Menopause

serious black woman

“My
mom never talked to me about menopause. She says her mother never talked about
it either.”

“I’m
not sad I’m past menopause. I’m glad those monthly periods are over.”

“Is
it hot in here, or is it me?”

Menopause, or
the “change of life,” is different for each woman. For example, hot flashes and
sleep problems may trouble your sister. Meanwhile, you could have a new sense of
freedom and energy. Your best friend might hardly be aware of a change at
all.

What is Menopause?

Menopause is a normal part of life, just like puberty. It is the time of your
last period, but symptoms can begin several years before that. And these
symptoms can last for months or years after. Some time around 40, you might
notice that your period is different—how long it lasts, how much you bleed, or
how often it happens may not be the same. Or, without warning, you might find
yourself feeling very warm during the day or in the middle of the night.
Changing levels of estrogen and progesterone, which are two female hormones made
in your ovaries, might lead to these symptoms.

This time of change, called perimenopause by many women and their
doctors, often begins several years before your last menstrual period. It lasts
for 1 year after your last period, the point in time known as
menopause. A full year without a period is needed before you can say
you have been “through menopause.” Postmenopause follows menopause and
lasts the rest of your life.

Menopause doesn’t usually happen before you are 40, but it can happen any
time from your 30s to your mid 50s or later. The average age is 51. Smoking can
lead to early menopause. Some types of surgery can bring on menopause. For
example, removing your uterus (hysterectomy) before menopause will make your
periods stop, but your ovaries will still make hormones. That means you could
still have symptoms of menopause like hot flashes when your ovaries start to
make less estrogen. But, when both ovaries are also removed (oophorectomy),
menopause symptoms can start right away, no matter what your age is, because
your body has lost its main supply of estrogen.

What Are the Signs of Menopause?

Women may have different signs or symptoms at menopause. That’s because
estrogen is used by many parts of your body. So, changes in how much estrogen
you have can cause assorted symptoms. But, that doesn’t mean you will have all,
or even most, of them. In fact, some of the signs that happen around the time of
menopause may really be a result of growing older, not changes in estrogen.

Changes in your period. This might be what you notice first.
Your period may no longer be regular. How much you bleed could change. It could
be lighter than normal. Or, you could have a heavier flow. Periods may be
shorter or last longer. These are all normal results of changes in your
reproductive system as you grow older. But, just to make sure there isn’t a
problem, see your doctor if:

  • your periods are coming very close together,
  • you have heavy bleeding,
  • you have spotting,
  • your periods are lasting more than a week.

Hot flashes. These are very common around the time of
menopause because they are related to changing estrogen levels. They may last a
few years after menopause. A hot flash is a sudden feeling of heat in
the upper part or all of your body. Your face and neck become flushed. Red
blotches may appear on your chest, back, and arms. Heavy sweating and cold
shivering can follow. Flashes can be as mild as a light blush or severe enough
to wake you from a sound sleep (called night sweats). Most hot flashes
last between 30 seconds and 10 minutes.

Problems with the vagina and bladder. Changing estrogen
levels can cause your genital area to get drier and thinner. This could make
sexual intercourse uncomfortable. You could have more vaginal or urinary
infections. You might find it hard to hold urine long enough to get to the
bathroom. Sometimes your urine might leak during exercise, sneezing, coughing,
laughing, or running.

Sex. Around the time of menopause you may find that your
feelings about sex have changed. You could be less interested. Or, you could
feel freer and sexier after menopause. You can stop worrying about becoming
pregnant after one full year without a period. But, remember you can’t ever stop
worrying about sexually-transmitted diseases (STDs), such as HIV/AIDS or
gonorrhea. If you think you might be at risk for an STD, make sure your partner
uses a condom each time you have sex.

Sleep problems. You might start having trouble getting a
good night’s sleep. Maybe you can’t fall asleep easily, or you wake too early.
Night sweats might wake you up. You might have trouble falling back to sleep if
you wake during the night.

Mood changes. You might find yourself more moody, irritable,
or depressed around the time of menopause. It’s not clear why this happens—is
there is a connection between changes in estrogen levels and emotions or not?
It’s possible that stress, family changes such as growing children or aging
parents, or always feeling tired could be causing these mood changes.

Changes in your body. You might think your body is changing.
Your waist could get larger. You could lose muscle and gain fat. Your skin could
get thinner. You might have memory problems, and your joints and muscles could
feel stiff and achy. Are these a result of having less estrogen or just related
to growing older? We don’t know.

What About My Heart and Bones?

Two common health problems can start to happen at menopause, and you might
not even notice.

Osteoporosis. Day in and day out your body is busy breaking down old
bone and replacing it with new healthy bone. Estrogen helps control bone loss.
So losing estrogen around the time of menopause causes women to begin to lose
more bone than is replaced. In time, bones can become weak and break easily.
This condition is called osteoporosis.
Talk to your doctor to see if you
should have a bone density test to find out if you are at
risk for this
problem. Your doctor can also suggest ways to prevent or treat osteoporosis.

Heart disease. After menopause, women are more likely to have heart
disease. Changes in estrogen levels may be part of the cause. But, so is getting
older. As you age, you may develop other problems, like high blood pressure or
weight gain, that put you at greater risk for heart disease. Be sure to have
your blood pressure and levels of triglycerides, fasting blood glucose, and LDL,
HDL, and total cholesterol checked regu

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