Menopause

• Symptoms of Menopause
• Symptom Relief
• Track Your Symptoms
• Symptoms Beyond Menopause
• Stay Healthy As You Age

Menopause is a normal change in a woman’s life when her period stops. That’s why some people call menopause “the change of life.” During menopause, a woman’s body slowly makes less of the hormones estrogen and progesterone. This often happens between the ages of 45 and 55 years old. A woman has reached menopause when she has not had a period for 12 months in a row, and there are no other causes for this change. As you near menopause, you may have symptoms from the changes your body is making. Many women wonder if these changes are normal, and many are confused about how to treat their symptoms. You can feel better by learning all you can about menopause, and talking with your doctor about your health and your symptoms. If you want to treat your symptoms, your doctor can tell you more about your options and help you make the best treatment choices.

Symptoms of Menopause

Every woman’s period will stop at menopause. Some women may not have any other symptoms. But as you near menopause, you may have these symptoms:

• Changes in your period. The time between periods and the flow from month to month may be different.

• Abnormal bleeding or “spotting." This is common as you near menopause. But if your periods have stopped for 12 months in a row, and you still have “spotting,” you should talk to your doctor to rule out serious causes, like cancer.

• Hot flashes (“hot flushes”). You get warm in the face, neck and chest.

• Night sweats and sleeping problem. These may lead to feeling tired, stressed, or tense.

• Vaginal changes. The vagina may become dry and thin, and sex and vaginal exams may be painful. You also might get more vaginal infections.

• Thinning of your bones. This may lead to loss of height and bone breaks (osteoporosis).

• Mood changes. May include mood swings, depression, and irritability.

• Urinary problems. You may have leaking, burning or pain when urinating, or leaking when sneezing, coughing, or laughing.

• Problems with concentration or memory.

• Less interest in sex and changes in sexual response.

• Weight gain or increase in body fat around your waist.

• Hair thinning or loss.

Many women in perimenopause and menopause also feel depressed and irritable. Some researchers believe that the decrease in estrogen triggers changes in your brain, causing depression. Others think that other symptoms you're having, such as sleep problems, hot flashes, night sweats, and fatigue cause these feelings. Or it could be a combination of hormone changes and symptoms. But these symptoms also can have causes that are unrelated to menopause. If you are having these symptoms, and you think they are interfering with your quality of life, it is important to discuss them with your doctor. Talk openly with your doctor about the other things going on in your life that might be adding to your feelings. Other things that could cause depression and/or anxiety include:

• having depression during your lifetime before menopause

• feeling negative about menopause and getting older

• increased stress

• having severe menopause symptoms

• smoking

• not being physically active

• not being happy in your relationship or not being in a relationship

• not having a job

• not having enough money

• low self-esteem (how you feel about yourself)

• not having the social support you need

• regretful that you can't have children anymore

If you need treatment for these symptoms, you and your doctor can work together to find a treatment that is best for you.

Symptom Relief

As you near menopause, you may have symptoms from the changes your body is making. Here are some ways to relieve those symptoms.

• Hot Flashes. A hot environment, eating or drinking hot or spicy foods, alcohol, or caffeine, and stress can bring on hot flashes. Try to avoid these triggers. Dress in layers and keep a fan in your home or workplace. Regular exercise might also bring relief from hot flashes and other symptoms. Ask your doctor about taking an antidepressant medicine. There is proof that this can be helpful for some women.

• Vaginal Dryness. Use an over-the-counter vaginal lubricant. There are also prescription estrogen replacement creams that your doctor might give you. If you have spotting or bleeding while using estrogen creams, you should see your doctor.

• Problems Sleeping. One of the best ways to get a good night's sleep is to get at least 30 minutes of physical activity on most days of the week. But avoid a lot of exercise close to bedtime. Also avoid alcohol, caffeine, large meals, and working right before bedtime. You might want to drink something warm, such as herb tea or warm milk, before bedtime. Try to keep your bedroom at a comfortable temperature. Avoid napping during the day and try to go to bed and get up at the same times every day.

• Memory problems. Ask your doctor about mental exercises you can do to improve your memory. Try to get enough sleep and be physically active.

• Mood swings. Try to get enough sleep and be physically active. Ask your doctor about relaxation exercises you can do. Ask your doctor about taking an antidepressant medicine. There is proof that this can be helpful. Think about going to a support group for women who are going through the same thing as you, or getting counseling to talk through your problems and fears.

