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Definition

Menopause is when a woman has not had a menstrual period for one year. It is called early menopause when it happens before age 40.

Causes

Menopause happens when estrogen and progesterone hormones lower. The ovaries stop releasing eggs when hormones are too low.

Surgery to remove the uterus or ovaries can also cause menopause. Cancer treatments can also cause it.

Risk Factors

Menopause is a normal part of aging. It is most common in women who are 40 to 58 years of age.

When it happens early, risk factors are:

  • Smoking
  • Cancer treatments
  • Surgery to remove the uterus or ovaries
  • Contact with arsenic
  • Use of oral birth control
  • Low body fat
  • Having a mother who was given diethylstilbestrol (DES) when pregnant

Symptoms

There may not be symptoms. Women who do have symptoms may have them in the time leading up to menopause. Problems may be:

  • Irregular periods
  • Hot flashes and night sweats
  • Problems sleeping, such as insomnia
  • Vaginal dryness, discharge, itching, and pain with sex

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done. The doctor will ask about your periods. This is often enough to make the diagnosis.

Sometimes, a blood test to look for follicle-stimulating hormone (FSH) may be done to confirm the diagnosis. High levels of FSH suggest menopause.

Treatment

Menopause is a normal part of life. It does not need treatment.

Hormone changes can cause symptoms. These can be managed with medicine and lifestyle changes.

Female Reproductive Organs
Osteoporosis
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Hormone Replacement Therapy (HRT)

HRT can be used for a short time. Here are some options:

  • Estrogens
  • Progesterone
  • A blend of estrogen and progesterone
  • Low amounts of male hormones

Non-hormone Options

HRT is not a good choice for some women. Here are other options:

  • Certain blood pressure medicines
  • Antidepressant medicines
  • Antiseizure medicines

Lifestyle Changes

Some lifestyle changes may help manage symptoms, such as eating a healthful diet and exercising reguarly.

Prevention

Menopause is a normal part of aging that cannot be prevented.

RESOURCES

Office on Women's Health  https://www.womenshealth.gov 

The North American Menopause Society  http://www.menopause.org 

CANADIAN RESOURCES

Health Canada  https://www.canada.ca 

Women's Health Matters—Women's College Hospital  http://www.womenshealthmatters.ca 

References

American College of Obstetricians and Gynacologists (ACOG). Practice Bulletin No. 141: management of menopausal symptoms. Obstet Gynecol. 2014 Jan;123(1):202-16, reaffirmed 2016, correction can be found in Obstet Gynecol 2016 Jan;127(1):166.

Menopause. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/menopause  . Updated December 5, 2019. Accessed July 22, 2020.

Menopause. Planned Parenthood website. Available at: https://www.plannedparenthood.org/learn/health-and-wellness/menopause. Accessed July 22, 2020.

Menopause 101: A primer for the perimenopausal. North American Menopause Society website. Available at: http://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/menopause-101-a-primer-for-the-perimenopausal. Accessed July 22, 2020.

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