Menopause - Symptoms & Information

Lifestages and Perimenopause Dr. Horner explains perimenopause

Perimenopause - Natural Medicine by Dr. Marci Scott

Menopause Dr. Camilla Parham explains menopause

Menopause symptoms and descriptions

Alternative Treatments for perimenopause symptoms from peer reviewed research journals

Estriol Cream may offer benefits for post-menopausal women without side effects

Progesterone What are the benefits and side effects?

Plastic endocrine disruptor

Soy endocrine disruptor

Medical Review of Herbal Remedies ADHD - ADD Acid Reflux Symptoms Alzheimer's Disease Anxiety Attack Symptoms Breast Cancer Symptoms Cancer Defense Chronic Fatigue Syndrome Cold, Flu - Sinus Infections Congestive Heart Failure Colon Cancer Symptoms Crohn's Disease Depression Symptoms Detoxification Diabetes Symptoms Fibromyalgia Heart Disease Prevention Heart Attack Symptoms Immune System Defense Irritable Bowel Syndrome Lung Cancer Osteoarthritis Symptoms Ovarian Cancer Pregnancy Signs Stomach Ulcer Symptoms Thyroid Cancer Pictures of Skin Cancer Perimenopause Symptoms Prostate Cancer

Get Free Information about Herb, Vitamin and Drug Interactions!

Health Notes is the leading provider of science-based information on healthy living. Gathered from scientific studies published in over 550 peer-reviewed medical and scientific journals. Visit Health Notes for drug interactions

MEDLINEplus Health Encyclopedia - Menopause A.D.A.M. / National Library of Medicine www.nlm.nih.gov

Menopause Symptoms Mayo clinic www.mayoclinic.com

Menopause Symptoms Emedicine.com www.emedicinehealth.com

What are the symptoms of menopause and their treatments? Univ Maryland www.umm.edu

Menopause Self-help Guide National Health Service, NHS Direct online United Kingdom www.nhsdirect.nhs.uk

Menopause Symptoms Aetna InteliHealth / Harvard Medical School www.intelihealth.com

Health Care Directory
Our Approach
Contact Us

Menopause Symptoms

By th National Institutes of Health (NIH)

Changes in periods. One of the first signs may be a change in a woman’s periods. Many women become less regular; some have a lighter flow than normal; others have a heavier flow and may bleed a lot for many days. Periods may come less than 3 weeks apart or last more than a week. There may be spotting between periods. Women who have had problems with heavy menstrual periods and cramps will find relief from these symptoms when menopause starts.

Hot flashes. A hot flash is a sudden feeling of heat in the upper part or all of your body. Your face and neck become flushed. Red blotches may appear on your chest, back, and arms. Heavy sweating and cold shivering can follow. Flashes can be as mild as a light blush or severe enough to wake you from a sound sleep (called night sweats). Most flashes last between 30 seconds and 5 minutes.

Problems with the vagina and bladder. The genital area can get drier and thinner as estrogen levels change. This dryness may make sexual intercourse painful. Vaginal infections can become more common. Some women have more urinary tract infections. Other problems can make it hard to hold urine long enough to get to the bathroom. Some women find that urine leaks during exercise, sneezing, coughing, laughing, or running.

Sex. Some women find that their feelings about sex change with menopause. Some have changes to the vagina, such as dryness, that makes sexual intercourse painful. Others feel freer and sexier after menopause — relieved that pregnancy is no longer a worry. Until you have had 1 full year without a period, you should still use birth control if you do not want to become pregnant. After menopause a woman can still get sexually transmitted diseases (STDs), such as HIV/AIDS or gonorrhea. If you are worried about STDs, make sure your partner uses a condom each time you have sex.

Sleep problems. Some women find they have a hard time getting a good night’s sleep – they may not fall asleep easily or may wake too early. They may need to go to the bathroom in the middle of the night and then find they aren’t able to fall back to sleep. Hot flashes also may cause some women to wake up.

Mood changes. There may be a relationship between changes in estrogen levels and a woman’s mood. Shifts in mood may also be caused by stress, family changes such as children leaving home, or feeling tired. Depression is NOT a symptom of menopause.

