Menopause is a phase within a woman's reproductive cycle where there have been twelve consecutive months without a mentrual cycle. Menopause can occur naturally or be the result of surgery (where the ovaries and/or uterus is removed), chemotherapy, radiation therapy, or primary ovarial insufficiency (Mayo, 2023). Although menopause can occur during your 40s or 50s, the average age for menopause to occur is 51 (Mayo, 2023).
When occurring naturally, ovaries stop producing estrogen and progesterone. It is a gradual process that occurs in stages. The first stage is perimenopause that can begin anywhere between eight to ten years before monopause. During this period, estrogen and progesterone are produced at different levels and decrease durin this period. The next period is menopause where the ovaries cease to release eggs and producing estrogen for twelve consecutive months. During this time, women tend to have increased symptoms. The last stage is postmenopause. In this stage, symptoms decrease and there is an increased risk of certain health conditions such as osteoporosis, stroke, and heart disease (Cleveland Clinic, 2023)(OASH, 2023(Duke, 2023).
There are many signs and symptoms of menopause to include:
- Hot flashes (vasomotor symptoms) - sudden feeling of warmth that encompasses the entire body
- Night sweats
- Cold flashes
- Vaginal dryness
- Urinary urgency
- Urinary Tract Infections
- Insomnia
- Emotional changes - irritability, mood swings, anxiety
- Dry skin
- Dry eyes
- Dry mouth
- Racing heart rate
- Weight gain
- Joint and muscle aches
- Difficulty concentrating
- Changes in libido
- Breast tenderness
- Increasing symptoms of PMS
- Irregular periods
- Hair loss (Cleveland Clinic, 2023)
- Estrogen levels
- Follicle Stimulating Hormone (FSH)
- Luteinizing Hormones (LH) (Medline, 2020)
- Hormone therapy - can replace hormones that ovaries no longer make. Helps symptoms like hot flashes and vaginal dryness. Can also help to prevent Osteoporosis.
- Estrogen therapy (ET) - can be used only with women that have had their uterus removed. There is a risk with ET when used with women who still have their uterus in tact of endometrial cancer.
- Hormone Thereapy with both Estrogen and Progesterone (EPT) - can be used with women who still have their uterus in tact.
- Risks of hormone therapy include:
- Gallstones
- Deep Vein Thrombosis
- Pulmonary Embolism
- Stroke
- Risks are lower when therapy is started within 10 years of menopause
- Non Hormonal therapy
- Changing diet - limit caffiene and spicy foods
- Avoiding triggers of hot flashes
- keep bedroom cool at night
- Quitting smoking
- Losing weight
- Excercise - can help with insomnia
- Support groups - outlet for emotions
- Anti-depressants - can manage mood swings
- Gabepentin - decreases hot flashes
- Clonidine - decreases hot flashes
- Fezolinetant - decreases hot flashes
- Medications to prevent or treat Osteoporosis (Mayo, 2023)
- Endometrial or vaginal atrophy
- Uterine or endometrial cancer
- Endometrial hyperplasia
- Uterine polyps
- Cervical cancer
- Cervicitis
- Endometritis (Cleveland Clinic, 2023)
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