Menopause - Symptoms and causes - Mayo Clinic

Menopause is the time that marks the end of your menstrual cycles. It's diagnosed after you've gone 12 months without a menstrual period. COVID-19:Advice,updatesandvaccineoptions FindoutaboutCOVID-19,COVID-19vaccines,andMayoClinicpatientandvisitorupdates. Skiptositenavigation SkiptoContent ThiscontentdoesnothaveanEnglishversion.ThiscontentdoesnothaveanArabicversion. SectionsforMenopauseSymptoms&causesDiagnosis&treatmentDoctors&departments Print OverviewMenopauseisthetimethatmarkstheendofyourmenstrualcycles.It'sdiagnosedafteryou'vegone12monthswithoutamenstrualperiod.Menopausecanhappeninyour40sor50s,buttheaverageageis51intheUnitedStates. Menopauseisanaturalbiologicalprocess.Butthephysicalsymptoms,suchashotflashes,andemotionalsymptomsofmenopausemaydisruptyoursleep,loweryourenergyoraffectemotionalhealth.Therearemanyeffectivetreatmentsavailable,fromlifestyleadjustmentstohormonetherapy.Products&ServicesAssortmentWomen'sHealthProductsfromMayoClinicStoreBook:MayoClinicTheMenopauseSolutionShowmoreproductsfromMayoClinic SymptomsInthemonthsoryearsleadinguptomenopause(perimenopause),youmightexperiencethesesignsandsymptoms: Irregularperiods Vaginaldryness Hotflashes Chills Nightsweats Sleepproblems Moodchanges Weightgainandslowedmetabolism Thinninghairanddryskin Lossofbreastfullness Signsandsymptoms,includingchangesinmenstruationcanvaryamongwomen.Mostlikely,you'llexperiencesomeirregularityinyourperiodsbeforetheyend. Skippingperiodsduringperimenopauseiscommonandexpected.Often,menstrualperiodswillskipamonthandreturn,orskipseveralmonthsandthenstartmonthlycyclesagainforafewmonths.Periodsalsotendtohappenonshortercycles,sotheyareclosertogether.Despiteirregularperiods,pregnancyispossible.Ifyou'veskippedaperiodbutaren'tsureyou'vestartedthemenopausaltransition,considerapregnancytest. WhentoseeadoctorKeepupwithregularvisitswithyourdoctorforpreventivehealthcareandanymedicalconcerns.Continuegettingtheseappointmentsduringandaftermenopause. Preventivehealthcareasyouagemayincluderecommendedhealthscreeningtests,suchascolonoscopy,mammographyandtriglyceridescreening.Yourdoctormightrecommendothertestsandexams,too,includingthyroidtestingifsuggestedbyyourhistory,andbreastandpelvicexams. Alwaysseekmedicaladviceifyouhavebleedingfromyourvaginaaftermenopause.MoreInformationBleedingaftermenopause:Isitnormal?CaffeineandmenopausesymptomsVaginaldrynessaftermenopause:Howtotreatit?   Thereisaproblemwith informationsubmittedforthisrequest.Review/updatethe informationhighlightedbelowandresubmittheform. FromMayoClinictoyourinbox Signupforfree,andstayuptodateonresearchadvancements,healthtipsandcurrenthealthtopics,likeCOVID-19,plusexpertiseonmanaginghealth. Email ErrorEmailfieldisrequired ErrorIncludeavalidemailaddress LearnmoreaboutMayoClinic’suseofdata. Toprovideyouwiththemostrelevantandhelpfulinformation,andunderstandwhich informationisbeneficial,wemaycombineyouremailandwebsiteusageinformationwith otherinformationwehaveaboutyou.IfyouareaMayoClinicpatient,thiscould includeprotectedhealthinformation.Ifwecombinethisinformationwithyourprotected healthinformation,wewilltreatallofthatinformationasprotectedhealth informationandwillonlyuseordisclosethatinformationassetforthinournoticeof privacypractices.Youmayopt-outofemailcommunicationsatanytimebyclickingon theunsubscribelinkinthee-mail. Subscribe! Thankyouforsubscribing OurHousecalle-newsletterwillkeepyouup-to-dateonthelatesthealthinformation. Sorrysomethingwentwrongwithyoursubscription Please,tryagaininacoupleofminutes Retry RequestanAppointmentatMayoClinic CausesMenopausecanresultfrom: