Menopause Health Center
Menopause and Perimenopause - Cause
Natural and expected hormone changes cause perimenopause, menopause, and postmenopause.
Perimenopause
As you age, your body begins the natural sequence of changes that eventually bring an end to your menstrual cycle (menopause). The number and quality of your eggs decline, hormone levels fluctuate, and your menstrual cycle becomes less predictable. This time of unpredictable change is called perimenopause.
Menopause and postmenopause
After a few years of fluctuating hormones, your estrogen and progesterone levels begin to decline. When your estrogen drops past a certain point, your menstrual cycle and your ability to become pregnant end. After 1 year with no menstrual bleeding, you reach menopause and begin postmenopause.
A year or more into postmenopause, estrogen levels typically even out at a low level. Since estrogen also plays a role in other functions of your body, its decline has far-reaching effects, including faster bone loss and drying and thinning of the skin and the vaginal and urinary tracts.
Menopause can be caused suddenly and prematurely by surgical removal of the ovaries (oophorectomy), by chemotherapy, or by radiation therapy to the abdomen or pelvis.
Causes of early menopause
Your body has its own timeline for when menopause will start and how long it will last. In fact, it's likely that your timeline will be much like your mother's was. But certain lifestyle choices and medical treatments can cause or are linked to an earlier menopause, including:
- Smoking. On average, women who smoke reach menopause 1½ years earlier than those who don't. The longer you have smoked and the more you smoke, the stronger this effect is likely to be.2
- Radiation therapy to or removal of the pituitary gland.
- Chemotherapy.
- Radiation therapy or other treatment to the abdomen or pelvis that damages the ovaries so that they no longer function.
- Genetic and autoimmune diseases.
- Removal of both ovaries (oophorectomy), which causes sudden menopause.
- Living at high altitudes.2
- A vegetarian diet.2
- Low body fat (body mass index of 25 or less).
WebMD Medical Reference from Healthwise
Menopause and Perimenopause Topics
VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRIPTION ONLY.
INDICATION
Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.
IMPORTANT SAFETY INFORMATION
Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).
Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.
The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.
You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see Full Prescribing Information for Vivelle-Dot.
A generation ago, no one talked about menopause. Today it's openly discussed. But some common menopause myths persist.
