Menopause is the permanent cessation of menstruation and diagnosed in females after 1 year of absent menstrual periods.  The average age of menopause is 51 years.

Perimenopause usually begins a few years before the last menstrual cycle and is characterized by symptoms associated with decreased blood levels of the female hormones estrogen and progesterone.

Possible Causes of Early Menopause:

  • Surgical removal of ovaries
  • Chemotherapy
  • Radiation therapy, especially targeted to the pelvic area
  • Premature Ovarian Failure

Physical/Emotional Changes of Perimenopause or Menopause:

  • Menstrual irregularity
  • Hot flashes or flushes, night sweats- sensation of heat spreading from the waist or chest toward the neck, face and upper arms
  • Headaches
  • Dizziness
  • Rapid or irregular heartbeat
  • Vaginal itching, burning, discomfort, and dryness during intercourse
  • Thinning of lining of urethra, causing frequent or urgent urination
  • Bloating of upper abdomen
  • Breast tenderness
  • Mood changes, increased tension and anxiety
  • Sleeping difficulty
  • Decreased sexual desire and response
  • Possible changes in memory or other mental abilities
  • Depression and fatigue
  • Bone loss and increased risk for osteoporosis
  • Cholesterol level may increase


Treatment Options for Menopause Symptoms:

Systemic Hormone Replacement-

  • Estrogen therapy
  • Progesterone and estrogen treatment in patients with a uterus. Estrogen therapy alone can increase the risk of endometrial cancer in a patient with a uterus.
  • Risks and benefits need to be discussed with a healthcare provider. Systemic hormone replacement therapy may increase a patient’s risk of stroke, blood clots, cardiovascular disease and breast cancer.

Localized Vaginal Estrogen Therapy-

Used to relieve vaginal symptoms of menopause.  Vaginal estrogen therapy can be administered into the vagina through a pill, cream or ring method.  It is believed to be free of systemic effects and risks for most patients.

Nonhormonal Treatments-

  • Prescription medications such as types of antidepressants.
  • Herbal remedies such as soy products, black cohosh are helpful in some patients.
  • Vaginal moisturizers and water-soluble lubricants to relieve vaginal symptoms.
  • Paced breathing exercises, acupuncture, yoga.

Menopause can be a challenging time in a woman’s life. Help is available by exploring your treatment options with an experienced healthcare provider.