What is menopause? Symptoms and causes

 Menopause is a natural condition for women that may cause hormonal changes and other factors that can lead to hot flashes, mood changes, and other symptoms. 

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On this page:

• What is menopause?
• Symptoms
• Causes
• Treatment
• Lifestyle tips
• Diagnosed   
• Complications
• FAQ 
• Summary

Around the time of menopause, many females experience physical symptoms such as: 

• Hot flashes

• Night sweats

• Vaginal dryness

• Decreased sex drive 

Menopause can also lead to anxiety, mood changes, and decreased sex drive.  

Menopause usually begins between the ages(1) of 40 and 58, and for some it may occur earlier due to a medical condition or treatment.  

These symptoms may begin before the end of the menstrual cycle, and can last for several years. 

The impact on a person's quality of life can range from mild to severe.  As each person will experience menopause differently.  

A healthy diet and regular exercise can help a person feel better and boost their overall health in the long term.   

For those experiencing menopausal symptoms, treatments and support are available.   

Hormone therapy and lifestyle measures can help manage these symptoms.  

In this article, let us learn about the symptoms of menopause, what menopause is, lifestyle, and treatments. 

What is menopause?

A normal condition in women, menopause is defined as the stage of life that follows the end of the menstrual cycle.   

Each person may experience menopause differently, and it may last for several years or may not end. Women go through three stages:

• The premenopausal period: This is the transitional period that begins before menopause and includes the 12 months that follow the person’s last menstrual period

• Menopause: Menopause begins either 12 months after the last menstrual period or when menstruation stops for a clinical reason, such as removal of the ovaries, other surgery, or some strenuous physical activity

• Postmenopause: Menopause refers to the years following menopause, although it can be difficult to know when menopause ends and postmenopause begins

How long do menopause symptoms last?

Studies show that people typically experience hot flashes for an average(2) of 4.5 years after the last phase and 7.4 years overall.   

However, they may last for more(3) than 10 years. 

The extended duration of these symptoms results from the body rebalancing and reducing estrogen and progesterone levels as the ovaries lose their function.

Common ages to experience symptoms

It is not possible to determine how long menopause lasts, but there are common ages to experience symptoms.  

According to the Office on Women's Health(4), the average age of menopause in women is 52, and it usually occurs between the ages of 48 and 58. 

This may happen earlier if the person has never had children or if he or she smokes. 

 The changes usually begin in the late 40s, and menstruation stops on average after about 4 years, but the transition period can last between 2 and 8 years.   

When there is no menstruation for 12 months, menopause occurs.  Sometimes menopause occurs early.  

Doctors call it "early menopause" if it occurs before the age of 40, and "early" if it begins between the ages of 40 and 45.  Early menopause occurs naturally in about 5% of females(5). 

Symptoms usually begin with hot flashes before menopause and may continue for several years afterward, but each person's hot flash severity is different. 

What are the symptoms of menopause?

Symptoms may vary from one woman to another, but menopause symptoms usually begin when estrogen levels begin to decline. 

Smokers are more likely to experience unpleasant menopause than non-smokers. Smoking can also intensify menopausal symptoms and severity, including hot flashes and difficulty sleeping.  

 Symptoms(6) may include: 

• Vaginal dryness: Low estrogen levels can lead to a decrease in vaginal lubrication.   As lubrication decreases, the vaginal tissues also become thinner.   This can lead to pain during intercourse and vaginitis

• Hot flashes: Fluctuations in hormone levels may lead to hot flashes, or a sudden feeling of heat and redness.   These flashes may be mild, occurring primarily in the upper body, or they may spread throughout the body

• Irregular menstruation: As estrogen levels decrease, your menstrual cycle may change.   A person may miss periods or experience a longer time between periods.   Your menstrual flow may also change

• Decreased fertility: As estrogen levels decline in perimenopause, conceiving may become more difficult.   When a woman reaches menopause, the ovaries stop releasing eggs, which means pregnancy is not possible

• Night sweats: Hot flashes during sleep cause night sweats, which can lead to excessive sweating that wakes the person up 

• Sudden weight gain: Metabolism tends to slow down during menopause, which may cause sudden weight changes  

• Attention problems: Many people find it difficult to focus and concentrate during menopause and may experience poor memory

• Thinning of skin and hair: Extreme fluctuations in hormone levels may cause the skin to become thinner.   Some people may experience hair loss

•  Sleep disorders: Menopause often makes it difficult to sleep.  Many find that sleep disturbances occur more often around the time of menopause.   The disorders may be related to night sweats

• Urinary frequency and urinary incontinence: During menopause, people may experience an increase in urinary frequency due to weak pelvic floor muscles

• Low mood: Some women experience mood changes during menopause.   This may be due to hormonal fluctuations, but life conditions that tend to occur around menopause can also contribute

Everyone's experience with menopause is unique.  Some people experience severe and widespread symptoms, while others may barely notice the change. 