Menopause Overview

Use your back button to navigate the menopause symptom menu.

You may not even notice two important changes that happen with menopause.

• Loss of bone tissue can weaken your bones and cause osteoporosis.
  
  
• Heart disease risk may grow, due to age-related increases in weight, blood pressure, and cholesterol levels.

• Don’t smoke.

• Eat a healthy diet that is low in fat and cholesterol and moderate in total fat. Your diet should –aim to be high in fiber and include fruits, vegetables, and whole-grain foods. It should also be well balanced in vitamins and minerals, including calcium.

• Lose weight if you are overweight.

• Take part in weight-bearing exercise, such as walking, jogging, running, or dancing, at least 3 days each week.

• Take medicine to lower your blood pressure if your doctor prescribes it for you.

• For vaginal discomfort, use a water-based vaginal lubricant (not petroleum jelly) or an estrogen cream.

or about other treatments (for example, biofeedback) that may ease menopausal symptoms.

What About Menopause and the Effects of Phytoestrogens?

National Institute on Aging
U. S. Department of Health and Human Services National Institutes of Health
September 2002

Menopause & Menopause Treatments

By The National Women's Health Information Center

• What is menopause?
• Symptoms of menopause?
• I will be having a hysterectomy to remove both my uterus and my ovaries, and I am only 37. Will I go into menopause?
• What is premature menopause?
• What is postmenopause?
• I've reached menopause, but I still have been feeling so depressed and irritable. I'm just not myself. Will these feelings ever go away?
• I've reached menopause and haven't had my period for a few years now. But, the other day I had some bleeding off and on. Should I be concerned?
• Who needs treatment for the symptoms of menopause?
• What are the benefits and risks of hormone therapy?
• So, what have we learned about taking hormone therapy for menopause?
• What about natural treatments for menopause?
• How else can I help my symptoms?
• How can I stay healthy as I age?
• Do you have a tool I can use to track my symptoms?

See Also: Perimenopause

What is menopause?

Menopause is a normal change in a woman's life when her period stops. That's why some people call menopause the change of life.” During menopause a woman's body slowly makes 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 (and there are no other causes for this change). As you near menopause you may have symptoms from the changes your body is making. Many women wonder if these changes are normal, and many are confused about how to treat their symptoms. You can feel better by learning all you can about menopause, and talking with your doctor about your health and your symptoms. If you want to treat your symptoms, he or she can teach you more about your options and help you make the best treatment choices.

What are the symptoms of menopause?

Every woman's period will stop at menopause. Some women may not have any other symptoms. But, as you near menopause, you may have:

• Changes in your period the time between periods and the flow from month to month may be different.
• Abnormal bleeding or spotting" common as you near menopause. But if your periods have stopped for 12 months in a row and you still have spotting,” you should report this symptom to your doctor to rule out serious causes, such as cancer.
• Hot flashes (hot flushes”) getting warm in the face, neck and chest.
• Night sweats and sleeping problems these may lead to feeling tired, stressed, or tense.
• Vaginal changes the vagina may become dry and thin, and sex and vaginal exams may be painful. You also might get more vaginal infections.
• Thinning of your bones this may lead to loss of height and bone breaks (osteoporosis).
• Mood changes such as mood swings, depression, and irritability.
• Urinary problems such as leaking, burning or pain when urinating, or leaking when sneezing, coughing, or laughing.
• Problems with concentration or memory.
• Less interest in sex and changes in sexual response.
• Weight gain or increase in body fat around your waist.
• Hair thinning or loss.

I will be having a hysterectomy to remove both my uterus and my ovaries, and I am only 37. Will I go into menopause?

Sometimes, younger women need a hysterectomy (surgery to remove the uterus and ovaries) to treat health problems such as endometriosis or cancer. After your surgery, you will enter into what is known as induced or surgical menopause. This is menopause that happens to your body right away, and it is brought on by the surgery. You will no longer have periods. Since your ovaries will be removed, you may have many menopausal symptoms right away, instead of gradually. You can talk with your doctor about how to best manage these symptoms.

