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Menopause is the end of a woman's menstrual cycle and fertility. It happens when the ovaries no longer make estrogen and progesterone, two hormones needed for a woman's fertility, and periods have stopped for 1 year.

Menopause happens naturally with age. But it can also happen as a result of surgery, treatment of a disease, or illness. In these cases it is called induced menopause or premature ovarian failure.

When Do Women Usually Enter Menopause?

When menopause happens naturally, it tends to happen on average at the age of 51. But for some women it can happen before age 40. this is called premature menopause. The age when women enter menopause is thought to be mostly determined by their genes.

What Are the Symptoms of Menopause?

For many women who enter menopause naturally, their menstrual cycle first becomes irregular. On average, it stops completely within about 4 years. Other symptoms that can happen during this time include:

  • Mood swings
  • Lower sex drive
  • Hot flashes
  • Sweating
  • Racing heart
  • Headaches
  • Vaginal dryness and soreness
  • Painful sex
  • Trouble sleeping

Some symptoms can last for years and affect a woman's quality of life.

What Are the Stages of Menopause?

Menopause happens slowly over these stages:

  • Perimenopause. In this stage, menstrual cycles are irregular but have not stopped. On average, women are about 47 when they reach perimenopause. About half of all women in the earlier stages to most women in the later stages of perimenopause have symptoms like hot flashes. Women can still get pregnant in perimenopause.
  • Menopause. This is when women have had their final menstrual period. Women will not be able to pinpoint their final period until they've been completely free from periods for 1 year. Hot flashes, vaginal dryness, sleep problems, and other symptoms are common in this stage.
  • Postmenopause. This stage happens after women have had no periods for at least 1 year. Once a woman is past menopause, she will be referred to as postmenopausal for the rest of her life. Note: After more than 1 year of no menstrual periods due to menopause, any vaginal bleeding is considered abnormal.  


Are There Any Tests for Menopause?

The most accurate way to tell if a woman is in menopause is to watch her menstrual cycles for 12 consecutive months. It helps to keep track of periods and chart them as they become irregular.

Follicle stimulating hormone (FSH) levels will dramatically rise as the ovaries begin to shut down; these levels are checked through a blood test. The drop in estrogen can lead to signs such as hot flashes, vaginal dryness, and less lubrication.

In addition, the tissue in and around the vagina thins as estrogen drops. The only way to check for this is through a Pap-like smear, but it is rarely done. Thinning of this area can lead to urinary incontinence, painful sex, a low sex drive, and vaginal itching. 

experiencing moderate to severe painful intercourse

Moderate to Severe Painful Sex Due to Menopause?

Many women experiencing very painful sex after menopause never initiate a conversation with their healthcare providers. But providers can help. Open up and start talking.

find the words to get help

Find the Words to Get Help

Don't live in silence about the changes you face in your menopausal years. Moderate to severe painful intercourse after menopause can often be treated. You are not alone.

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Important Safety Information for Osphena

Most Important Information you should know about Osphena (ospemifene)

Osphena works like estrogen in the lining of the uterus, but can work differently in other parts of the body.

Taking estrogen alone or Osphena may increase your chance for getting cancer of the lining of the uterus, strokes, and blood clots. Vaginal bleeding after menopause may be a warning sign of cancer of the lining of the uterus. Your healthcare provider should check any unusual vaginal bleeding to find out the cause, so tell them right away if this happens while you are using Osphena.

You and your healthcare provider should talk regularly about whether you still need treatment with Osphena.

Call your healthcare provider right away if you get changes in vision or speech, sudden new severe headaches, and severe pains in your chest or legs with or without shortness of breath, weakness and fatigue.

Osphena should not be used if you have unusual vaginal bleeding; have or have had certain types of cancers (including cancer of the breast or uterus); have or had blood clots; had a stroke or heart attack; have severe liver problems; or think you may be pregnant. Tell your healthcare provider if you are going to have surgery or will be on bed rest.

Possible side effects of Osphena

Serious but less common side effects can include stroke, blood clots, and cancer of the lining of the uterus.

Common side effects can include hot flashes, vaginal discharge, muscle spasms and increased sweating.

Tell your healthcare provider about all of the medicines you take as some medicines may affect how Osphena works. Osphena may also affect how other medicines work.

What is Osphena (ospemifene) tablets?

Osphena is a prescription oral pill that treats painful intercourse, a symptom of changes in and around your vagina, due to menopause.

Please read the Patient Information for Osphena (ospemifene) tablets, including Boxed WARNING in the Full Prescribing Information.

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