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Summary
What is menopause?
Menopause is the time in your life when you stop having your period and can no longer get pregnant. You have reached menopause when you have not had a period for 12 months.
The time leading up to menopause is called the menopausal transition, or perimenopause. This transition usually begins in when you are in your 40s, but sometimes it can start earlier. It can last for several years. The most common age for reaching menopause is between 45 and 55 years old.
What is early menopause?
Early, or premature menopause happens when your ovaries stop making hormones and periods stop before age 40. This can happen on its own (with no known cause). It can also happen because of surgery to remove the ovaries or uterus. Medical treatments such as chemotherapy or hormone therapy to treat breast cancer may also cause early menopause.
A condition called primary ovarian insufficiency (POI) happens when your ovaries stop working normally before you are age 40. But this condition is different from early menopause. If you have POI, you may still have periods, even though they might not come regularly. And you might still be able to get pregnant.
What are the symptoms of menopause?
During the menopausal transition, your ovaries start to make less of the estrogen and progesterone hormones. The changes in these hormones cause the symptoms of menopause, which can include:
- A change in your periods; they may be:
- Irregular, with more or less time in between periods.
- Shorter or longer.
- Lighter or heavier.
- Hot flashes, a sudden warm feeling in your face, neck, and chest. They may cause you to sweat. If they happen at night and cause sweating, they are called night sweats.
- Trouble sleeping, such as trouble falling asleep or getting back to sleep when you wake up. Over time, a lack of sleep can lead to fatigue and memory problems.
- Vaginal dryness, which may cause pain or discomfort during sexual intercourse.
- Mood changes, which can make you feel moody, anxious, or more irritable.
- Bladder issues, such as urinary incontinence (loss of bladder control) and urinary tract infections (UTIs).
You may also have other physical changes which could put you at risk for certain diseases. For example, the loss of estrogen can:
- Cause you to lose bone density. This can lead to osteoporosis, a condition that causes bones to become weak and break easily.
- Raise your cholesterol levels and increase your risk of heart disease and stroke.
What are the treatments for the symptoms of menopause?
You may not need treatment for the symptoms of menopause. But if you do, there are several different types of treatments:
Lifestyle changes
You may find that you can manage your symptoms with lifestyle changes. Here are some changes that might make you feel better:
- If you have hot flashes, dress in layers that can be removed at the start of a hot flash. You may want to carry a portable fan to use when you get a hot flash.
- Avoid alcohol, spicy foods, and caffeine. They can make your menopause symptoms worse.
- If you smoke, try to quit, not only for hot flashes, but for your overall health.
- Try to maintain a healthy weight. Being overweight or having obesity can make hot flashes worse.
- Have good sleep habits. Keep your bedroom dark, quiet, and cool.
- Get regular exercise. It can help you sleep better, improve your mood, and help lower your risk for many age-related diseases.
- Lower stress, for example by using relaxation techniques such as meditation, deep breathing, and muscle relaxation exercises.
If lifestyle changes are not enough to improve your symptoms, you may want to contact your health care provider. They will talk to you about your symptoms, family and medical history, and preferences. They also can explain the risks and benefits of the treatments.
Non-hormone treatments
There are various non-hormone treatments for menopause symptoms, such as:
- Medicines for hot flashes, including certain antidepressants, a medicine just for hot flashes, an antiseizure medicine, and a blood pressure medicine. Some of these medicines may also help with sleep problems.
- Medicines for urinary incontinence.
- Medicines to treat or help prevent osteoporosis.
- Low-dose birth control pills for very heavy bleeding or periods that are close together.
- Water-based lubricants to treat vaginal dryness.
- Medicines for painful intercourse that is caused by vaginal changes from menopause.
- Cognitive behavioral therapy (CBT), a type of talk therapy, for trouble sleeping.
Hormone treatments
Another treatment for menopause symptoms is menopausal hormone therapy (MHT). It may also be called hormone replacement therapy (HRT). This treatment is usually with estrogen or estrogen plus progestin (a type of progesterone that's made in a lab). MHT can be given in pills, skin patches, rings, implants, gels, or creams. It may be used to treat symptoms such as hot flashes and vaginal dryness and to help prevent osteoporosis.Like all medicines, MHT has benefits and risks. Talk with your provider about whether it is safe for you. If you decide to take MHT, your provider may recommend taking the lowest dose that works for the shortest time needed.