Women who have a hysterectomy, but have their ovaries left in place, will not have induced menopause because their ovaries will continue to make hormones. But, because their uterus is removed, they no longer have their periods and they cannot bear children. They also might have hot flashes since the surgery can sometimes disturb the blood supply to the ovaries. Later on, they also might have natural menopause a year or 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

Having premature menopause puts a woman at more risk for osteoporosis later in her life. It also may be a source of great distress, since many women younger than 40 still want to have children. Women who still want to become pregnant can talk with their doctor about donor egg programs.

What is postmenopause?

The term postmenopause refers to all the years beyond menopause. It is the period past the time at which you have not had a period for 12 months in a row — whether your menopause was natural or induced.

I've reached menopause, but I still have been feeling so depressed and irritable. I'm just not myself. Will these feelings ever go away?

Many women in perimenopause and menopause feel depressed and irritable. Some researchers believe that the decrease in estrogen triggers changes in your brain, causing depression. Others think that other symptoms you're having, such as sleep problems, hot flashes, night sweats, and fatigue cause these feelings. Or, it could be a combination of hormone changes and symptoms. But these symptoms also can have causes that are unrelated to menopause. If you are having these symptoms, and you think they are interfering with your quality of life, it is important to discuss them with your doctor. Talk openly with your doctor about the other things going on in your life that might be adding to your feelings. Other things that could cause depression and/or anxiety include:

• having depression during your lifetime before menopause
• feeling negative about menopause and getting older
• increased stress
• having severe menopause symptoms
• smoking
• not being physically active
• not being happy in your relationship or not being in a relationship
• not having a job
• not having enough money
• low self-esteem (how you feel about yourself)
• not having the social support you need
• regretful that you can't have children anymore

If you need treatment for these symptoms, you and your doctor can work together to find a treatment that is best for you.

I've reached menopause and haven't had my period for a few years now. But, the other day I had some bleeding off and on. Should I be concerned?

Changes in bleeding are normal as you near menopause. There are also other common causes of bleeding in the years after menopause. The decline in your body's estrogen levels can cause tissues lining the vagina to become thin, dry, and less elastic. Sometimes this lining can become broken or easily inflamed and bleed. It can also become injured during sex or even during a pelvic exam. Once you've reached menopause, though, you should report any bleeding that you have to your doctor. Uterine bleeding after menopause could be a sign of other health problems. Other things that can cause abnormal bleeding include:

• fibroids
• the use of birth control pills
• a hormonal imbalance
• non-cancerous growths in the lining of the uterus

Who needs treatment for the symptoms of menopause?

For some women, many of their menopause symptoms will go away over time without treatment. Other women will choose treatment for their symptoms and to prevent bone loss that can happen near menopause. Treatments may include prescription drugs that contain types of hormones that your ovaries stop making around the time of menopause. Hormone therapy can contain estrogen alone or estrogen with progestin (for a woman who still has her uterus or womb). Estrogen therapy usually is taken by pill, skin patch, as a cream or gel, or with an intrauterine device (IUD) or vaginal ring. How estrogen is taken can depend on its purpose. For instance, a vaginal ring or cream can ease vaginal dryness, leakage of urine, or vaginal or urinary infections, but does not relieve hot flashes. If you want to prevent bone loss, you also should talk with your doctor about medicines other than hormone therapy that can help your bones.

What are the benefits and risks of hormone therapy?

Benefits: Hormone therapy can help with menopause by:

• reducing hot flashes
• treating vaginal dryness
• slowing bone loss
• decreasing mood swings and depression

DO NOT use hormone therapy to prevent heart attacks, strokes, memory loss or Alzheimer's disease. Remember there also are other medicines that can help your bones.

Risks: For some women, hormone therapy may increase their chance of getting:

• blood clots
• heart attacks
• strokes
• breast cancer
• gall bladder disease

For a woman with a uterus, taking estrogen alone, without progesterone, increases her chance of getting endometrial cancer (cancer of the lining of the uterus). Adding progesterone to the hormone therapy lowers this risk.