Track Your Symptoms

You can use this chart to keep track of menopausal symptoms that bother you. Take it with you when you visit your doctor, so you both can figure out the best way to handle them.

click here for a printable version of this chart

Symptoms Beyond Menopause

The term postmenopause refers to all the years beyond menopause. It is the period past the time at which you have not had a period for 12 months in a row. During these years, you may have some bleeding. There are common causes of bleeding. The decline in your body's estrogen levels can cause tissues lining the vagina to become thin, dry, and less elastic. Sometimes this lining can become broken or easily inflamed and bleed. It can also become injured during sex or even during a pelvic exam. Once you've reached menopause, though, you should report any bleeding that you have to your doctor. Uterine bleeding after menopause could be a sign of other health problems. Other things that can cause abnormal bleeding include:

• fibroids

• the use of birth control pills

• a hormonal imbalance

• non-cancerous growths in the lining of the uterus

Stay Healthy As You Age

Take these steps to stay healthy during this time in your life.

• Be active. Try to get at least 30 minutes of physical activity on most days of the week. Try weight-bearing exercises, like walking, running, or dancing.

• If you smoke, quit. Ask your doctor for help. Visit www.4woman.gov/QuitSmoking for more information.

• Eat healthy foods. Eat a variety of fruits and dark green veggies, such as broccoli, kale, and other dark leafy greens; get calcium-rich foods; eat whole-grain cereals, breads, crackers, rice, or pasta; choose lean meats and poultry; and limit saturated fats and salt.

• Limit alcohol. If you drink alcohol, limit to no more than one drink each day.

• Control your weight. Ask your doctor what a healthy weight is for you.

• Ask your doctor what tests you need. Have your blood pressure, cholesterol, and blood sugar checked. Have breast exam and a breast x-ray (mammogram).

• Talk to your doctor about bone health. Ask your doctor if you’re getting enough calcium and vitamin D. Get a bone density test if you’re over 65, or if your doctor says you have a high chance of getting osteoporosis. Ask about taking medicine to help preserve bone and slow down bone loss. Get enough calcium to keep your bones strong. Before menopause, you need about 1,000 mg of calcium per day. After menopause, you need 1,500 mg per day.

Publications

1. Age Page: Menopause - This fact sheet explains what menopause is, and the different symptoms and health concerns that accompany its different stages. It gives recommendations for what women can do to stay healthy throughout menopause and answers common questions about hormone therapy, phytoestrogens and other important issues for menopausal women.
   
   
2. Frequently Asked Questions - Menopause and Menopause Treatments - This fact sheet discusses menopause symptoms and treatments, including postmenopausal hormone therapy (HT) and the practical steps women can take to alleviate symptoms and prevent diseases like osteoporosis and heart disease.
   
   
3. La Menopausia y las Hormones (Fact Sheet) - Esta hoja de datos explica los síntomas de la menopausia, y los beneficios y los riesgos asociados con el tratamiento de reemplazo hormonal.
   
   
4. Menopause & Hormones: Fact Sheet - This fact sheet explains the benefits and risks of treating symptoms of menopause with hormone therapy, and explains the Food and Drug Administrations recommendations for menopausal hormone therapy.
   
   
5. Menopause and Bladder Control - This brochure discusses the effect of menopause on bladder control. It explains the different types of incontinence and how it can be treated.
   
   
6. Menopause Guidebook (Copyright © NAMS) - This guidebook explains the emotional and physical changes that often accompany menopause. It also explains what to expect and how to care for yourself after menopause.
   
   
7. Menopause Tutorial from the National Library of Medicine - This interactive tutorial explains the signs and symptoms associated with menopause, and how to cope. It also explains the health concerns facing women in postmenopause and discusses recent evidence on the risks and benefits of hormone therapy.
   
   
8. Menopause Years - ACOG Publication #AP047 (Copyright © ACOG) - This brochure describes the physical changes that may occur around menopause and what can be done to stay healthy during this time.
   
   
9. Menopause: An Update, 2003 - Since "Menopause: One Woman’s Story, Every Woman’s Story—A Resource for Making Healthy Choices" was printed, there have been several significant research findings involving the treatments used for the symptoms of menopause. This booklet highlights the most important updates.
   
   
10. Menopause: One Woman's Story, Every Woman's Story - A Resource for Making Healthy Choices - This publication is written to provide women with information so they can make choices about their health care before, during, and after menopause. It explains menopause, lists symptoms to look for, and the impact menopause can have on women's' health. This discusses treatment for menopause symptoms and ways to reduce the health risks associated with aging, including discussions on hormone replacement therapy or HRT, plant estrogens, diet, exercise and smoking cessation.
    
    
11. Menopause: Managing Your Body's Changes (Copyright © Hormone Foundation) - This publication contains helpful information how the changes of menopause happen and what you can do to help yourself through many common menopause symptoms.
    
    

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