A number of causes can lead to menopause including a natural decline in the reproductive hormones, chemotherapy, radiation therapy, hysterectomy or removal of the uterus and primary ovarian insufficiency. Natural decline of the reproductive hormones is the leading cause of menopause as the ovaries begin to produce fewer hormones, which are responsible for regulating menstruation, causing fertility to decline. Menstrual periods begin to change in the late 30s and early 40s becoming longer or shorter, lighter or heavier and even more frequent or less frequent. On average, by the time a woman reaches the age of 51, her ovaries will cease egg production and menstruation will cease entirely.
During and after menopause, there is a greater risk of developing certain medical conditions. These include: blood vessel disease, cardiovascular disease, osteoporosis, sexual function difficulties, urinary incontinence and weight gain. Because there are complications associated with menopause and because many can be potentially life threatening or can threaten quality of life, working with a physician is essential during this time.
During the months or years that precede menopause (perimenopause), there are a number of signs and symptoms that a woman might experience. These include: period irregularity, vaginal dryness, mood changes, night sweats, sleep difficulties, loss of fullness in the breasts, dry skin, thinning hair, slowed metabolism and weight gain. Some people will continue to experience menstruation up until the very last period while others will begin to skip periods leading up to the point of menopause.
The symptoms of perimenopause or menopause will typically be enough to reach a diagnosis, though physicians may run other tests to confirm. These tests include: running blood samples to check for estrogen levels, follicle stimulating hormone levels and thyroid stimulating hormone levels. FSH levels and estrogen or estradiol levels decrease during perimenopause. Thyroid stimulating hormone levels indicate whether or not hypothyroidism is present, which can cause symptoms similar to menopause.
Menopause does not inherently require medical treatment, but many patients undergo treatment in order to deal with side effects of the menopausal process. Hormone therapy will relieve hot flashes and vaginal estrogen therapy will relieve vaginal dryness, which may improve urinary symptoms and intercourse discomfort. Low antidepressant dosages, typically serotonin reuptake inhibitors or SSRIs, may decrease hot flashes and help with mood issues. Gabapentin or Neurontin works to decrease hot flashes and treat migraines. Some patients may also require medications to prevent or to treat osteoporosis depending on their current physical health. Treatments for menopause are used to deal with symptoms of perimenopause and potential complications such as weight gain, cardiovascular disease, blood vessel diseases and sexual difficulties. Most women do not require treatment for menopause or menopausal symptoms unless they interfere with everyday life, but working with a physician during this transitional period is still quite beneficial.