Menopause occurs when the ovaries stop producing the hormones, estrogen, and progesterone and a woman no longer ovulates, which concludes her reproductive life. When a woman has stopped having menstrual periods for 12 consecutive months, she is said to be postmenopausal.
While there are dozens of signs you are entering menopause, here are some key symptoms that you should look out for. Remember that menopausal symptoms usually start up to 5 years before actual menopause begins.
Here is what you can expect:
• Irregular periods. As the ovaries give out, they produce fluctuating amounts of estrogen. Some cycles will produce an egg and will be “ovulatory,” while other cycles will not produce an egg and will be “anovulatory.” Ovulatory cycles and anovulatory cycles last different lengths of time so the periods may be irregular and there may be skipped periods. Some periods will be heavy and some periods will be light.
• Hot flashes. This is the most common sign of menopause. It involves having periods of time when the body feels very hot and flushed. It can last for a few seconds or for a couple of hours. It is due to the fluctuations in ovarian production of hormones. Hot flashes usually start in the perimenopausal years prior to menopause but often disappear after menopause is over with.
• Night sweats. These are times when a woman awakens during the night and feels drenched in sweat. The pillow and the bed clothing are wet and the woman often has to change her nightgown in order to be dry again. Night sweats are perhaps the second most common sign of menopause.
• Mood swings. This involves having times of depression and times of elation that cannot be predicted. The woman is more irritable and emotional; she feels that she can’t control her feelings. This can last for several years. Sometimes the mood swings can be so severe that they interfere with relationships and can require psychiatric management.
• Depression. Many women will have their first bout of depression during menopause. Women who have had depression in the past will have an increased risk of developing menopausal-related depression during this time. At times, the depression can be so severe that the woman needs to take antidepressants or needs to undergo psychotherapy to manage the depressive symptoms.
• Anxiety. The hormonal fluctuations can cause a woman to be more anxious during menopause. The anxiety can be so severe that it interferes with the woman’s quality of life. The anxiety can be mild or can be so severe that the woman needs to practice relaxation techniques or needs anti-anxiety medications.
• Lack of libido. A woman in menopause will have a decreased interest in sex. Sex may be more painful and she may have no ability to have sex because of a decrease in interest in sex. Physiological changes in the sexual organs can cause problems with a woman’s interest in having sexual relations.
• Urinary incontinence. There is an increase in urge incontinence during menopause. This is an increase in urination symptoms any time the woman is exposed to water. She feels as though she must urinate at any time and may have problems with bedwetting or may urinate when the water faucet is turned on. Fortunately, there is medication for this so that these symptoms can be relieved.
• Increased urinary frequency. For reasons that aren’t completely clear, the woman may have an increased frequency of urination. She will urinate during the day more often and may get up more often to urinate at night.
• Vaginal dryness. Due to a lack of estrogen exposure to the vaginal tissues, the woman may have an increase in vaginal dryness. This can lead to a thinning and drying out of the vaginal tissue that can add to pain in intercourse. Fortunately, there are treatments for this. The woman can use a vaginal lubricant during sex, use a vaginal moisturizer, or can be prescribed estrogen in the form of a gel, cream, or impregnated vaginal ring containing estrogen that will have few systemic effects but will increase vaginal secretions. Hormone replacement therapy can also increase vaginal moisture.
• Insomnia. Sleep becomes more difficult during menopause. There may be difficulties in getting to sleep as well as difficulties in staying asleep during the night.
Not every woman in menopause will experience each and every one of these symptoms and a few women will have no symptoms at all. If you are experiencing menopausal symptoms that interfere with quality of life, you should see your doctor about getting on some type of treatment.