Menopause

A woman has reached menopause when she has not had a menstrual period for one year. The time of transition, or perimenopause, usually begins when a woman is in her 40s. Each woman’s experience can be very different, however.

Although most changes occurring during perimenopause will not continue far beyond menopause and will stop without treatment, it is important to seek a medical evaluation. Hot flashes and other changes can be a sign of disease or can be caused by other conditions, such as a thyroid disorder. Any changes should always be reported to your health care provider.

The most reliable test for menopause measures the blood level of the follicle-stimulating hormone (FSH), which is produced by the pituitary gland. This hormone stimulates the ovaries to secrete estrogen. As the ovaries age and production of estrogen declines, the pituitary gland tries to stimulate greater estrogen production by releasing more FSH into the blood. When a woman’s FSH rises to a constant level in the blood of 30 to 40 mIU/mL or higher, it is generally accepted that she is nearing menopause.

Many women go through the menopause transition with minimal discomfort. Those who do experience discomforts may reduce them by making lifestyle changes. These include stopping smoking; exercising; modifying alcohol intake; eating a healthy diet, and practicing safe sex. For those who need additional help with symptoms, hormone therapy (HT) is an option. The decision on whether to use HT should be made by a woman and her health care provider.