What is menopause?

Menopause is the time in your life when you stop having periods because of hormonal changes. This usually happens in your late 40s or early 50s, but may happen earlier.  

What happens during menopause?

Born with a uterus and ovaries? Menopause is a natural and normal process that happens to you as you get older. Menopause usually happens between ages 45 and 55, with 51 being the most common age.

Menopause starts when your ovaries stop making estrogen, and slow down making other reproductive hormones, like progesterone. Without these hormones, you stop getting your period and stop being able to get pregnant.

If you’re between 45-55 and you haven’t had your period in a year, you aren’t pregnant, and you don’t have a serious illness, you may be going through menopause.

Not everyone goes through menopause because of aging. Sometimes other health issues kickstart menopause. If your ovaries are removed through surgery, you may experience sudden symptoms of menopause instead of the gradual change that usually happens. Medical treatments like chemotherapy and radiation can also make menopause happen early or suddenly.

Your doctor or nurse can help you figure out if you’re going through menopause. They can also help you manage menopause symptoms.  

What is perimenopause?

Perimenopause means the time leading up to menopause where you may have symptoms. This stage can last anywhere from a few months to up to 10 years, and is a process that may start, stop, and start up again.

Perimenopause usually begins in your 40s, but it can start earlier, too. People who smoke usually start perimenopause 2 years earlier than nonsmokers.

The amount of estrogen made by your ovaries starts to change in your 30s and 40s — it can go up and down. You may notice this is happening because your periods begin to change. Changes to periods during perimenopause is common and totally normal.

Some changes you might notice include:

  • The time between one period and another changing (either longer or shorter)

  • Totally skipping a period

  • Bleeding patterns changing during your period (heavier or lighter)

  • Bleeding between periods

Changes in menstrual bleeding are pretty normal during perimenopause, but it’s still a good idea to talk with your doctor or nurse about them.

You can still get pregnant during perimenopause. If you don’t want to get pregnant, continue using your birth control method for at least a year after you have your last period. Your doctor or nurse can talk with you about stopping your birth control method and answer any other questions you have about perimenopause.  

Your body stops making some hormones during perimenopause and menopause. Taking them as medicine can help with symptoms and have added health benefits for some people.

What is hormone therapy?

Hormone therapy works by replacing the hormones that your body stops making when you’re going through perimenopause and menopause — estrogen and progesterone.

There are two different kinds of hormone therapy:

Estrogen therapy: This is the best treatment for hot flashes, night sweats, and vaginal dryness. If you’ve had a hysterectomy and don’t have a uterus, estrogen therapy is given.

Combined hormone therapy: If you still have a uterus, your doctor may prescribe combined hormone therapy. This is estrogen and also artificial progesterone (called progestin) taken together. Combined hormone therapy helps prevent uterine cancer and may also help prevent colon cancer.

Hormone therapy can help with:

  • reducing hot flashes

  • vaginal dryness

  • sleep problems

  • urinary tract infections and sudden urges to pee

  • arthritis pain

  • lowering your risk of colon cancer

  • lowering your risk of diabetes

Some of the options for how to take hormone therapy are like the options for taking hormonal birth control. These options are:

  • pills

  • patches

  • rings

  • vaginal creams (best for people who only have vaginal dryness as a symptom)

What are the side effects of hormone therapy?

Hormone therapy can have some side effects, but they’re usually mild and tend to go away after a few months. Side effects can include:

  • bloating

  • sore and tender breasts

  • headaches

  • difficulty going to the bathroom

  • upset stomach

  • vaginal bleeding

What are the risks of hormone therapy?

Hormone therapy can have some risks, depending on your personal medical history and your family’s medical history.

Combined hormone therapy may increase your risk for:

  • heart disease

  • breast cancer (if you take it for more than 3-5 years)

  • blood clots

Estrogen therapy may increase your risk for:

  • blood clots

  • breast cancer (if you’re on it for more than 10-15 years)

  • uterine cancer

  • gallbladder disease

  • heart disease

It’s best to take the lowest dose of hormone therapy possible, for the shortest amount of time possible. Hormones that you swallow in pill form increase some of these risks more than hormones that you take in other forms.

If you’re thinking about taking hormone therapy, your doctor or nurse will ask about your personal and family medical history. They can help you decide if the benefits are worth the risks.

Are there other treatment options for menopause symptoms?

People sometimes choose other methods of treating menopause symptoms if they’re worried about the risks of hormone therapy.

Some other methods are:

  • homeopathy

  • herbal treatments

  • Chinese medicine

  • acupuncture

Research hasn’t proven that these therapies are safe or effective. And they can also have side effects and risks. So if you want to go in that direction, consult someone who’s skilled and experienced. They can help you decide if their method is right for you and help you do it safely.