Menopause describes the time when a person with ovaries has gone one full year without a menstrual period. Reaching this phase is a natural aging process that marks the end of reproductive years.

Read on to learn more about the causes, stages, signs, and management of menopause.

What causes menopause?

As you age, your ovaries begin making less estrogen and progesterone—two of the hormones involved in menstruation—and your fertility declines, causing menopause.

Most people begin perimenopause, the transitional time that ends in menopause, in their late 40s, but it can start earlier. On average, people in the U.S. experience menopause in their early 50s.

Your body may reach early menopause for a variety of reasons, including having an oophorectomy, a surgery that removes the ovaries. In this case, the hormonal changes happen abruptly rather than gradually.

Chemotherapy and radiation therapy for cancer patients may also induce menopause, as these treatments may impact ovary function.

What are the stages of menopause?

There are three stages:

• Perimenopause typically occurs eight to 10 years before menopause happens. During this stage, estrogen production begins to decline and ovaries release eggs less frequently.
• Menopause marks the point when you have gone 12 consecutive months without a menstrual period. This means the ovaries have stopped releasing eggs and producing estrogen.
• Postmenopause describes the time after menopause. Once your body reaches this phase, it remains there for the rest of your life.

How do the stages of menopause affect fertility?

Your ovaries still produce eggs during perimenopause, so it is still possible to get pregnant during that stage. If you do not wish to become pregnant, continue using your preferred form of birth control throughout perimenopause.

Once you’ve reached menopause, you can no longer get pregnant naturally. People who would like to become pregnant after that may pursue in vitro fertilization (IVF) using eggs that were frozen earlier in life or donor eggs.

What are the signs of menopause?

Hormonal shifts result in a number of bodily changes. Signs you are approaching menopause may include:

• Hot flashes (a sudden feeling of warmth).
• Irregular menstrual periods, or unusually heavy or light menstrual periods.
• Night sweats and/or cold flashes.
• Insomnia.
• Slowed metabolism.
• Irritability, mood swings, and depression.
• Vaginal dryness.
• Changes in libido.
• Dry skin, eyes, and/or mouth.
• Worsening of premenstrual syndrome (PMS).
• Urinary urgency (a sudden need to urinate).
• Brain fog.

How can I manage the effects of menopause?

You may not need any treatment to manage the effects of menopause. However, if the effects are disrupting your life, your doctor may prescribe hormone therapy.

If you have had a hysterectomy, your doctor may prescribe estrogen therapy (ET), which may be administered via a pill, patch, cream, spray, or vaginal ring. If you still have a uterus, your doctor may prescribe estrogen progesterone/progestin hormone therapy (EPT), which is sometimes called “combination therapy.”

Both of these therapies work by replacing the hormones your body has stopped making, which can reduce the physical and mental effects of menopause.

Other treatment options may include antidepressants, which can help manage mood swings and hot flashes; prescription creams to alleviate vaginal dryness; or gabapentin, an anti-seizure medication that has been shown to reduce hot flashes.

Lifestyle changes may help alleviate the effects on their own or in combination with prescription medication. Those changes include:

• Incorporating movement into your daily life.
• Limiting caffeine and alcohol.
• Quitting smoking.
• Maintaining a regular sleep schedule.
• Practicing relaxation techniques, such as meditation.
• Consuming foods rich in plant estrogens, such as grains, beans, fruits, vegetables, and seeds.
• Seeking support from a therapist and from loved ones.

What health risks are associated with menopause?

Having lower levels of estrogen may put you at greater risk of certain health complications, including osteoporosis and coronary artery disease.

Osteoporosis occurs when bones lose their density, increasing the risk of fractures. A 2022 study found that the prevalence of osteoporotic fractures in postmenopausal women was 82.2 percent.

Coronary artery disease occurs when the arteries that send blood to your heart become narrow or blocked with fatty plaque.

Estrogen therapy can reduce your risk of osteoporosis and coronary artery disease by preserving bone mass and maintaining cardiovascular function.

For more information, talk to your health care provider.

This article first appeared on Public Good News and is republished here under a Creative Commons license.