Menopause is the time in a woman’s life when she naturally stops having menstrual periods. Menopause marks the end of the reproductive years. The average age of menopause for women in the United States is 51 years.
Most women enter a transitional phase in the years leading up to menopause called perimenopause. Perimenopause is a time of gradual change in the levels of estrogen, a hormone that helps control the menstrual cycle. Changing estrogen levels can bring on symptoms such as hot flashes and sleep changes. To manage these symptoms, some women may choose to take hormone therapy.
The signs and symptoms that many women experience during perimenopause are caused by gradually decreasing levels of estrogen. You may have only a few symptoms, or you may have many. Symptoms may be mild, or they may be severe.
Changes in Your Menstrual Cycle
A common sign of perimenopause is a change in your menstrual cycle. Cycles may become longer than usual for you, or they may become shorter. You may begin to skip periods. The amount of flow may become lighter or heavier. Although changes in menstrual bleeding are normal as you approach menopause, you still should report them to your health care provider. Abnormal bleeding may be a sign of a problem. Talk to your health care provider if you have any of the following:
- Bleeding between periods
- Bleeding after sex
- Spotting at anytime in the menstrual cycle
- Bleeding that is heavier or lasts for more days than usual
- Any bleeding after menopause
Although the removal of the uterus (a hysterectomy) ends menstrual periods, it does not cause menopause unless the ovaries also are removed. This type of surgery is called an oophorectomy. An oophorectomy causes immediate menopause signs and symptoms if it is done before a woman reaches menopause.
Menopause has happened when a woman has not had a period for one year. The average age for menopause in the U.S. is 51. A few women go through menopause in their 30’s. The ovaries stop releasing eggs. Since the ovaries produce hormones, the change in the ovaries affects a balance of hormones in the body.
If the woman does not start hormone therapy, the symptoms of estrogen deficiency will worsen over time. This deficiency can affect the vagina, brain, bone, blood vessels, skin, joints, mucous membranes, and genitals.
What About Hormone Therapy?
Women beginning hormone therapy near menopause have a significantly reduced risk of coronary heart disease1 and an overall reduced incidence of mortality2. Research shows the earlier the hormone therapy is started, the greater the long-term benefit2. There is a reduced incidence of Alzheimer’s disease with early hormone therapy taken at least 10 years3. As with any treatment, discuss your individual situation and your risk factors with your provider to determine the best treatment for you.
1 Journal of Women’s Health 2006; 2 Menopause 2007; 3 Journal of Neuroscience Research 2006