What to Expect during Menopause
2 of 12 in Series: The Essentials of Women's Sexual Health
Menopause is a fact of life for every woman, although each woman goes through the process at a different age and with different levels of symptoms. The result of menopause is that a woman stops releasing eggs and menstruating — but it also causes a decrease in the production of the female hormones, estrogen and progesterone, which means menopause has other effects that women sometimes find unsettling.
Understanding what is happening can allow a woman to ease into menopause with greater grace and relief.
When does menopause happen?
Although every woman is different, the average American woman hits menopause at age 51, so women spend the last third of their lives as postmenopausal. Menopause isn’t something that occurs suddenly. Women may start having symptoms as many as 10 to 15 years before menopause. Usually the changes develop slowly, and the period of change is called the climacteric. A woman’s period may become irregular and the flow lighter or heavier. The actual length of time for the woman to cease having periods may be one to two years from the start of the climacteric.
A woman reaches menopause when she hasn’t had a period for 12 months, so never consider yourself to be into the menopausal years until that period of time has elapsed. If you have unprotected sex during this time, you may become pregnant.
Symptoms of menopause
Technically, menopause happens when a woman’s egg supply runs out. She is no longer fertile and has no more risk of getting pregnant. Estrogen and progesterone, the female hormones, decrease. The hormonal changes can result in a number of unwelcome symptoms:
A more frequent urge to urinate
The most classic of these is the hot flash, a sudden feeling of heat that takes over the entire body. This can happen at any time of the day or night, and the number of hot flashes and their duration is different for every woman. Because the woman’s face usually also becomes flushed, these hot flashes may be visible to the entire world and can be embarrassing, though she certainly has no need to feel embarrassed.
Although not every woman experiences hot flashes, the normal duration for this symptom is two years. About 25 percent of women have hot flashes for a longer period of time if they go untreated, right into their 90s.
Menopause and hormone replacement therapy
Medical science found a way of alleviating many of the symptoms of menopause through hormone replacement therapy (HRT). Studies proved that having a woman take estrogen to replace that hormone she is no longer producing alleviated many of the symptoms of menopause, as well as protected against certain kinds of cancers, especially cancer of the cervix. But other studies subsequently have shown an added risk of various diseases, including heart attack and breast cancer, for some women using HRT. This very confused picture means that any woman beginning menopause should consult her doctor to find out what options are available to her. You may decide against HRT, or, if you have severe menopausal symptoms, you may opt for short-term therapy. To relieve vaginal dryness only, a very small dose of estrogen applied directly into the vagina can relieve this problem without adding significant risk.
Talk to your gynecologist to get the latest information about HRT and to help you decide whether to use the treatment.