Naturallydecliningreproductivehormones.Asyouapproachyourlate30s,yourovariesstartmakinglessestrogenandprogesterone—thehormonesthatregulatemenstruation—andyourfertilitydeclines. Inyour40s,yourmenstrualperiodsmaybecomelongerorshorter,heavierorlighter,andmoreorlessfrequent,untileventually—onaverage,byage51—yourovariesstopreleasingeggs,andyouhavenomoreperiods. Surgerythatremovestheovaries(oophorectomy).Yourovariesproducehormones,includingestrogenandprogesterone,thatregulatethemenstrualcycle.Surgerytoremoveyourovariescausesimmediatemenopause.Yourperiodsstop,andyou'relikelytohavehotflashesandexperienceothermenopausalsignsandsymptoms.Signsandsymptomscanbesevere,ashormonalchangesoccurabruptlyratherthangraduallyoverseveralyears. Surgerythatremovesyouruterusbutnotyourovaries(hysterectomy)usuallydoesn'tcauseimmediatemenopause.Althoughyounolongerhaveperiods,yourovariesstillreleaseeggsandproduceestrogenandprogesterone. Chemotherapyandradiationtherapy.Thesecancertherapiescaninducemenopause,causingsymptomssuchashotflashesduringorshortlyafterthecourseoftreatment.Thehalttomenstruation(andfertility)isnotalwayspermanentfollowingchemotherapy,sobirthcontrolmeasuresmaystillbedesired.Radiationtherapyonlyaffectsovarianfunctionifradiationisdirectedattheovaries.Radiationtherapytootherpartsofthebody,suchasbreasttissueortheheadandneck,won'taffectmenopause. Primaryovarianinsufficiency.About1%ofwomenexperiencemenopausebeforeage40(prematuremenopause).Prematuremenopausemayresultfromthefailureofyourovariestoproducenormallevelsofreproductivehormones(primaryovarianinsufficiency),whichcanstemfromgeneticfactorsorautoimmunedisease.Butoftennocauseofprematuremenopausecanbefound.Forthesewomen,hormonetherapyistypicallyrecommendedatleastuntilthenaturalageofmenopauseinordertoprotectthebrain,heartandbones. ComplicationsAftermenopause,yourriskofcertainmedicalconditionsincreases.Examplesinclude: Heartandbloodvessel(cardiovascular)disease.Whenyourestrogenlevelsdecline,yourriskofcardiovasculardiseaseincreases.Heartdiseaseistheleadingcauseofdeathinwomenaswellasinmen.Soit'simportanttogetregularexercise,eatahealthydietandmaintainanormalweight.Askyourdoctorforadviceonhowtoprotectyourheart,suchashowtoreduceyourcholesterolorbloodpressureifit'stoohigh. Osteoporosis.Thisconditioncausesbonestobecomebrittleandweak,leadingtoanincreasedriskoffractures.Duringthefirstfewyearsaftermenopause,youmaylosebonedensityatarapidrate,increasingyourriskofosteoporosis.Postmenopausalwomenwithosteoporosisareespeciallysusceptibletofracturesoftheirspine,hipsandwrists. Urinaryincontinence.Asthetissuesofyourvaginaandurethraloseelasticity,youmayexperiencefrequent,sudden,strongurgestourinate,followedbyaninvoluntarylossofurine(urgeincontinence),orthelossofurinewithcoughing,laughingorlifting(stressincontinence).Youmayhaveurinarytractinfectionsmoreoften. StrengtheningpelvicfloormuscleswithKegelexercisesandusingatopicalvaginalestrogenmayhelprelievesymptomsofincontinence.Hormonetherapymayalsobeaneffectivetreatmentoptionformenopausalurinarytractandvaginalchangesthatcanresultinurinaryincontinence. Sexualfunction.Vaginaldrynessfromdecreasedmoistureproductionandlossofelasticitycancausediscomfortandslightbleedingduringsexualintercourse.Also,decreasedsensationmayreduceyourdesireforsexualactivity(libido). Water-basedvaginalmoisturizersandlubricantsmayhelp.Ifavaginallubricantisn'tenough,manywomenbenefitfromtheuseoflocalvaginalestrogentreatment,availableasavaginalcream,tabletorring. Weightgain.Manywomengainweightduringthemenopausaltransitionandaftermenopausebecausemetabolismslows.Youmayneedtoeatlessandexercisemore,justtomaintainyourcurrentweight. ByMayoClinicStaff RequestanAppointmentatMayoClinic Diagnosis&treatment Oct.14,2020 Print Shareon:FacebookTwitter Showreferences