Menopause is a biological, naturally occurring process women experience as they age. It marks the end of their reproductive phase, and usually occurs between ages 45 and 55.
During the menopause life stage, a woman's body undergoes significant changes. Eighty-five percent of women will experience symptoms that can range from mildly annoying to severely impacting physical and mental health. Sadly, there are very few healthcare professionals trained in menopause care, and women often feel disappointed and left on their own to figure things out. Fortunately, digital health technology is stepping in to bridge the gap in care and support. Now, women can access the care and support they need and deserve using an expert-developed menopause app.
What is Menopause?
Menopause is a natural biological process that occurs when women permanently stop menstruating. Menopause is reached when a woman's ovaries stop releasing eggs, and she no longer has a menstrual period. This happens because the levels of hormones produced by the ovaries, estrogen and progesterone, decrease as a woman ages.
The process of menopause is typically divided into three stages:
Perimenopause
This is the period leading up to menopause when a woman's ovaries begin to produce less estrogen and progesterone. It can last several years and start as early as a woman's 30s, but more typically in the early 40s. The menstrual cycle may become irregular, but you can still get pregnant. Before experiencing menstrual cycle irregularity, symptoms like mood swings, sleep disturbance, and low libido may begin.
Menopause
Menopause is defined as the point in time when a woman has not had a menstrual period for 12 consecutive months that is not due to another reason. At this point, the ovaries have stopped releasing eggs, you can no longer get pregnant, and estrogen levels have dropped significantly. Leading up to and around the time of menopause, symptoms such as hot flashes, sleep disturbance, and vaginal dryness may become more bothersome.
Postmenopause
This refers to the period after reaching menopause. During this time, a woman may continue to experience symptoms. Some symptoms, such as hot flashes, may decrease in frequency and intensity, while others, including vaginal dryness and bone loss, will accelerate and become more severe for many women.
Causes of Menopause
Natural menopause
For most women, menopause will happen naturally as they age.
Surgical removal of the ovaries
If you undergo surgery to remove the ovaries, you will experience menopause immediately.
Chemotherapy or radiation therapy
These treatments can trigger the process to occur earlier, during, or shortly after treatment. The halt of menstruation is not always permanent, so birth control measures should be considered.
Primary Ovarian Insufficiency (POI)
POI occurs in about one percent of women and leads to premature menopause. Several factors contribute to POI, such as autoimmune disease and genetic factors, but there may be no known cause.
What Are the Menopause Symptoms?
Menopause can cause a variety of physical and emotional symptoms. These can include:
Hot flashes
Hot flashes are the most common symptom that eighty percent of women experience for seven to nine years on average. They are characterized by a sudden feeling of warmth that spreads throughout the body, often accompanied by sweating, rapid heartbeat, and chills. Hot flashes can last a few seconds to several minutes and can be triggered by various things, including spicy food, stress, anxiety, and caffeine.
Night sweats
Night sweats are hot flashes that occur during the night, and the sweating varies from unnoticeable to waking up with night clothes and sheets drenched in sweat. Night sweats often interrupt sleep and leave women tired and irritable during the day.
Vaginal dryness
When estrogen levels decline, vaginal tissues become thinner, drier, and less elastic. This causes discomfort during sexual intercourse and an increased risk of vaginal infections.
Mood changes
Many women, even those without a history of mood disturbance, experience mood changes during menopause, including irritability, anxiety, and depression. These mood changes can be caused by hormonal changes in the body and the physical symptoms of menopause, such as sleep disturbance and fatigue.
Sleep disturbances
The most common reason for sleep disturbance during menopause is hot flashes and night sweats. However, other causes include insomnia and sleep apnea, which can seriously impact health.
Weight gain
Weight gain is a function of aging and is not a menopause symptom. The redistribution of the weight around the midsection (“belly fat”) is caused by menopause. Weight gain and belly fat are due to hormonal changes, a slower metabolism, and decreased physical activity.
Urinary symptoms
As estrogen levels decline, the tissues in the urinary tract can become thinner and less elastic, leading to urinary incontinence and an increased risk of urinary tract infections.
Changes in sexual function
Menopause can cause a decrease in libido, as well as vaginal dryness and discomfort or pain during sexual intercourse.
Treatment Options
While menopause is a normal part of aging, it can cause uncomfortable symptoms that interfere with the quality of life, work, and relationships. Fortunately, there are several treatment options available to manage the symptoms. They include:
Menopausal Hormone Therapy
Menopausal hormone therapy (MHT) is an effective treatment for hot flashes and vaginal dryness. It also benefits women at elevated risk for bone loss or fracture.
MHT is prescribed in two forms: estrogen alone or estrogen in combination with progestin (a synthetic version of progesterone).
Estrogen is the hormone that declines during menopause, and MHT replaces the estrogen that the body is no longer producing. Progestin is usually added to MHT to protect the uterus from the effects of estrogen alone, which can increase the risk of uterine cancer.
MHT comes in many forms and can be taken as a pill, patch, gel, cream, or vaginal ring.
MHT is not recommended for women with a history of breast cancer, blood clots, or stroke.
The decision to use MHT is an individual one and ideally made with a healthcare professional trained in menopausal care who can knowledgeably discuss the benefits and risks.
Non-Hormonal Treatments
There are several non-hormonal treatments available. These include:
Antidepressants: Some antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), can relieve hot flashes and mood changes.
Gabapentin: Gabapentin is an anticonvulsant medication that can relieve hot flashes.
Clonidine: Clonidine is a blood pressure medication that can relieve hot flashes.
Non-hormonal treatments are a good option for women who cannot use menopausal hormone therapy or prefer a non-hormonal approach to symptom management.
Holistic Therapies
Cognitive behavioral therapy (CBT) is recognized as a gold-standard evidence-based treatment for hot flashes, sleep, and anxiety. Research suggests CBT can be as effective as hormone therapy in managing symptoms.
Hypnotherapy is also considered a top evidence-based strategy for managing symptoms like hot flashes. It is a type of mind–body intervention in which hypnosis is used to create a state of focused attention and increased suggestibility. You are not under anyone’s “control.” Instead, hypnotherapy helps people relax and turn their attention inward to discover and utilize resources within themselves that can help them achieve desired behavioral changes or better manage pain or other physical concerns.
Lifestyle Changes
Lifestyle changes can also help manage menopause symptoms. These include:
Regular exercise: Exercise may relieve hot flashes and help manage weight gain and mood changes. Exercise can also improve sleep.
Healthy diet: A healthy diet can help manage weight gain and reduce the risk of heart disease, dementia, and bone loss, which are more common after menopause.
Stress management: Stress can trigger and worsen menopause symptoms, and stress-management techniques, such as meditation and yoga, can be helpful.
Smoking cessation: Smoking can increase the risk of premature menopause, hot flashes, and other symptoms, so quitting can be beneficial.
Conclusion
Menopause can cause uncomfortable symptoms. However, several treatment options are available to manage symptoms, such as hormone therapy, non-hormonal treatments, holistic therapies, and lifestyle changes. Discussing these options with a healthcare provider will help create a personalized plan that is right for you.
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