Hormone therapy also may cause these side effects:

• bleeding
• bloating
• breast tenderness or enlargement
• headaches
• mood changes
• nausea

So, what have we learned about taking hormone therapy for menopause?

We know that hormone therapy may be a way to get over the symptoms of menopause if taken for only a short time and in the smallest amount. Hormones do NOT help prevent heart or bone disease, stroke, memory loss or Alzheimer's disease. If you decide to use hormones, use them at the lowest dose that helps and for the shortest time needed. Check with your doctor every 3 to 6 months to see if you still need them. Because there are both benefits and risks linked to taking them, every woman should think about these in regard to her own health and discuss these issues with her doctor. We are still trying to learn more about the long- and short-term effects of hormone therapies on women's health. For more information on the risks and benefits of hormone therapy, go to http://www.nhlbi.nih.gov/
health/women/index.htm.

What about natural treatments for menopause?

Some women decide to take herbal, natural, or plant-based products to help their symptoms. Some of the most common ones are:

• Soy. This contains phytoestrogens (estrogen-like substances from a plant). But, there is no proof that soyor other sources of phytoestrogensreally do relieve hot flashes. And the risks of taking soy, especially the pills and powders, are not known. You can get soy from foods too. Soy food products include tofu, tempeh, soy milk, and soy nuts. These soy products are more likely to work on mild hot flashes.
• Other sources of phytoestrogens. These include herbs such as black cohosh, a member of the buttercup family, wild yam, dong quai, and valerian root.
• Bioidentical hormone therapy. Some women visit alternative medicine doctors and get a prescription for these products, which are made from different plant hormones that are like those in a woman's body. Each prescription is hand-mixed, and the dose can vary from patient to patient.

Products that come from plants may sound like they are more natural or safer than other forms of hormones, but there is no proof they really are. There also is no proof that they are better at helping symptoms of menopause. Make sure to discuss herbal products with your doctor before taking them. You also should tell your doctor if you are taking any other medicines, since some of the herbal products can be harmful to you with other drugs.

How else can I help my symptoms?

• Hot Flashes. A hot environment, eating or drinking hot or spicy foods, alcohol, or caffeine, and stress can bring on hot flashes. Try to avoid these triggers. Dress in layers and keep a fan in your home or workplace. Regular exercise might also bring relief from hot flashes and other symptoms. Ask your doctor about taking an antidepressant medicine. There is proof that these can be helpful for some women.
• Vaginal Dryness. Use an over-the-counter vaginal lubricant. There are also prescription estrogen replacement creams that your doctor might give you. If you have spotting or bleeding while using estrogen creams, you should see your doctor.
• Problems Sleeping. One of the best ways to get a good night's sleep is to get at least 30 minutes of physical activity on most days of the week. But, avoid a lot of exercise close to bedtime. Also avoid alcohol, caffeine, large meals, and working right before bedtime. You might want to drink something warm, such as herb tea or warm milk, before bedtime. Try to keep your bedroom at a comfortable temperature. Avoid napping during the day and try to go to bed and get up at the same times every day.
• Memory problems. Ask your doctor about mental exercises you can do to improve your memory. Try to get enough sleep and be physically active.
• Mood swings. Try to get enough sleep and be physically active. Ask your doctor about relaxation exercises you can do. Ask your doctor about taking an antidepressant medicine. There is proof that these can be helpful. Think about going to a support group for women who are going through the same thing as you, or getting counseling to talk through your problems and fears.

How can I stay healthy as I age?

There are a lot of ways to stay healthy during this time in your life. These steps are more likely to keep you healthy than just taking hormones:

• Be active and get more exercise. Try to get at least 30 minutes on most days of the week. Try weight-bearing exercises, like walking, running, or dancing.
• If you smoke, quit. Ask your doctor for help. You also can visit this special section of the NWHIC web site: www.4woman.gov/QuitSmoking
• Eat healthy.
• Eat lots of whole grain products, vegetables, and fruits.
• Choose foods low in fat and cholesterol.
• Get enough calcium to keep your bones strong. Before menopause, you need about 1,000 mg of calcium per day. After menopause, you need 1,500 mg per day.
• If you drink alcohol, limit it to no more than one drink per day.
• Control your weight. Ask your doctor what a healthy weight is for you.
• Talk with your doctor and get regular check-ups:
• Discuss bone health. Ask if you are getting enough calcium and vitamin D. Get a bone density test if you're over 65, or if your doctor says you have a high chance of getting osteoporosis. Ask about taking medicine to help preserve bone and slow down bone loss.
• Have your blood pressure, cholesterol, and blood sugar checked.
• Have a breast exam and a breast x-ray (mammogram).

