Menopause Services

Menopause is the time in your life when you naturally stop having menstrual periods. Menopause happens when the ovaries stop making estrogen. Estrogen is a hormone that helps control the menstrual cycle. Menopause marks the end of the reproductive years. The average age that women go through menopause is 51 years.

The years leading up to menopause are called perimenopause. Beginning in your 30s and 40s, the amount of estrogen produced by the ovaries begins to fluctuate. A common sign of perimenopause in women is a change in the menstrual cycle. Cycles may become longer than usual for you or become shorter. You may begin to skip periods. The amount of flow may become lighter or heavier. Although changes in menstrual bleeding are normal during perimenopause, women should still report them to a menopause specialist. Abnormal bleeding may be a sign of a health problem.

Some women do not have any symptoms of perimenopause or have only a few mild symptoms. Others have many symptoms that can be severe. Common signs and symptoms include the following:

• Hot flashes—A hot flash is a sudden feeling of heat that rushes to the upper body and face. A hot flash may last from a few seconds to several minutes or longer. Some women have hot flashes a few times a month. Others have them several times a day. Hot flashes that happen at night (night sweats) may wake you up and cause you to feel tired and sluggish during the day.
• Sleep problems—You may have insomnia (trouble falling asleep), or you may wake up long before your usual time. Night sweats may disrupt your sleep.
• Vaginal and urinary tract changes—As estrogen levels decrease, the lining of the vagina may become thinner, dryer, and less elastic. Vaginal dryness may cause pain during sex. Vaginal infections also may occur more often. The urethra can become dry, inflamed, or irritated. This can cause more frequent urination and increase the risk of urinary tract infections. More info

Menopause is defined as the absence of menstrual periods for 1 year. The average age of menopause is 51 years, but the normal range is 45 years to 55 years.

The years leading up to this point are called perimenopause. This term means “around menopause.” This phase can last for up to 10 years. During perimenopause, shifts in hormone levels can affect ovulation and cause changes in the menstrual cycle.

During a normal menstrual cycle, the levels of the hormones estrogen and progesterone increase and decrease in a regular pattern. Ovulation occurs in the middle of the cycle, and menstruation occurs about 2 weeks later. During perimenopause, hormone levels may not follow this regular pattern.  As a result, women may have irregular bleeding or spotting. Some months, your period may be longer and heavier. The number of days between periods may increase or decrease. You may begin to skip periods.

Any bleeding after menopause is abnormal and should be reported to your health care provider. Although the menstrual period may become irregular during perimenopause, you should be alert for abnormal bleeding, which can signal a problem not related to perimenopause. A good rule to follow is to tell your menopause specialist if you notice any of the following changes in your monthly cycle:

• Very heavy bleeding
• Bleeding that lasts longer than normal
• Bleeding that occurs more often than every 3 weeks
• Bleeding that occurs after sex or between periods

Health treatment for abnormal perimenopausal bleeding or bleeding after menopause depends on its cause. If there are growths (such as polyps) that are causing the bleeding, surgery may be needed to remove them. Endometrial atrophy can be treated with medications. Endometrial hyperplasia can be treated with progestin therapy, which causes the endometrium to shed. Thickened areas of the endometrium may be removed using hysteroscopy or D&C.

Women with endometrial hyperplasia are at increased risk of endometrial cancer. They need regular endometrial biopsies to make sure that the hyperplasia has been treated and does not return.

Endometrial cancer is treated with surgery (usually hysterectomy with removal of nearby lymph nodes) in most cases. Discuss your options with your menopause specialist for the best health care treatment for you. More info