Patient Handout

What is menopause?

• The menopause represents a change in life. It is marked by the end of menstrual periods, and the end of your reproductive years. At menopause, the ovaries stop producing eggs and stop making the hormone estrogen.
  • If you have had no menstrual cycles for 12 months, you have gone through the menopause. At this point, you can no longer become pregnant.
  • Most women experience menopause between the ages of 45 and 55.

Menopause is a transition

• Generally, the ovaries do not stop producing estrogen suddenly. Instead, estrogen production becomes erratic, and over months, or years, your body's estrogen levels begin to decrease.
• The loss of estrogen causes the first signs of approaching menopause.

What are the signs of menopause?

• Irregular periods
  • If you are approaching menopause, your periods will eventually stop. However, even if you are the right age for the menopause, you need to see your healthcare provider if you have:
    • Periods that are closer together than every 21 days
    • Periods that last longer than 7 days
    • Periods that are very heavy
    • Bleeding between periods
• The hot flush
  • This is a sensation of warmth or intense heat that spreads over the face, scalp, and chest. You may sweat profusely.
  • Hot flushes usually last several minutes. They may happen occasionally or many times a day.
  • Roughly 75% of women will have hot flushes.
  • Because they are common during the night, they may prevent you from having a good night's sleep.
• Vaginal dryness
  • As your estrogen level drops, the lining of the vagina becomes thin, and is less able to make secretions.
    This dryness can cause pain during sex. It might also cause vaginal infections.
  • The urethra (the tube that carries urine from the bladder out of the body) also becomes thin as the menopause approaches. This may produce a burning sensation during urination.

Can these symptoms be treated?

• Hormone replacement therapy (either estrogen and progestin or estrogen alone) can help reduce these menopausal symptoms.
• If you have a uterus, it is important to take both estrogen and progestin. Estrogen alone can increase your risk of developing uterine cancer; adding progestin protects you against this.
• If you have had a hysterectomy, you can take estrogen alone.
• In addition to hormone replacement therapy you might try the following:
• For hot flushes: wear light, layered clothing; drink ice water during a flush
• Vaginal dryness: use a vaginal lubricant such as KY Jelly or estrogen cream

Are there other reasons to take estrogen?

• At the time of menopause your health risks change dramatically. Estrogen provides protection against some diseases and can help preserve your health beyond menopause.
• After menopause, you have a higher risk for developing osteoporosis, heart disease, Alzheimer's disease, and colon cancer.
• Research shows that estrogen reduces your risk for these conditions.
• You can take hormone replacement therapy for many years after menopause. It is not just a temporary measure to relieve your symptoms.

Are there side effects?

• Although the majority of women can safely take estrogen, there are some women who cannot. Please talk with your healthcare provider to find out what makes sense for you. What about breast cancer?
• Some studies suggest that estrogen increases your risk of developing breast cancer. Other studies show no such risk. This question has not been answered definitively. But if there is any risk of HRT adversely affecting your risk of breast cancer, it is minimal. Explore this topic with your healthcare provider.
• After menopause, heart disease kills far more women than breast cancer. Menopause is a time to take stock of your current lifestyle and chart a healthy course for the future. Please talk with us about your concerns and questions.