Menopause – Causes, Risk factors, Symptoms, Diagnosis, Treatment, Prevention

What is Menopause

Menopause is the natural end of menstruation. Menopause can occur as early as age 40 or even as late as age 60. If menopause occurs before age 40, it is thought that this is abnormal and is called premature menopause.

Menopause is the result of the depletion of ovaries in the ovaries and the reduction of female hormones. Menopause is considered complete when you have not had your period for a full year. Instead of being a single moment in life, menopause is a process or transition period in which women move from the phase of life in which reproduction is possible.

Menopause is a normal part of life. It marks the end of a slow and long process that begins when the ovaries begin to produce less estrogen and progesterone. These female hormones are important for normal menstrual cycles and for a successful pregnancy. In premenopausal women, surgery to remove the ovaries, called ovariectomy, causes the premature onset of menopause. This is known as 'surgical menopause.'

In addition to its role in reproduction, estrogen is an important hormone to maintain bone health, and could also play important roles in heart health, skin elasticity, and brain function.

Stages of Menopause


It could start 3-5 years before your last menstrual period
It lasts about one year from the last menstruation.
Signs and symptoms may appear during this phase


Complete cessation of menstrual periods
Did not have menstruation for a year, has surgical menopause or has a menopausal confirmation with a blood test.
Having children is no longer possible naturally


It starts after the last menstruation.
You no longer have menstrual periods.
Increase the risk of suffering from certain health problems. These include osteoporosis, cardiovascular diseases and vaginal dryness.

Risk Factors for Premature Menopause

A risk factor is something that increases your chance of getting a disease or condition.

Menopause is a natural process, which usually occurs at approximately 50 years of age. However, if the normal menstrual cycle is interrupted before age 40, it is thought to be abnormal and is called premature menopause.

Risk factors for premature menopause include:

  • Premature menopause family history
  • Surgical removal of the ovaries
  • Radiation
  • Chemotherapy
  • Medications that reduce estrogen levels
  • Smoking
  • Autoimmune diseases
  • Medical treatments (pelvic surgery, surgical removal of the ovaries, chemotherapy, or pelvic radiation therapy)

Symptoms of Menopause

Each woman experiences menopause in a different way. Some women have many symptoms and others have few. Changing levels of estrogen and progesterone can cause this variety of symptoms.

Symptoms include:

Irregular menstruation and ovulation

Shorter or longer cycles
Heavier or lighter bleeding
Blood dripping between periods
Reduced Fertility


Reported up to 75% of American women
Sudden onset of a sensation of heat
Face and neck reddened
They last between 30 seconds and five minutes
They happen at any time
They usually stop within a few years after menopause

Vaginal Problems and Bladder

The skin in the genital area becomes more dry and thinner
Sexual intercourse could become painful
Vaginal dryness and burning
Problems in the urinary tract, such as infection and incontinence may occur

Changes in Sexuality

It could change the attitude towards sex
Decrease in sexual appetite
Excitement and comfort may be difficult to achieve
Relief from worries by chance are pregnancies (but contraceptives should be used until one year after the last menstruation)
The risk of sexually transmitted diseases remains

Fatigue and Sleeping Difficulties

Normal sleep patterns may be interrupted
Early morning awakening
Changes in the mood
Stress and change in family dynamics could contribute to mood problems

Visible Changes in Your Body

Thickening at the waist
Loss of muscle mass
Increase in fat
Loss of elasticity in the skin

Others Possible Symptoms

Rigidity or joint and muscle pain
Difficulty concentrating
Thinning hair; most prominent facial hair

Diagnosis of Menopause

Natural menopause is usually diagnosed when a woman has not had her menstrual period for 12 consecutive months. The doctor will ask about the symptoms, the medical history and family history, and perform a physical examination. You may have blood tests, a pelvic exam, and a Pap test.

Most women between 45 and 55 have symptoms of menopause. The doctor will evaluate if it is necessary to perform tests to detect other possible causes of these symptoms.

In most cases, hormone tests are not needed. However, the doctor may order a follitropin (FSH) test, which measures the level of the hormone in the blood. This is done to confirm that you are in menopause. The women most likely to undergo this test are those who have had a hysterectomy with ovarian conservation. Without the cessation of menstrual periods as a guide, the FSH level could be used to diagnose menopause.

FSH is produced by your pituitary gland and stimulates your ovaries to produce estrogen. As your estrogen levels decrease, your pituitary gland produces more FSH, which enters your blood in an attempt to stimulate more estrogen. When the blood level of FSH rises evenly at certain levels, it is likely that you have reached menopause. It may take more than one FSH test to confirm menopause. You should not be taking birth control pills when you take the FSH test because the birth control pills contain hormones that will affect the results of the test.

Treatments for menopause

Menopause is a natural part of life and does not necessarily require treatment. Decide how to proceed in the best way when talking to your doctor. The treatment plan must be considered according to the person. First, consider how the symptoms are impacting your daily life. Then, talk with your doctor about your family history and medical history. Remember to talk about the risks of heart disease, osteoporosis and breast cancer.

Remember that any decision is not final. You can, and should, review it with your doctor every year during your annual review. You can see a gynecologist, a general practitioner, or an internist doctor.

It is also important to check the screening tests you may need based on your age, family history and medical history.

