Menopause
Learn more about menopause and how it is treated.
Overview
Menopause is the stage of life that begins after your last menstrual period. The years leading up to this point are called perimenopause.
People are born with approximately 700,000 eggs, which are gradually used over a lifetime. Menopause occurs when these eggs run out. Menopause can occur after surgery or chemotherapy.
More than 90 per cent of people experience menopause by age 56. About five per cent experience it earlier, between ages 40 and 45. The average age of menopause is 51.
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Symptoms
Common symptoms of menopause and perimenopause include:
- Hot flashes
- Night sweats
- Vaginal dryness
- New sleep difficulties
- New or worsened mood changes
- Changes in sexual desire
- New pain during intercourse
- New non-deforming joint pain
Diagnosis
Menopause is diagnosed when you have not had a menstrual period for 12 straight months. Symptoms often begin years earlier.
About 20 per cent of people experience severe symptoms.
Treatment
Menopause is a normal phase of life. Treatments can help reduce severe symptoms. Talk to your health-care provider if your symptoms affect your quality of life.
Your treatment plan depends on your symptoms and your personal and family medical history. Current treatment options include:
- Lifestyle changes
- Over-the-counter medication
- Psychotherapy
- Prescription non-hormonal and hormonal medication (hormone therapy)
- Lubricants, moisturizers or local estrogen therapies for vaginal and sexual symptoms
Hormone therapy
Hormone therapy is replacement estrogen (or estrogen and progesterone) that gives you the same hormone levels that are produced before perimenopause. For people with a uterus, hormone therapy should include both estrogen and progesterone to prevent uterine cancer. If a hysterectomy has been performed, only estrogen is needed.
The primary purpose of hormone therapy during menopause is to treat symptoms related to estrogen deficiency.
Hormone therapy is the most effective treatment for hot flashes and night sweats. It can improve sleep and joint pain. It is also helpful for mild mood symptoms associated with menopause and can work together with antidepressants.
Evidence suggests that hormone therapy can have positive effects on bone and heart health for people in their 50s without underlying heart disease.
Hormone therapy and cancer risk
There is a lot of disagreement about hormone therapy and cancer risks. The largest prospective randomized trial done in the U.S. showed that those who took a specific type of estrogen hormone actually had fewer cases of breast cancer. However, those who took estrogen and progestin (a synthetic form of progesterone) had an additional one to two breast cancer cases in 1,000 women after five years.
Other studies on hormone therapy in menopause and cancer risk have had mixed findings.
The decision to take hormone therapy should consider a person's specific symptoms, risks, benefits and wishes.