Supplements, herbs, and "natural" hormone creams
There are various products that are marketed for menopause symptoms. They include supplements, herbs, and over-the-counter "natural" hormone creams. There has been research on many of these products. So far, none of them has clearly been shown to be helpful. Also, there is little information on the long-term safety of these products. Some supplements can have harmful side effects or interact with medicines. Check with your provider before you take use any of them.
Symptoms
- What Are the Symptoms of Menopause? (Eunice Kennedy Shriver National Institute of Child Health and Human Development) Also in Spanish
Diagnosis and Tests
- Anti-Müllerian Hormone Test (National Library of Medicine) Also in Spanish
- Estrogen Levels Test (National Library of Medicine) Also in Spanish
- Follicle-Stimulating Hormone (FSH) Levels Test (National Library of Medicine) Also in Spanish
- Hot Flashes (Mayo Foundation for Medical Education and Research) Also in Spanish
- Vaginal Atrophy (Mayo Foundation for Medical Education and Research) Also in Spanish
Treatments and Therapies
- 4 Things to Know about Menopausal Symptoms and Complementary Health Practices (National Center for Complementary and Integrative Health)
- Bioidentical Hormones: Are They Safer? (Mayo Foundation for Medical Education and Research) Also in Spanish
- Black Cohosh (National Center for Complementary and Integrative Health)
- Hormone Replacement Therapy: MedlinePlus Health Topic (National Library of Medicine) Also in Spanish
- Hot Flashes: What Can I Do? (National Institute on Aging) Also in Spanish
- Menopausal Symptoms: In Depth (National Center for Complementary and Integrative Health)
- Menopause Relaxation Techniques (Endocrine Society) - PDF
- Menopause Treatment (Endocrine Society)
- Sleep Problems and Menopause: What Can I Do? (National Institute on Aging) Also in Spanish
- Soy (National Center for Complementary and Integrative Health)
- What Are the Treatments for Other Symptoms of Menopause? (Eunice Kennedy Shriver National Institute of Child Health and Human Development) Also in Spanish
Living With
- Preparing for Menopause: A Woman's Midlife Change (National Institutes of Health) Also in Spanish
Related Issues
- Burning Mouth Syndrome (National Institute of Dental and Craniofacial Research) Also in Spanish
- Menopause and Bone Loss (Endocrine Society)
- Menopause and Cardiovascular Risk (American Heart Association) Also in Spanish
- Menopause and High Blood Pressure: What's the Connection? (Mayo Foundation for Medical Education and Research) Also in Spanish
- The Reality of Menopause Weight Gain (Mayo Foundation for Medical Education and Research) Also in Spanish
Specifics
- Early or Premature Menopause (Department of Health and Human Services, Office on Women's Health) Also in Spanish
- Menopause and You: Postmenopause (Endocrine Society)
- Perimenopausal Bleeding and Bleeding after Menopause (American College of Obstetricians and Gynecologists)
- Perimenopause (Mayo Foundation for Medical Education and Research) Also in Spanish
Health Check Tools
- Menopause Map (Endocrine Society)
Videos and Tutorials
- Menopause (Endocrine Society)
- What Are the Signs and Symptoms of Menopause? (National Institute on Aging) Also in Spanish
- What is Menopause (National Institute on Aging) Also in Spanish
Test Your Knowledge
- Test Your Menopause Knowledge (Medical Encyclopedia) Also in Spanish
Statistics and Research
- Menopausal Symptoms and Complementary Health Practices: What the Science Says (National Center for Complementary and Integrative Health)
Clinical Trials
- ClinicalTrials.gov: Hot Flashes (National Institutes of Health)
- ClinicalTrials.gov: Menopause (National Institutes of Health)
- ClinicalTrials.gov: Premenopause (National Institutes of Health)
Journal Articles References and abstracts from MEDLINE/PubMed (National Library of Medicine)
Find an Expert
- Department of Health and Human Services, Office on Women's Health Also in Spanish
- Find an Endocrinologist (Endocrine Society)
- National Institute on Aging Also in Spanish
Patient Handouts
- Cancer treatment -- early menopause (Medical Encyclopedia) Also in Spanish
- Deciding about hormone therapy (Medical Encyclopedia) Also in Spanish
- Menopause (Medical Encyclopedia) Also in Spanish
- Types of hormone therapy (Medical Encyclopedia) Also in Spanish