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Menopause is a natural phase in every woman's life. It is the time when a woman stops having monthly periods, and the ovaries stop releasing eggs and making the hormones estrogen and progesterone. Most women are between the ages of 45 and 55 when menopause occurs. The average age is 51. Some women in their 30s can experience symptoms of early menopause, or perimenopause.

"Most women start to wonder about menopause when their periods start to change," explains Mary McKenzie, D.O. Dr. McKenzie says common signs menopause has started include:

  • having periods more or less often than usual (for example, every 5 to 6 weeks instead of every 4)
  • bleeding lasts for fewer days than before
  • skipping 1 or more periods
  • symptoms of menopause, such as hot flashes

"If your uterus has been removed, but you still have your ovaries, it might be tough to tell when you are going through menopause. Still, women who do not have a uterus can have menopause symptoms," explains Dr. McKenzie.

Those symptoms vary from woman to woman. Dr. McKenzie says most women have one or more of the following symptoms.

  • Hot flashes - Hot flashes feel like a wave of heat that starts in your chest and face and then moves through your body. Hot flashes usually start happening before you stop having periods.
  • Night sweats - When hot flashes happen during sleep, they are called "night sweats." They can make it hard to get a good night's sleep.
  • Sleep problems - During the transition to menopause, some women have trouble falling or staying asleep. This can happen even if night sweats are not a problem.
  • Vaginal dryness - Menopause can cause the vagina and tissues near the vagina to become dry and thin. This can be uncomfortable or make sex painful.
  • Depression - During the transition to menopause, some women start having symptoms of depression. That's especially true for women who have been depressed before. Depression symptoms include: sadness, losing interest in doing things and sleeping too much or too little.
  • Trouble concentrating or remembering things - This might be caused by lack of sleep that often happens at menopause, or by the lack of estrogen. Some experts suspect estrogen is important for good brain function.

Many women who experience these symptoms often wonder if they should see a doctor. "If your periods start changing, you are 45 or older and you have symptoms that really bother you, see your doctor," says Dr. McKenzie. "For instance, you should see your doctor if you cannot sleep because of night sweats, or if you start to feel sad or blue and don't seem to enjoy things anymore."

You should also see your doctor if you:

  • Have your period more often than every 3 weeks
  • Have very heavy bleeding during your period
  • Have spotting between your periods
  • Have been through menopause (have gone 12 months without a period) and start bleeding again, even if it's just a spot of blood

Menopause symptoms can be treated in a variety of ways. Options include hormone replacement therapy (HRT), antidepressants, and plant-derived estrogens.

"The hormone estrogen is the most effective treatment for menopause symptoms and prevents osteoporosis (thinning of the bones)," explains Dr. McKenzie. "You should not take hormones if you have had breast cancer, a heart attack, a stroke, a blood clot or smoke."

Women who have vaginal dryness without other symptoms of menopause can try vaginal estrogen. "This is a form of estrogen that goes directly into the vagina without systemic effects. It comes in creams, tablets, or a flexible ring," says Dr. McKenzie.

Antidepressants can ease hot flashes and depressions. Dr. McKenzie says even women who are not depressed can take them to ease menopause symptoms.

Plant-derived estrogens, or phytoestrogens, have been marketed as a "natural" or "safer" alternative to hormones for women with menopausal symptoms. Phytoestrogens are found in many foods, including soybeans, chickpeas, lentils, flaxseed, grains, fruits, vegetables, and red clover. Isoflavone supplements are phytoestrogens as well. Dr. McKenzie warns phytoestrogens have not been proven to help reduce hot flashes or night sweats. "Most studies have not reported benefit. In addition, some phytoestrogens might act like estrogen in some tissues of the body. Many experts suggest women who have a history of breast cancer should avoid phytoestrogens."

Herbal treatments have also been used to relieve menopause symptoms, but Dr. McKenzie says studies have yet to demonstrate efficacy better than placebo. There are also some safety concerns. "Some herbs, including black cohosh, might stimulate breast tissue, similar to estrogen. Like phytoestrogens, herbal treatments are not recommended for women with high risk for breast cancer," Dr. McKenzie says. It is best to discuss treatments options with your doctor to ensure the safest, most effective therapy.

Osteoporosis is a big concern for women going through menopause. Dr. McKenzie suggests woman take calcium and vitamin D supplements to help strengthen bones. She also advises, "Be active. Exercise helps keep bones strong. And ask your doctor when you should start having bone density tests." Dr. McKenzie says your doctor can prescribe medicines to help keep your bones strong, if needed.

memorial health partnersCHI Memorial Medical Group
5600 Brainerd Road, Suite 500, Chattanooga, TN 37411