Menopausebasics.OfficeonWomen'sHealth.https://www.womenshealth.gov/menopause/menopause-basics.AccessedSept.8,2020. CasperRF.Clinicalmanifestationsanddiagnosisofmenopause.https://www.uptodate.com/contents/search.AccessedSept.8,2020. JamesonJL,etal.,eds.Menopauseandpostmenopausalhormonetherapy.In:Harrison'sPrinciplesofInternalMedicine.20thed.McGrawHill;2018.https://accessmedicine.mhmedical.com.AccessedSept.9,2020. Frequentlyaskedquestions:Women'sHealthFAQ047.Themenopauseyears.AmericanCollegeofObstetriciansandGynecologists.https://www.acog.org/patient-resources/faqs/womens-health/the-menopause-years.AccessedSept.9,2020. AmericanCollegeofObstetriciansandGynecologists.PracticeBulletinNo.141:Managementofmenopausalsymptoms.Obstetrics&Gynecology.2014;doi:10.1097/01.AOG.0000441353.20693.78. SantenRJ,etal.Menopausalhotflashes.https://www.uptodate.com/contents/search.AccessedSept.8,2020. Menopauseandyourhealth.OfficeonWomen'sHealth.https://www.womenshealth.gov/menopause/menopause-and-your-health.AccessedSept.15,2020. WeltCK,etal.Ovariandevelopmentandfailure(menopause)innormalwomen.https://www.uptodate.com/contents/search.AccessedSept.8,2020. NorthAmericanMenopauseSociety.The2017hormonetherapypositionstatementofTheNorthAmericanMenopauseSociety.Menopause.2017;doi:10.1097/GME.0000000000000921. WeltCK.Pathogenesisandcausesofspontaneousprimaryovarianinsufficiency(prematureovarianfailure).https://www.uptodate.com/contents/search.AccessedSept.8,2020. WeltCK.Clinicalmanifestationsanddiagnosisofspontaneousprimaryovarianinsufficiency(prematureovarianfailure).https://www.uptodate.com/contents/search.AccessedSept.8,2020. Heartdiseasefacts.CentersforDiseaseControlandPrevention.https://www.cdc.gov/heartdisease/facts.htm.AccessedSept.8,2020. MenoNote:Vaginaldryness.TheNorthAmericanMenopauseSociety.http://www.menopause.org/publications/consumer-publications/-i-menonotes-i-.AccessedSept.9,2020. AskMayoExpert.Menopausalhormonetherapy(adult).MayoClinic;2019. Menopausesymptomsandrelief.OfficeonWomen'sHealth.https://www.womenshealth.gov/menopause/menopause-symptoms-and-relief.AccessedSept.15,2020. NorthAmericanMenopauseSociety.Nonhormonalmanagementofmenopause-associatedvasomotorsymptoms:2015positionstatementofTheNorthAmericanMenopauseSociety.Menopause.2015;doi:10.1097/GME.0000000000000546. Menopausalsymptoms:Indepth.NationalCenterforComplementaryandIntegrativeHealth.https://www.nccih.nih.gov/health/menopausal-symptoms-in-depth.AccessedSept.8,2020. Yoga,Kegelexercises,pelvicfloorphysicaltherapy.NorthAmericanMenopauseSociety.https://www.menopause.org/for-women/sexual-health-menopause-online/effective-treatments-for-sexual-problems/yoga-kegel-exercises-pelvic-floor-physical-therapy.AccessedSept.9,2020. Blackcohosh.NaturalMedicines.https://naturalmedicines.therapeuticresearch.com.AccessedSept.9,2020. Redclover.NaturalMedicines.https://naturalmedicines.therapeuticresearch.com.AccessedSept.9,2020. Kava.NaturalMedicines.https://naturalmedicines.therapeuticresearch.com.AccessedSept.9,2020. Dongquai.NaturalMedicines.https://naturalmedicines.therapeuticresearch.com.AccessedSept.9,2020. DHEA.NaturalMedicines.https://naturalmedicines.therapeuticresearch.com.AccessedSept.9,2020. Wildyam.NaturalMedicines.https://naturalmedicines.therapeuticresearch.com.AccessedSept.9,2020. Menopause.U.S.FoodandDrugAdministration.https://www.fda.gov/medical-devices/home-use-tests/menopause.AccessedSept.16,2020. BachmannG,etal.Treatmentofgenitourinarysyndromeofmenopause(vulvovaginalatrophy).https://www.uptodate.com/contents/search.AccessedSept.8,2020. BurnettTL(expertopinion).MayoClinic.Sept.18,2020. Related Bioidenticalhormones:Aretheysafer? Bleedingaftermenopause:Isitnormal? Caffeineandmenopausesymptoms Hormonetherapy Menopausehormonetherapyandyourheart Menopausehormonetherapy:Doesitcausevaginalbleeding? Testosteronetherapyinwomen Vaginaldrynessaftermenopause:Howtotreatit? 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