Do you have a tool I can use to track my symptoms?

You can use this chart to keep track of menopausal symptoms that bother you. Take it with you when you visit your doctor, so you both can figure out the best way to handle them.

For More Information

For more information on menopause and hormones, call the National Women's Health Information Center at 1-800-994-9662 or contact the following organizations:

National Institute on Aging (NIA), NIH, HHS
Phone: (800) 222-2225
Internet Address: http://www.nih.gov/nia

Food and Drug Administration (FDA)
Phone: (888) 463-6332
Internet Address: www.fda.gov/

American College of Obstetricians and Gynecologists (ACOG)
Phone: (202) 638-5577
Internet Address: www.acog.org

American Menopause Foundation (AMF)
Phone: (212) 714-2398
Internet Address: www.americanmenopause.org

North American Menopause Society (NAMS)
Phone: (440) 442-7550
Internet Address: www.menopause.org

The Hormone Foundation
Phone: (800) 467-6663
Internet Address: www.hormone.org

August 2004

Contact NWHIC or call 1-800-994-WOMAN

[Printer-friendly version -- PDF file, 140 Kb]

Pycnogenol May Offer An Alternative Method To Reducing Menopause Symptoms Without Unwanted Side Effects

A randomised, double-blind, placebo-controlled trial on the effect of Pycnogenol on the climacteric syndrome in peri-menopausal women. Continue

Estrogen-like effect of a Black Cohosh extract

Sept 2007, Department of Human Physiology and Pharmacology, University of Rome La Sapienza

Black cohosh (Cimicifuga racemosa) is used in the treatment of painful menstruation and menopausal symptoms. Data about the nature of the active compounds and mechanism(s) of action are still controversial, chiefly with respect to its estrogenic activity. This work aimed to assess the possible estrogenic activity of a commercial dry hydro-alcoholic extract of Black Cohosh. Continue

Herbal Supplement Black Cohosh Fails to Relieve Hot Flashes

By The National Institute of Aging - Dec. 18, 2006

The herbal supplement black cohosh, whether used alone or with other botanical supplements, did not relieve hot flashes in postmenopausal women or those approaching menopause Continue

Hormonal imbalances can cause or worsen the following:

By The National Institute of Health

• Acceleration of the aging process
• Autoimmune disorders, such as rheumatoid arthritis and thyroiditis
• Anxiety
• Breast cancer
• Breast tenderness
• Cervical dysplasia (abnormal cells on the bottom third of the cervix)
• Cold hands and feet
• Decreased sex drive
• Depression
• Dry eyes
• Fatigue
• Foggy thinking
• Hair loss
• Headaches
• Infertility
• Irregular menstrual periods
• Irritability
• Insomnia
• Magnesium deficiency
• Memory loss
• Mood swings
• Osteoporosis
• Premenstrual syndrome
• Sluggish metabolism
• Uterine cancer
• Water retention
• Weight gain, especially around the abdomen, hips, and thighs
• Zinc deficiency.6

More Menopause Resources

Menopause Changes - Estrogen & Progesterone Illustration
The Foundation for Better Health Care www.fbhc.org/

Hormone Replacement Therapy - Pros and Cons
The Health Gazette - Karl Hempel, M.D. www.freenet.scri.fsu.edu/

Menopause diagnosis, symptoms, news, research
National Libary of Medicine www.nlm.nih.gov/

Menopause Change - A Major Turning Point
Planned Parenthood www.plannedparenthood.org

Menopause Management Publication
British Menopause Society www.the-bms.org