to this point is characterized by unstable hormone levels, which produce the symptoms of the menopause transition period. The average age at the beginning of this time is between 45 and 47 years of age, but this can be earlier in women who smoke, who have had their uterus (womb) or ovaries removed, who have been through chemotherapy and in women who have medical conditions which affect the ovaries. Menopause is usually complete by 51 years of age. Women with family members who experience menopause early or late are likely to follow this pattern.

The most typical symptom of the menopause transition are menstrual periods which are different from the regular menstrual cycle. These may become heavier or lighter, and tend to come further apart until they eventually stop. Other common symptoms include hot flashes or flushes, sweating at night, difficulty sleeping, weight change, mood swings, a low mood, a low sex drive, vaginal dryness and tender breasts. Symptoms can vary from mild to unbearable and can cause severe interference with daily activities.

The diagnosis is usually made based on the symptoms and change in the menstruation pattern in a woman of the appropriate age. A diary of the details of any menstrual bleeding may be helpful in making the diagnosis. If there is any doubt, blood tests may be taken to measure hormone levels.

The treatment of this condition involves managing the symptoms. Many women find that lifestyle changes, such as taking regular exercise, reducing caffeine and alcohol intake, eating a healthy diet and staying social help to manage symptoms. Hormonal therapies may help with the irregular bleeding and the mood symptoms. This includes hormone replacement therapy. Using lubricants or estrogen-containing creams may help with vaginal dryness. There are many herbal remedies that are marketed as being helpful for peri-menopausal symptoms. Some of these can interact with other medications, so it is wise to discuss the use of these with a doctor or pharmacist.

• Menopause transition
• Perimenopause