Menopause is the time that marks the end of your menstrual cycles. It's diagnosed after you've gone 12 months without a menstrual period. Menopause can happen in your 40s or 50s.
Menopause is a natural biological process. But the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt your sleep, lower your energy or affect emotional health. There are many effective treatments available, from lifestyle adjustments to hormone therapy.
In the months or years leading up to menopause (perimenopause), you might experience these signs and symptoms:
Symptoms, including changes in menstruation, are different for every woman. Most likely, you'll experience some irregularity in your periods before the end.
Skipping periods during perimenopause is common and expected. Often, menstrual periods will skip a month and return, or skip several months and then start monthly cycles again for a few months. Periods also tend to happen on shorter cycles, so they are closer together. Despite irregular periods, pregnancy is possible. If you've skipped a period but aren't sure you've started the menopausal transition, consider a pregnancy test.
Menopause can result from:
It is not a disease. Menopause is a normal, natural event—defined as the final menstrual period and usually confirmed when a woman has missed her periods for 12 consecutive months (in the absence of other obvious causes). Menopause is associated with reduced functioning of the ovaries due to aging, resulting in lower levels of estrogen and other hormones. It marks the permanent end of fertility. Menopause occurs, on average, at age 51. It occurs most often between ages 45 and 55. The term “premenopause” refers to the phase of life that precedes menopause. For many women, it is an optimal time to reassess their health.
Induced menopause refers to menstrual periods which stop after surgical removal of the ovaries, chemotherapy or radiation damage to the ovaries, or from the use of other medications to intentionally induce menopause as part of the treatment of certain diseases. Women who have induced menopause experience the hot flashes, vaginal dryness, trouble sleeping and other symptoms of menopause, but without the gradual onset of a natural menopause. Seek out a certified menopause practitioner for help finding the many options available in regard to induced menopause.
Postmenopause includes all the years beyond menopause.
Each woman’s menopause experience is different. Many women who undergo natural menopause report no physical changes at all during the perimenopausal years except irregular menstrual periods that eventually stop when they reach menopause. Other changes may include hot flashes, difficulty sleeping, memory problems, mood disturbances, vaginal dryness, and weight gain. Not all these changes are hormone-related, and some, such as hot flashes and memory problems, tend to resolve after menopause. Maintaining a healthy lifestyle during this time of transition is essential for your health and can even prevent or blunt some of these changes.
Some women report sleep disturbances (insomnia) around the time of menopause, and women and their healthcare providers sometimes attribute sleep disturbances to menopause symptoms. However, there are many reasons for sleep disturbances besides menopausal night sweats (simply, hot flashes at night). Your sleep disturbances may be caused by factors that affect many women beginning at midlife, such as sleep-disordered breathing (known as sleep apnea), restless legs syndrome, stress, anxiety, depression, painful chronic illnesses, and even some medications. Any treatment should first focus on improving your sleep routine—use regular hours to sleep each night, avoid getting too warm while sleeping, avoid stimulants such as caffeine and dark chocolate. When lifestyle changes fail to alleviate sleep disturbances, your clinician may want to refer you to a sleep center to rule out sleep-related disorders before initiating prescription treatment. If your sleep disturbance is related solely to hot flashes, hormone therapy is likely to help.