What are the causes of menopause?  

Menopause is a normal stage in life, not a disease.  Most women experience natural menopause during middle age or in their 40s. Causes of menopause include: 

Surgery and treatment 

If a woman undergoes surgery to remove her ovaries, she will experience menopause.   If this happens before middle age, doctors may refer to it as “premature menopause.”  

A person who has clinically induced amenorrhea will experience the same symptoms(7) as someone who has natural menopause.  However, symptoms may appear suddenly.  

Some treatments, such as chemotherapy and radiotherapy, can cause the ovaries to stop working either temporarily or permanently. 

The likelihood of this happening depends on several factors, such as: 

• The person's age

• Type of treatment

• Location of the disease in the body 

Early loss of fertility may lead to sadness and depression.  

Some people decide to freeze eggs or pursue other options to have children later in life. 

People who experience early menopause may be more susceptible to heart disease and osteoporosis. 

Consulting a doctor reduces potential health effects. 

Natural menopause

A female’s reproductive years last from puberty to menopause, but as menopause approaches, levels of estrogen hormones decrease.  

And progesterone in the body because it is no longer necessary for procreation.  

Early menopause

Some women may suffer from menopause earlier than others for reasons other than therapeutic and surgical interventions, including(8): 

• An autoimmune disease

• A genetic condition that affects chromosomes, such as Turner syndrome

• Infection, such as tuberculosis, malaria, or mumps, rare cases

In short, the causes of menopause are multiple, so anyone experiencing changes in menstrual patterns before the age of 45 should see a doctor or healthcare provider for appropriate medical advice. 

What is the treatment for menopause?

The physical and psychological changes associated with menopause are undesirable. 

Therefore, it is preferable to treat this natural and healthy stage that people go through.  

After seeking medical advice, the doctor may recommend one or more of the following treatments: 

Hormone therapy

Hormone therapy is the main weapon for menopause, as this treatment helps balance(9) the body’s hormone levels by providing supplemental estrogen with progesterone.

There are different types of hormonal therapy, including: 

• Skin patches

• Topical creams

These methods can help reduce the occurrence of hot flashes and other symptoms.  

Hormone therapy may increase your risk of developing certain diseases and health conditions due to side effects of hormone therapy.  

A person should not use hormone therapy if they have risk factors for the following health problems, or if they have a personal or family history of these problems: 

• Blood clots

• Cardiovascular diseases

• High levels of triglycerides in the blood

• Liver disease

• Digestive disease such as gallbladder

• Some cancers, especially breast 

• potassium deficiency

• Stroke

 It is important to discuss the potential benefits and risks of hormone therapy with your doctor before starting treatment.  

Other medical treatments

Some other treatments depend on alleviating the symptoms of menopause. 

They may include(10) the following: 

• Medical pills, creams, and rings to treat vaginal dryness

• Low doses of antidepressants for hot flashes, even among people who are not depressed

• Over-the-counter gels and other products to treat vaginal dryness 

• Low-dose hormonal birth control pills for hot flashes, vaginal dryness, and mood changes

The American College of Obstetricians and Gynecologists(11) suggests that taking magnesium supplements can help reduce bloating, mood symptoms, and breast tenderness during menstruation. 

Studies(12) in 2015 suggest that supplements containing 1,000 mg of calcium plus 400 IU of vitamin D do not affect menopause-related symptoms over an average of 5.7 years of follow-up among postmenopausal women. 

Vitamin C may help relieve hot flashes for women during menopause by supporting the normal functioning of the adrenal glands responsible for producing stress hormones.

It is preferable to take medical advice before treatment to avoid possible side effects. 

What are the most important lifestyle tips during menopause?

