Menopause

What is menopause?
Menopause is a normal change in a woman's life when her menstrual period stops. That's why some people call menopause "the change of life" or "the change." Before menopause a woman's body slowly produces less of the hormones estrogen and progesterone. This often happens between the ages of 45 and 55 years old. A woman has reached menopause when she has not had a period for 12 months in a row - whether menopause was natural or induced. Menopause, as defined by health care professionals, is only one day in a woman's life - the day after she has not had a menstrual period for 12 consecutive months, and no other biological or physiological cause can be identified.

What is perimenopause?
Perimenopause is a transition period before menopause when a woman's body starts making less of the female hormones. During this time, women can have symptoms such as hot flashes and mood swings, and may or may not have a period. While the average age to experience perimenopause is age 51, a few women reach natural menopause as early as their 30s (which is called premature menopause) and as late as their 60s.

What are the symptoms of menopause?
Every woman's period will stop at menopause. Some women may not have any other symptoms at all. As you near menopause, you may have:
• Changes in your period - the length of time between periods or flow may be different.
• Hot flashes ("hot flushes") - getting warm in the face, neck and chest.
• Night sweats and sleeping problems that lead to feeling tired, stressed or tense.
• Changes in mood - mood swings, depression or irritability.
• Vaginal changes - the vagina may become dry and thin, and sex may be painful.
• Thinning of your bones, which may lead to loss of height and bone breaks (osteoporosis).

What is surgical menopause?
Sometimes, younger women need a hysterectomy (surgery to remove the uterus and ovaries) to treat health problems such as endometriosis or cancer. After surgery, the body will enter into what is known as induced or surgical menopause. Since the ovaries are removed the woman will no longer have periods and may experience menopausal symptoms immediately rather than gradually.

Women who have a hysterectomy removing only the uterus will not have induced menopause because the ovaries will continue to make hormones. But, because the uterus is removed, the woman will no longer have a period or be able to bear children. Some women might have hot flashes as the surgery can sometimes disturb the blood supply to the ovaries. Natural menopause might also occur a year of two earlier than expected.

What is premature menopause?
Premature menopause is menopause that happens before the age of 40 - whether it is natural or induced. Some women have premature menopause because of:
• Family history (genes)
• Medical treatments, such as surgery to remove the ovaries
• Cancer treatments, such as chemotherapy or radiation to the pelvic area

Who needs treatment for symptoms of menopause?
• For some women, many of these changes will go away over time without treatment.
• Some women will choose treatment for their symptoms and to prevent bone loss. If you choose treatment, estrogen alone or estrogen with progestin (for a woman who still has her uterus or womb) can be used.

This document was developed by the National Women's Health Resource Center (NWHRC) using information and documents from the FDA and other agencies of the Department of Health and Human Services.