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The Manual's Editorial Staff

Reviewed/Revised Feb 2023
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Topic Resources

What is menopause?

Menopause is when women stop having periods (stop menstruating) and can no longer get pregnant.

Menopause usually happens after age 40. In the United States, the average age for menopause is about 52.

  • Some symptoms, such as irregular periods and hot flashes, may appear years before you go through menopause

  • Your bones may weaken after menopause

  • Some doctors may give you medicines to help with your symptoms

Menopause doesn't happen all at once. Over time, your periods happen less often. Menopause is complete when you haven’t had a period for a full year. It is possible to get pregnant before then. If you don't want to get pregnant, use birth control until you've gone a year without any periods.

What causes menopause?

Menopause is normal and happens as your body ages.

For several years before menopause, your body gradually makes less estrogen and progesterone. These are sex hormones that are needed for menstruation (getting your period) and pregnancy. With less of these hormones, your ovaries stop releasing eggs, and your periods stop.

What are the symptoms of menopause?

Menopause doesn't happen all of a sudden. At first you may notice:

  • Irregular periods

  • Hot flashes (when you suddenly feel hot and sweaty, even thought it isn't hot)—hot flashes last from 30 seconds to about 5 minutes

  • Waking up covered with sweat (night sweats, which are hot flashes that occur at night)

At the same time, many women also have symptoms like:

  • Mood changes

  • Depression

  • Irritability

  • Worry

  • Sleep problems

  • Loss of focus

  • Headache

  • Tiredness

These symptoms often go on for a year or more. Eventually your periods stop completely, and the symptoms usually get better. Sometimes hot flashes go on longer.

Symptoms after menopause are due to lower levels of sex hormones. You may have:

How can doctors tell if I have menopause?

Usually, menopause needs no tests. If it begins too early, doctors may check for other diseases that can make your periods stop.

How do doctors treat menopause?

Understanding menopause may help you cope with your symptoms. Talking with other women who have gone through menopause or with your doctor may also help you decide what treatment can work for you.

Because your symptoms are caused by low hormone levels, taking hormones (hormone replacement therapy) is the most effective way to relieve symptoms. However, hormone replacement has risks so doctors usually try other things first.

Hot flash treatments may include:

  • Dressing in removable layers of clothes

  • Wearing clothing that breathes or wicks moisture, such as cotton and sports clothes

  • Avoiding hot environments and bright lights

  • Certain medicines that aren't hormones

Incontinence treatments may include:

  • Exercises to strengthen the muscles that stop and start urination

Dry vagina treatments may include:

  • Vaginal lubricant or moisturizer

  • Continuing to have sex—this increases blood flow to the vagina

Some women take medicinal herbs and other supplements Overview of Dietary Supplements Dietary supplements are the most common therapies among integrative medicine and health (IMH) and complementary and alternative medicine (CAM), which include healing approaches and therapies... read more to relieve symptoms. There are many different supplements. Most of them don’t work well, and none are reviewed for safety the way prescription medicines are. Also, some herbs and supplements can interfere with other medicines you take. If you’re thinking about taking supplements, discuss them with your doctor.

Hormone therapy

If other treatments don't work, hormone therapy may help. However, hormone therapy has benefits and risks. Talk to your doctor about whether these treatments are right for you.

Hormone therapy can include:

  • Estrogen

  • A progestin (such as progesterone)

  • Both (combination therapy)

Hormone therapy can be given as:

  • Pills

  • Creams, tablets, or rings you put in your vagina

  • Lotions or sprays you put on your skin

  • Skin patches

Benefits of hormone therapy include:

  • Lessened menopause symptoms like hot flashes and vaginal dryness

  • Lower chance of getting osteoporosis (weakened bones)

  • Lower chance of getting endometrial cancer (cancer of the lining of the uterus)

  • Lower chance of getting colorectal cancer (cancer in the lower parts of the large intestine)

Risks of hormone therapy include:

  • Blood clots in your lungs or legs (with progestin alone)

  • Stroke

  • Higher chance of getting endometrial cancer (with estrogen alone)

  • Higher chance of getting breast cancer (after 3 to 5 years of taking combination therapy or 10+ years of taking estrogen)

  • Urinary incontinence (with estrogen alone)

  • Lower levels of the "good" (HDL) cholesterol (with progestin alone)

Taking lower doses may lower these risks.

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