Menopause Health Center
Menopause and Perimenopause - Overview
What is menopause? What is perimenopause?
Menopause is the point in a woman's life when she has not had a menstrual period for 1 year. Menopause marks the end of the childbearing years. It is sometimes called "the change of life."
For most women, menopause happens around age 50, but every woman's body has its own timeline. Some women stop having periods in their mid-40s. Others continue well into their 50s.
Perimenopause is the process of change that leads up to menopause. It can start as early as your late 30s or as late as your early 50s. How long perimenopause lasts varies, but it usually lasts from 2 to 8 years. You may have irregular periods or other symptoms during this time.
Menopause is a natural part of growing older. You don't need treatment for it unless your symptoms bother you. But it’s a good idea to learn all you can about menopause. Knowing what to expect can help you stay as healthy as possible during this new phase of your life.
What causes menopause?
Normal changes in your reproductive and hormone systems cause menopause. As your egg supply ages, your body begins to ovulate less often. During this time, your hormone levels go up and down unevenly (fluctuate), causing changes in your periods and other symptoms. In time, estrogen and progesterone levels drop enough that the menstrual cycle stops.
Some medical treatments can cause your periods to stop before age 40. Having your ovaries removed, radiation therapy, or chemotherapy can trigger early menopause.
What are the symptoms?
Common symptoms include:
- Irregular periods. Some women have light periods. Others have heavy bleeding. Your menstrual cycle may be longer or shorter, or you may skip periods.
- Hot flashes.
- Trouble sleeping (insomnia).
- Emotional changes. Some women have mood swings or feel grouchy, depressed, or worried.
- Headaches.
- Feeling that your heart is beating too fast or unevenly (palpitations).
- Problems with remembering or thinking clearly.
- Vaginal dryness.
Some women have only a few mild symptoms. Others have severe symptoms that disrupt their sleep and daily lives.
Symptoms tend to last or get worse the first year or more after menopause. Over time, hormones even out at low levels, and many symptoms improve or go away. Then you can enjoy being free from periods and birth control concerns.
Do you need tests to diagnose menopause?
You don't need to be tested to see if you have started perimenopause or reached menopause. You and your doctor will most likely be able to tell based on irregular periods and other symptoms.
If you have heavy, irregular periods, your doctor may want to do tests to rule out a serious cause of the bleeding. Heavy bleeding may be a normal sign of perimenopause. But it can also be caused by infection, disease, or a pregnancy problem.
WebMD Medical Reference from Healthwise
Menopause and Perimenopause Topics
VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION 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.

