Menopause definition and facts

• Menopause is defined as the absence of menstrual periods for 12 months. It is the time in a woman's life when the function of the ovaries ceases.
• The process of menopause does not occur overnight, but rather is a gradual process. This so-called perimenopausal transition period is a different experience for each woman.
• The average age of menopause is 51 years old, but menopause may occur as early as the 30s or as late as the 60s. There is no reliable lab test to predict when a woman will experience menopause.
• The age at which a woman starts having menstrual periods is not related to the age of menopause onset.

Most of the symptoms associated with menopause actually happen during the perimenopause stage. Some women go through menopause without any complications or unpleasant symptoms. But others find menopausal symptoms debilitating, beginning even during perimenopause and lasting for years.

The symptoms that women experience are primarily related to a lowered production of the female sex hormones estrogen and progesterone. Symptoms vary widely because of the many effects that these hormones have on the female body. 

Estrogen regulates the menstrual cycle and affects the following parts of the body: 

• reproductive system
• urinary tract
• heart 
• blood vessels
• bones
• breasts
• skin
• hair
• mucous membranes
• pelvic muscles
• brain

Changes in menstrual cycle

Your period may not be as regular as it used to be. You may bleed heavier or lighter than usual, and occasionally spot. Also, your period may be shorter or longer in duration. 
If you do miss your period, make sure to rule out pregnancy. If you’re not pregnant, a missed period could indicate the onset of menopause. 

Hot flashes

Many women complain of hot flashes as a primary menopause symptom. Hot flashes can be a sudden feeling of heat either in the upper portion of your body or all over. Your face and neck might turn red, and you may feel sweaty or flushed.

The intensity of a hot flash can range from mild to very strong, even waking you from sleep. A hot flash generally lasts between 30 seconds and 10 minutes, according to the National Institute on Aging. Most women experience hot flashes for a year or two after their final menstrual period. Hot flashes may still continue after menopause, but they lessen in intensity over time.

Insomnia or problems sleeping

For optimal health, doctors recommend adults get seven to eight hours of sleep each night. But during menopause it might be hard for you to fall asleep or stay asleep. You might wake up earlier than you wish and have trouble going to back to sleep. 

To get as much rest as you can, try relaxation and breathing techniques. It’s also important to exercise during the day so that you’re tired once you hit the sheets. Avoid leaving your computer or cell phone near your bed as lights can disrupt your sleep. Bathing, reading, or listening to mellow music before bed may help you relax. 

Simple steps to improve sleep hygiene include going to bed at the same time every night, taking steps to stay cool while sleeping, and avoiding foods and drinks that alter sleep like chocolate, caffeine, or alcohol.

Frequent urination or urinary incontinence

It’s common for women in menopause to lose control of their bladder. You may also feel a constant need to urinate even without a full bladder, or experience painful urination. This is because during menopause, the tissues in your vagina and urethra lose their elasticity and the lining thins. The surrounding pelvic muscles may also weaken.

Decreased libido

It’s common to feel less interested in sex during menopause. This is caused by physical changes brought on by reduced estrogen. These changes can include a delayed clitoral reaction time, slow or absent orgasmic response, and vaginal dryness.

Vaginal atrophy

Vaginal atrophy is a condition caused by the decline in estrogen production and characterized by the thinning and inflammation of the vaginal walls. The condition can make sexual intercourse painful for women, which can ultimately decrease their interest in sex. 

Depression and mood swings

Changes in hormone production affect the moods of women during menopause. Some women report feelings of irritability, depression, and mood swings, and often go from extreme highs to severe lows in a short period of time. It’s important to remember that these hormone fluctuations affect your brain and that “feeling blue” is not unnatural.

Skin, hair, and other tissue changes

As you age, you will experience changes in your skin and hair. Loss of fatty tissue and collagen will make your skin drier and thinner, and will affect the elasticity and lubrication of the skin near your vagina and urinary tract. Reduced estrogen may contribute to hair loss or cause your hair to feel brittle and dry. Make sure to avoid harsh chemical hair treatments, which can cause further damage.