Menopause (All Stages)

Menopause is a stage in life when a woman stops having her monthly period. It is a normal part of aging and marks the end of a woman's reproductive years. Menopause typically occurs in a woman's late 40s to early 50s; however, women who have their ovaries surgically removed may undergo "sudden" menopause. 

what are the hormonal changes during menopause?

The traditional changes we think of as "menopause" happen when the ovaries no longer produce high levels of hormones. The ovaries are the reproductive glans that store eggs and release them into the fallopian tubes. They also produce the female hormones estrogen and progesterone as well as testosterone. Together, estrogen and progesterone control menstruation. Estrogen also influences how the body uses calcium and maintains cholesterol levels in the blood. 

how does natural menopause occur?

Natural menopause is the permanent ending of menstruation that is not brought on by any type of medical treatment. For women undergoing natural menopause, the process is gradual and is described in three stages:

  1. Perimenopause or "menopause transition" - Perimenopause can begin 8 to 10 years before menopause, when the ovaries gradually produce less estrogen. It usually starts in a woman's 40s, but can start in the 30s as well. Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last 1-2 years of perimenopause, the drop in estrogen accelerates. At this stage, many women can experience menopause symptoms. Women are still having menstrual cycles during this time, and can get pregnant. 
  2. Menopause - Menopause is the point when a woman no longer has menstrual periods. At this stage, the ovaries have stopped releasing eggs and producing most of their estrogen. Menopause is diagnosed when a woman has gone without a period for 12 consecutive months. 
  3. Postmenopause - These are the years after menopause. During this stage, menopausal symptoms, such as hot flashes, can ease for many women. As a result of lower estrogen levels, postmenopausal women are at increased risk for a number of health conditions, such as osteoporosis and heart disease. Medication, such as hormone therapy and/or healthy lifestyle changes, may reduce the risk of some of these conditions. Since every woman's risk is different, discussions with your provider are recommended to reduce your individual risk. 

symptoms of menopause

  • Hot flashes (a sudden feeling of warmth that spreads over the body)
  • Night sweats and/or cold flashes
  • Vaginal dryness, discomfort during sex
  • Urinary urgency (a pressing need to urinate more frequently)
  • Difficulty sleeping (insomnia)
  • Emotional changes (irritability, mood swings, mild depression)
  • Dry skin, eyes or mouth

Women who are still in the menopause transition (perimenopause) may also experience:

  • Breast tenderness
  • Worsening of premenstrual syndrome (PMS)
  • Irregular periods or skipping periods
  • Periods that are heavier or lighter than usual 

Some women may also experience:

  • Racing heart
  • Headaches
  • Joint and muscle aches and pains
  • Changes in libido (sex drive)
  • Difficulty concentrating, memory lapses (often temporary)
  • Weight gain
  • Hair loss or thinning

Not all women get all of these symptoms; however, women affected with new symptoms of racing heart, urinary changes, headaches, or other new medical problems should see their WISH provider to make sure there is no other cause for these symptoms. 

*This information does not replace a provider consultation. You should schedule an appointment with your provider if you experience any of these symptoms. 

*Information provided by the Cleveland Clinic