Menopause is a natural phase of every woman’s life which marks the end of your menstrual cycles. It’s diagnosed after the period stops for 12 consecutive months. Transitional years leading up to menopause are called perimenopause and the time from the final menstrual period is called postmenopause. The age at which natural menopause occurs is between 45 and 55 years old worldwide. Menopause before the age of 40 is called premature menopause. Menopause can also be induced due to surgical procedures that involve removal of both ovaries or medical interventions like radiation therapy or chemotherapy.

Menopause occurs when your ovaries stop making female hormones necessary to maintain your menstrual cycles and fertility: estrogen and progesterone. As you near the end of your reproductive years, typically around your mid 40s, the rate of hormone production from ovaries becomes irregular and less predictable. These hormonal changes during perimenopasue can cause irregular menstrual cycles and many symptoms like hot flashes, insomnia, vaginal dryness, mood swings, low libido, and weight gain. 

Women typically start perimenopause in their mid 40s, though a wide range of ages is normal. This transitional period usually lasts for 4 to 8 years but can last longer than 10 years for some women. 

One of the first signs of perimenopause is a change in your menstrual cycles. Your period may become more often or less often and last more days or fewer days. It may be lighter or heavier. Significant changes can happen during perimenopause and there is a big variation in how women experience menopause. Common symptoms during the menopause transition include hot flashes, sleep problems, weight gain, mood swings, breast pain, vaginal and urinary issues, headaches, memory challenges, brain fog, joint pain, changes to skin, hair, and eyes. However, each woman’s experience is unique.

Menopause is associated with several health conditions. Cardiovascular disease is the leading killer of women worldwide. The rate of cardiovascular disease in women increases with a decline in estrogen levels. Estrogen is believed to have a protective effect on blood vessels. After menopause, you are also more likely to develop high cholesterol, high blood pressure, and weight gain, which increase your risk of heart disease. Diabetes is strongly linked to heart disease and your chance of developing diabetes increases with age. 

The prevalence of osteoporosis increases significantly with age. The rates of bone loss are highest at the time of menopause, with an average annual loss of 2% starting 1-3 years before menopause and lasting 5 to 10 years. By the time a woman reaches 80 years of age, she has lost about 30% of her peak bone mass. The prevalence of osteoporosis rises from 7% in women in the 50s to 35% in women 80 years and older.

A woman’s risk for developing cancer increases due to aging and obesity. It’s important to do regular cancer screening as a preventative measure.

Urinary incontinence increases with age. Menopause can lead to changes in your urinary system, resulting in bladder control difficulties and more frequent urinary tract infections. Approximately 1/3 of women will suffer from incontinence at the time of menopause.

Alzheimer’s disease is important in menopause. As more women than men are affected by Alzheimer’s Dementia (AD), female hormones have been thought to play a role. There is a link between earlier menopause and possible higher dementia risk.

There are many treatments available to manage symptoms including prescription therapies (hormone therapy, non-hormone medication options), diet and lifestyle options, vitamin and mineral options, and behavioral therapies. It’s important to seek medical professionals and get an individual treatment plan after a thorough anlaysis of risks and benefits.  

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