When a woman reaches menopause, her estrogen level has declined enough so that she has no menstrual bleeding, and bearing children is no longer possible. It is important to remember that once a woman has been through menopause, she is postmenopausal for the rest of her life. It is not a condition that she "outgrows".
Hormone levels do not usually decline in a uniform way. They rise and fall again and again over time. These hormone fluctuations are what cause the various symptoms that women have during this time of life.
These hormones affect a woman's breasts, vagina, bones, blood vessels, digestive system, urinary tract, and skin. The symptoms of postmenopause will vary from woman to woman. Some women may continue to have symptoms of perimenopause, including: fatigueheadachehot flashesincreased emotional feelingsinsomniapalpitations, or an unusual awareness of one's own heartbeat
Women also may have vaginal drying. The walls of the vagina become thinner and dryer and lose elasticity. Sexual intercourse may be painful. Some women may not have much interest in sex, while others report an increased interest in sex following menopause.
Menopause is caused by natural aging. During menopause, a woman's estrogen level decreases. This eventually causes a woman to stop menstruating.
If they live long enough all women will go through menopause and move into postmenopause.
A healthcare professional can diagnose postmenopause by looking at a woman's medical history and her symptoms. A blood test can be used to determine the follicle stimulating hormone (FSH) level which is elevated in menopause.
A woman who is postmenopausal is at higher risk for osteoporosis, and heart disease as a result of decreased estrogen production by the ovaries.
Menopause is not contagious and poses no risk to others.
While menopause itself is not treated, the symptoms that go along with menopause are sometimes treated. All of the risks due to estrogen loss may be prevented or treated. Some ways to do this include making lifestyle changes and taking hormone therapy (HT).
Calcium supplements may be taken by those women who do not get enough calcium through their diet. Urinary tract infections may come back again and again. To prevent these infections, a woman should urinate frequently, especially before and after sexual intercourse. She should also drink plenty of fluids and keep the genital area very clean.
Side effects of HT can include headaches, bloating, and irritability. Long-term use of hormone therapy may increase the number of women who get breast cancer. If a woman has a family history of breast cancer, menstruated before age 12, or did not have her first pregnancy until she was older, hormone therapy may not be advised.
Women who are at higher risk of developing blood clots may also be unable to use hormone therapy. The American Heart Association recently issued recommendations about hormone therapy (HT) in women. For women who have already had a heart attack or have heart disease, it appears that HT does not protect against having another heart attack or dying from heart disease.
The studies that support this information were done with women over 65 years of age. The latest analysis of the Women's Health Initiative data indicates that if women start HT before age 60 and do not have underlying cardiac disease they do not increase their risk of heart problems.
For women who have not already had a heart attack or who do not have heart disease, HT should not be started for the sole purpose of preventing heart disease. The research is not strong enough to support doing that at this time.
It is not necessary for a woman to stop HT if she is doing well on it. Overall, the decision to use HT should be based upon the proven benefits and risks of HT. A woman should discuss the benefits and risks with her healthcare professional. Together, they can choose the most appropriate course of action. A woman who is using hormone therapy during perimenopause may want to reassess using HT after menopause.
Most symptoms of menopause go away within four years of cessation of menses, however about 30% of women will have persistent symptoms for longer periods of time.
Postmenopause is monitored by yearly health maintenance exams. If a woman has menstrual bleeding 6 months or more after her last period, she should contact her healthcare professional. The lining of the uterus (the endometrium) should be sampled with an endometrial biopsy or a dilatation and curettage (D&C). Any new or worsening symptoms should also be reported to the healthcare professional.
Menopause, National Institute of Aging, NIA Information Center, PO Box 8057, Gaithersburg, MD 20898
Age Page: Hormone Replacement Therapy, National Institute of Aging,
Taber's Cyclopedic Medical Dictionary, F.A. Davis Company, Philadelphia, PA
What Is Menopause? National Institute of Health, December 1992, [hyperLink url="http://www.nih.gov/" linkTitle="www.nih.gov"]www.nih.gov[/hyperLink]