Consult this primer for details regarding the onset of menopause.
Menopause is the normal biological process in which a woman's ovaries gradually reduce hormone production and eventually stop producing eggs, ending fertility. Menopause affects all women differently; some experience a few relatively mild symptoms, while acute ongoing complications plague others.
Generally, menopause commences with a period known as perimenopause during which the ovaries' production of estrogen and progesterone decreases. On average, perimenopause begins during a woman's late 30s or early 40s and lasts about four years. Twelve months after the final menstruation, menopause is reached. In the U.S., the average age at menopause occurs is 51, according to the North American Menopause Society.
One of the first symptoms many women notice is a change in menstruation. Where it was once light and regular, it may now be heavy and unpredictable. These changes in the menstrual cycle, especially if they begin in the early 40s, may herald the onset of perimenopause. As the ovaries release less estrogen and progesterone, perimenopausal women may experience a myriad of related physical symptoms. Approximately 75-to-85 percent of women in North America will experience hot flashes, sudden, brief sensations of heat flooding the face and upper body, according to the Mayo Clinic. In addition, the following symptoms affect many perimenopausal and menopausal women:
• Mood swings
• Vaginal dryness
• Sleep disruption
• Change in sex drive
• Thinning hair on head
• Abdominal fat increase
• Urinary urgency
• Urinary leakage when laughing, coughing and exercising
• Change in menstruation (heavier/lighter, more or less frequent, unpredictable)
• Hot flashes and night sweats
If symptoms are severe enough, hormone replacement therapy (HRT) options may be prescribed. For many women, hot flashes are the most disturbing symptom of menopause. To date, the most effective relief for hot flashes is estrogen therapy. There are certain risks associated with hormone therapy, however, and some doctors prescribe other treatments. Medications like Effexor (an antidepressant), Neurontin (anti-seizure) and Catapres (for high blood pressure) have been shown to reduce the frequency and severity of hot flashes. Each has accompanying side effects that should be taken into consideration before therapy begins.
When menopause occurs naturally, it is usually gradual and only requires treatment if symptoms become severe. However, sometimes menopause occurs earlier because of medical interventions like hysterectomy (removal of the uterus), oophorectomy (removal of the ovaries), chemotherapy or radiation. In addition, that Mayo clinic estimates that about 1 out of 100 women experience premature ovarian failure, often for unknown reasons. Any of these can cause early menopause, which may provoke more intense physical reactions. For these women, The North American Menopause Society's "Early Menopause Guidebook" provides helpful information about available treatments.
• To find physicians who specialize in treating menopausal symptoms, consult the North American Menopause Society's referral lists.