WHAT IS MENOPAUSE?

As menopause nears, the ovaries make less estrogen. One of the earliest and most common signs that menopause may be approaching is a change in your menstrual periods. You may skip one or more periods. The amount of flow may become lighter or heavier.
At some point, the ovaries stop making enough estrogen to thicken the lining of the uterus. This is when the menstrual periods stop.

WHAT TO EXPECT

Menopause is a natural part of aging. The lower amounts of estrogen that come with menopause will cause changes in your body. These changes occur over time.

HOT FLUSHES

The most common symptom of menopause is hot flushes (hot flashes). As many as 75% of menopausal women in the United States will have them. A hot flush is a sudden feeling of heat that rushes to the upper body and face. The skin may redden like a blush. You also may break out in a sweat.

SLEEP PROBLEMS

Hot flushes can cause a lack of sleep by often waking a woman from a deep sleep. A lack of sleep may be one of the biggest problems you face as you approach menopause.

VAGINAL AND URINARY TRACT CHANGES

Loss of estrogen causes changes in the vagina. Its lining may become thin and dry. These changes can cause pain during sexual intercourse. They also can make the vagina more prone to infection, which can cause burning and itching.

BONE AND OTHER BODY CHANGES

Bone loss is a normal part of aging. At menopause, the rate of bone loss increases. Osteoporosis, which can result from this bone loss, increases the risk of breaking bones in older women. The bones of the hip, wrist, and spine are affected most often.

EMOTIONAL CHANGES

Menopause does not cause depression. However, the change in hormone levels may make you feel nervous, irritable, or very tired. These feelings may be linked to other symptoms of menopause, such as lack of sleep.

SEXUALITY

Menopause does not have to affect your ability to enjoy sex. Although the lack of estrogen may make the vagina dry, vaginal lubricants can help moisten the vagina and make sex more comfortable. Regular sex may help the vagina keep its natural elasticity.

Some women find that they have less interest in sex around and after menopause. Lower hormone levels may decrease the sex drive. You are not completely free of the risk of pregnancy until 1 year after your last period.

THE GYNECOLOGIC VISIT

Routine health care, even if you are not sick, can help detect problems early. You should visit your doctor once a year to have regular exams and tests. Certain tests should be done regularly for all women in your age group. Your doctor may do a Pap test to check for changes in cells that could lead to cancer of the cervix. Depending on your age, your doctor may recommend that you have a mammogram.

HORMONE THERAPY

Hormone therapy can help relieve the symptoms of menopause. It can replace female hormones no longer made by the ovaries. In some cases, you may begin hormone therapy before menopause. If you are taking contraception pills, they will be stopped when you begin treatment.

BENEFITS

Estrogen is used to treat the main symptom of menopause — hot flushes. It also relieves vaginal dryness and can help to relieve some changes that can cause problems in the urinary tract. Estrogen protects against bone loss. Hormone therapy slows bone loss after menopause and helps prevent osteoporosis. Estrogen also can help reduce the risk of colon cancer.

RISKS

Like any treatment, hormone therapy is not free of risk. In women with a uterus, using estrogen alone can increase the risk of endometrial cancer because estrogen causes the lining of the uterus to grow. Taking a progestin along with estrogen will help reduce the risk of uterine problems. The drawback of using a progestin is that [some types] seem to increase the risk of breast cancer.

OTHER THERAPIES

Women can take SERMs to help treat or prevent some of the bone problems that can occur during menopause. SERMs are a type of medication that strengthen tissues of the bones.