Menopause simply means the end of menstruation for one year. As a woman ages, there is a gradual decline in the function of her ovaries and the production of estrogen. Around the time a woman turns 40, this process speeds up. This transition is known as perimenopause.
Women typically menstruate for the last time at about 50 years of age. A few stop menstruating as young as 40, and a very small percentage as late as 60. Women who smoke tend to go through menopause a few years earlier than nonsmokers. Most women notice some menstrual changes -- such as periods occurring closer together, skipped menstrual periods, and occasional heavy periods -- up to a few years before menstruation ceases. Women who have menses which occur very close together, are heavier, and last longer than normal should call their health care provider because these could be signs of uterine cancer as well.
If you’ve been on hormone replacement therapy (HRT) for a while to relieve menopause symptoms, you may be wondering, what now? Should you stop taking it? If so, when? And how do you go about it?
If you are healthy, most experts agree that HRT is safe to use at the lowest dose that helps for the shortest time needed. If you're 59 or older, or have been on hormones for 5 years, you should talk to your doctor about quitting.
There is great variation in how different women experience menopause. About 75% of women have hot flashes. Nighttime hot flashes and sweats are more common and may result in chronic sleep deprivation. Mood changes aren't as well understood, but some women report an obvious change in mood. In addition, women may experience vaginal dryness, painful intercourse, and urinary symptoms. These symptoms are often temporary and pass as your body adjusts. Hormone replacement therapy (HRT) can help relieve these symptoms in the meantime. Non-hormonal treatment options also are available. Talk to your health care provider to see what approach is right for you.
Menopause does increase your risk of osteoporosis (thinning of the bones) and heart disease. Talk with your health care provider about how you can decrease these risks.