Menopause FAQ

Are there stages of menopause?

Yes, menopause is divided into three stages 1,2,3:

  • Perimenopause: this is the period that comes before menopause, when the levels of estrogen and progesterone, which are hormones produced by the ovaries, start to gradually decline. This decline causes irregularity in menstrual cycles, which can be accompanied by other symptoms, such as vaginal dryness, mood swings, and hot flashes. This period ends when the ovaries stop releasing eggs, which is when menopause, the next stage, starts.
  • Menopause: this is the time when ovaries stop releasing eggs and producing most part of their hormones, causing your menstrual cycles to stop. This period is commonly accompanied by symptoms such as vaginal dryness, mood swings,  hot flashes, and sleep disturbances. After having no menstrual period for 12 consecutive months, the next stage, postmenopause, begins.
  • Postmenopause: after not having a menstrual period for 12 consecutive months, people enter the stage of postmenopause, which will last for the rest of their lives. The menopause symptoms get better for most people at this stage. However, those may still last for up to 10 years or more for some people. Due to the low levels of hormones, people are at higher risk of cardiovascular disease and osteoporosis at this stage. 4

How do they test for menopause?

Most often there is no need to test for menopause since it can be tracked by observing people’s menstrual cycles. After 12 consecutive months without having a period, menopause usually can be diagnosed. 1,2,3

However, doctors can test for menopause when needed, usually by evaluating the blood levels of follicle-stimulating hormone, which become higher during menopause.

Is menopause bad?

No, menopause is not bad. Menopause, when it is not caused by any disease or surgery, is a natural process that happens with ageing. However, it is often accompanied by symptoms such as hot flashes, mood swings, vaginal dryness, and sleep disturbances that may affect people’s quality of life and require proper and careful management. 1,2,3

How is menopause treated?

Firstly, it is important to highlight that menopause is not a disease that needs to be treated, rather, it is a natural process of ageing. However, it is often accompanied by symptoms that can significantly affect people’s quality of life and those may require treatment. Therefore, menopause treatment differs for each person, since its focus is on easing the symptoms that cause discomfort for each individual.

The main treatments for menopause are 1,2:

  • Hormone replacement therapy: even though hormone therapy can effectively ease menopause symptoms, its use comes with health risks, such as blood clots and stroke, and should be carefully discussed with your doctor. When it is used, hormonal therapy is usually recommended in the first 10 years of menopause, when the health risks associated with it are lower, and usually in people younger than 60 years of age and for a short period of time;
  • Vaginal creams: can ease vaginal dryness and help with low lubrification during sex;
  • Antidepressants: can be used to treat mood swings or depression;
  • Anticonvulsant and blood pressure medication: can be used to relieve hot flashes.

How can I treat my menopause naturally?

There are many ways to treat menopause naturally, including lifestyle changes, acupuncture, and relaxation techniques. 5  Lifestyle changes include:

  • Healthy diet: maintaining a healthy diet with several groups of nutritious foods, avoiding caffeine and spicy food, not ingesting large amounts of alcohol, and eating foods rich in estrogens, such as soybeans, fruits, vegetables, and grains, can help ease menopause symptoms;
  • Practicing physical exercise regularly: can ease insomnia, mood swings, and depression. Weight-bearing exercises in particular can prevent and treat osteoporosis, a condition that people in menopause are at higher risk of developing;
  • Stop smoking: besides all the other health benefits that come with stopping smoking, it can ease hot flashes caused by menopause.

Even taking all these measures, menopause can be a challenging time for many people. Therefore, having strong support groups can be extremely beneficial. If you are struggling, talk to your family and friends, and also with your general practitioner about available support groups that you might benefit from.

Importantly, nontraditional treatments that include herbal medication and “natural” hormones should always be discussed with your doctor first, since those can be unsafe and/or ineffective. 6

How does menopause happen?

The ovaries are glands in the human body that store eggs, release them every month, and produce the hormones estrogen and progesterone. Menopause happens when the ovaries stop releasing the eggs and lower the production of estrogen and progesterone. 1,2,3

At what age does menopause happen?

The average age that menopause happens is around the age of 51. This is determined by many factors, but mostly by genetics. 1,2,3

How long does menopause last for?

Perimenopause can start up to a decade before menopause. Menopause lasts for the first 12 consecutive months without having a menstrual period. After menopause, postmenopause lasts for the rest of people’s lives, but fortunately, at this stage, most people have ease in menopause symptoms. 1,2,3

What is the main cause of menopause?

The main cause of menopause is natural menopause, which is a normal process of ageing when the ovaries stop releasing eggs and producing estrogen and progesterone. However, it can also be caused by surgical procedures, diseases, or the treatment of a disease. 1,2,3

What kind of doctor do I see for menopause issues?

For menopause issues, you can either consult your general practitioner or a gynecologist. During menopause, routine gynecological screening - including pap smear, pelvic exams, and mammograms - should continue, and bone density exams might also be recommended by your doctor. Therefore, keep scheduling your yearly check-up consults and talk with your general practitioner about how often you should make an appointment.

Additionally, during your consult, take the time to share your doubts and concerns about menopause with your general practitioner or other healthcare professional. Menopause can be a challenging period, however, many types of treatments and support are available and can be of help. 

References

  1. Grant MD, Marbella A, Wang AT, et al. Menopausal Symptoms: Comparative Effectiveness of Therapies [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2015 Mar. (Comparative Effectiveness Reviews, No. 147.) Introduction. Available from: https://www.ncbi.nlm.nih.gov/books/NBK285446/
  2. Gava G, Orsili I, Alvisi S, Mancini I, Seracchioli R, Meriggiola MC. Cognition, Mood and Sleep in Menopausal Transition: The Role of Menopause Hormone Therapy. Medicina (Kaunas). 2019 Oct 1;55(10):668. 
  3. Avis NE, Crawford SL, Green R. Vasomotor Symptoms Across the Menopause Transition: Differences Among Women. Obstet Gynecol Clin North Am. 2018 Dec;45(4):629-640. 
  4. Roa-Díaz ZM, Raguindin PF, Bano A, Laine JE, Muka T, Glisic M. Menopause and cardiometabolic diseases: What we (don't) know and why it matters. Maturitas. 2021 Oct;152:48-56.
  5. Minkin MJ. Menopause: Hormones, Lifestyle, and Optimizing Aging. Obstet Gynecol Clin North Am. 2019 Sep;46(3):501-514.
  6. Kenda M, Glavač NK, Nagy M, Sollner Dolenc M, On Behalf Of The Oemonom. Herbal Products Used in Menopause and for Gynecological Disorders. Molecules. 2021 Dec 8;26(24):7421.

Juliana Lima Constantino

Medical Doctor and Master Student in Epidemiology, University of Groningen, Netherlands

Juliana completed her studies in Medicine in Brazil in 2019, during which she studied a year abroad in The Netherlands at Vrije Universiteit Amsterdam and took a Medical Elective in England at Oxford University.

After graduating, she worked as a general practitioner and as an emergency doctor in the frontline against COVID-19 in Brazil. In 2021, she moved to the Netherlands to do her Master in Epidemiology.

She is currently working on her Master Thesis in the Global Health Department, with a focus on maternal and child health. She is passionate about medical writing as it serve as a way of spreading trustworthy knowledge to everyone.

Klarity is a citizen-centric health data management platform that enables citizens to securely access, control and share their own health data. Klarity Health Library aims to provide clear and evidence-based health and wellness related informative articles.