Lifestyle advice depends on good lifestyle management to pass the menopause stage safely and with psychological and physical comfort.  Tips include: 

• Practice relaxation and deep breathing exercises

• Do exercise regularly and lose weight

• Quit smoking and avoid passive smoking 

• Omega-3 fatty acids may improve bone and joint health, which is especially beneficial for people in menopause, so it is recommended to eat foods rich in omega-3

• Limit your intake of alcohol and energy drinks

•  Follow a healthy diet that includes plenty of fresh fruits, such as blueberries and avocado,  vegetables such as okra and spinach, nuts such as almonds, and whole grains such as oats and sesame seeds.

• Good hours of sleep to get plenty of rest and a calm mood 

• Eating the best anti-inflammatory diet during menopause to protect the body from inflammation or other diseases such as weight gain, especially around the waist

• Practicing physical activities, such as walking, to strengthen the pelvic muscles

• Talk to friends and family about your menopause experience

• Enjoy an active, intimate relationship with your partner away from diseases

• Hiking outdoors and practicing hobbies

 Menopause can reduce a person's sex drive, but it also removes the need for birth control.   For some, this can make sex more enjoyable.  

Some tips for maintaining health and sexual activity during menopause include: 

• Practicing physical activity

• Reduce spices and food that lead to digestive problems such as heartburn

• Reduce smoking and drinking alcohol

• Taking enough time to stimulate, which leads to improved vaginal lubrication

• Do not use antiseptics and scented vaginal soaps, as this may exacerbate irritation

It is worth noting that although a woman cannot become pregnant once menopause begins, it is still important to use a barrier during penetrative sex to protect against sexually transmitted diseases.  

Being open about any concerns and eating healthy foods and physical activities can help both partners feel better and explore new forms of intimacy that reduce menopausal symptoms. 

How is menopause diagnosed?

Although menopause is not a disease, many women benefit from seeing their doctors when their menstrual cycle ends and seeking advice. 

A doctor can often confirm whether this change is caused by perimenopause or menopause by asking a few questions.  

The doctor orders blood tests to confirm the possibility of menopause.   The [PicoAMH Elisa] diagnostic test can help determine(13) whether menopause has begun.  

Other blood tests can measure levels of FSH and estradiol, a form of estrogen.   Blood levels that are persistently 30 mIU/mL or higher, combined with lack of menstruation for one year, can confirm menopause.  

Depending on your symptoms and general history, your healthcare professional may order blood tests to rule out other underlying conditions.  This includes tests for: 

• Cholesterol

• Estradiol

• Kidney function

• Liver function

• Thyroid function

• Human chorionic gonadotropin (hCG)

• Progesterone

• Prolactin

• Testosterone

However, there are no tests that can conclusively indicate that menopause has begun.

Can menopause lead to complications? 

Physical changes during menopause can increase your risk of: 

• Heart disease 

• Kidney stones

• Osteoporosis 

• Difficulty managing diabetes

•  Incontinence

• Urinary tract infections (UTIs)

• Vaginal infections 

• Decreased amount of muscle and connective tissue, including the muscles, ligaments, and tissues that support the bladder, uterus, vagina, and rectum, as a result of menopause and aging, but does not affect the anteverted uterus

Therefore, inform the doctor of the presence of medical conditions to avoid complications in people and take appropriate treatment. 

Frequently Asked Questions

What are the three stages of menopause? 

 There are three stages of menopause: perimenopause, menopause, and postmenopause.  

Menopause occurs before menopause.   During this stage, menstruation becomes irregular and the menstrual flow may be heavier or lighter. 

You may experience symptoms such as hot flashes and night sweats.  

Menopause is when menstruation does not occur for an entire year.   Hot flashes and other symptoms may persist.  

Postmenopause refers to the years following menopause.   

During these years, menopausal symptoms usually diminish, but other health conditions may begin, such as osteoporosis, one of the most important problems for women after the age of 50.  

What are the first signs of menopause?

Early signs of menopause usually include irregular periods, but you may also start to notice hot flashes, mood changes, and other unusual symptoms.  

What happens in menopause?

When your reproductive years end, your body begins to produce less estrogen, and menstruation eventually stops.   

This decrease in estrogen can lead to a range of symptoms, such as hot flashes.  

Summary

Menopause marks the natural end of fertility and occurs 12 months after your last menstrual period.  

Symptoms of menopause may begin several years earlier and include menstrual changes, hot flashes, night sweats, and facial flushing. 

Symptoms can continue for several years after menopause.  

It's a good idea to seek medical help if menopausal symptoms are affecting your daily life, you're experiencing other symptoms unrelated to menopause, or you're experiencing menopausal symptoms when you're younger than 45 years old.