The treatments for menopause are aimed at:

  • Reduce the unpleasant physical and psychological symptoms of menopause
  • Reduce the risk of osteoporosis, heart disease and stroke

The treatment involves the following:

Changes in Lifestyle to Control Menopause

You may have to make some changes in lifestyle that will help you maintain good health after menopause. Remember that the risk of heart disease and osteoporosis increases with age. Some simple changes in lifestyle may help reduce the symptoms of menopause and improve overall health.

Heart health

If you take care of your heart, you can reduce the risk of heart disease, stroke and even some types of cancer.

  • If you smoke, stop smoking: smoking is the main preventable cause of premature death.
  • Follow a healthy diet: increase the consumption of fruits, vegetables and whole grains. The diet should have a low content of saturated fats and trans fats.
  • Exercise regularly: aim to do 30 to 60 minutes of exercise every day. This causes chemical substances to be released in the brain that make it feel better.
  • Control stress: stress comes from all aspects of life. Learn to relax and find time for yourself. This includes exercise and other pleasurable activities. Some relaxation techniques include meditation, deep breathing, progressive relaxation, yoga and biofeedback.

Bone Health

The body replaces the bone tissue permanently. With menopause and aging, the loss of bone tissue accelerates, making it difficult to replace it. This can lead to osteoporosis. You can reduce the risk of osteoporosis if you eat between 1,200 and 1,500 mg of calcium and 800 units of vitamin D every day.

Increase calcium intake by incorporating the following foods into the diet:

  • Green leafy vegetables.
  • Calcium-rich low-fat dairy, such as yogurt or milk.
  • Fruits and juices fortified with calcium.

Vitamin D helps your body absorb calcium. Increase your vitamin D intake by eating the following foods:

  • Fortified milk or other low-fat dairy products
  • Liver
  • Tuna

You also get vitamin D with sun exposure. Limit the amount of time you spend in the sun. With runs of a few minutes, some days a week, it is enough.

Talk to your doctor before taking any vitamin D or calcium supplement.

Improve sleep

Below are some ways to improve sleep:

  • Keep a regular sleep schedule.
  • Decrease noise, temperature and lighting in the bedroom.
  • Avoid caffeine, nicotine and alcohol before bedtime.
  • Dine something light and avoid heavy meals at night

Reduce the consumption of caffeine and alcohol

Decreased caffeine consumption can reduce the symptoms of anxiety and insomnia. It may also reduce the loss of calcium from your bones and reduce your risk of other health problems. You can drink alcohol in moderation. Drinking in moderation means one or two drinks per day.

Stay cool.

If you are having hot flashes, try to keep a diary of when they happen and what seems to cause them. This could help you find out what you should avoid. Otherwise:

  • When an embarrassment starts, go somewhere that is cool.
  • Sleeping in a cool room may prevent hot flashes from waking you up during the night.
  • Dress with several layers so you can remove them if you feel hot.
  • Use sheets and clothes that allow the skin to breathe.
  • Carry a small fan that runs on batteries in your briefcase or bag.
  • Try to drink a cold drink, such as water or juice, at the start of a hot flash.
  • Avoid hot foods such as soup or spicy foods.

Reduce Your Risk of Complications Associated with Menopause

Because menopause is a natural biological event in every woman's life, there is no way to prevent it from happening. This will happen.

However, take measures designed to reduce your risk of diseases associated with the loss of estrogen, including osteoporosis and heart disease. These include:

Maintain a healthy diet

A healthy diet during menopause can improve your sense of well-being. It can reduce the risk of heart disease, osteoporosis and certain cancers. Your diet should be low in saturated fat and high in fruits, vegetables, and grains. An adequate intake of calcium (1,200-1,500 mg per day) can help reduce your risk of osteoporosis. You can increase the amount of calcium in your diet by incorporating more low-fat, high-calcium foods, such as leafy green vegetables, and calcium-fortified foods and juices. Vitamin D, present in sunlight and some foods such as fortified milk, liver and tuna, helps the body absorb calcium.

Reduce the consumption of caffeine and alcohol

The decrease in caffeine consumption can reduce the symptoms of anxiety and insomnia. You can drink alcohol in moderation. Drinking in moderation means limiting alcohol consumption to one or two drinks per day.

Stop smoking

Smoking is the leading preventable cause of premature death. Quitting smoking can reduce your risk of early menopause, heart disease, osteoporosis, and many types of cancer, including lung and cervical cancer. Many women stop smoking successfully, often after several attempts. Your healthcare provider may offer medications and other cessation aids, such as patches and nicotine gum. Support groups and classes to stop smoking can also help. The most successful smoking cessation programs involve a combination of behavior modification techniques and medication therapy.

Exercise regularly

Regular exercise is a great remedy for many symptoms of menopause. It helps promote better sleep, stimulates brain chemicals that can reduce negative feelings and depression, and may reduce hot flashes. Weight-bearing exercises such as walking, climbing stairs, and resistance exercises such as lifting weights help strengthen your bones and reduce your risk of osteoporosis.

Control Stress

During menopause, you could face many stressors, such as raising children or having children leave home, caring for parents in old age, and cope with numerous responsibilities. You can reduce stress by taking care of your whole being. This means eating a healthy diet, sleeping the right amount, exercising regularly, and having enough time for rest and recreation. A variety of relaxation techniques can also help you cope more effectively with stress. Examples include meditation, deep breathing, deep relaxation, yoga, and bio-feedback.


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