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National Women’s Health Information Center


North American Menopause Society (NAMS)


Menopause occurs when menstrual periods have stopped for one whole year. It is also called “the change of life.” In general, this occurs between the ages of 45 and 55. It can, though, occur as early as age 35 or as late as age 65. It can also result when both ovaries are removed by surgery.

Signs &




to Ask

Self-Care /


Signs and symptoms usually span 1 to 2 or more years. This is called peri-menopause. Symptoms vary from woman to woman. They result from hormone changes, the aging process itself, fatigue, and stress.

Physical Signs and Symptoms

•  Hot flashes. These are sudden waves of heat that can start in the waist or chest and work their way to the neck and face and sometimes the rest of the body. They can occur as often as every 90 minutes. Each one can last from 15 seconds to 30 minutes; 5 minutes is average. Seventy-five to 80% of women going through menopause have hot flashes. Some women are more bothered by them than others. Sometimes heart palpitations come with hot flashes.

•  Vaginal dryness. The vaginal wall also becomes thinner. These problems can make sex painful or uncomfortable. Irritation can increase the risk for infection.

•  Loss of bladder tone. This can result in stress incontinence (leaking urine when you cough, sneeze, laugh, or exercise).

•  Headaches.

•  Dizziness.

•  The skin is more likely to wrinkle.

•  Hair grows on the face, but thins at the temples.

•  Muscles lose some strength and tone.

•  Bones become more brittle. This increases the risk for osteoporosis.

•  Irregular periods:

– Bleeding can occur between periods. This is the most common bleeding pattern in peri-menopause.

– Periods get shorter and lighter for 2 or more years.

– Periods can stop for a few months and then start up again and are more widely spaced.

– Periods occur with heavy bleeding and/or the passage of many small or large blood clots.

Emotional Signs and Symptoms

•  Irritability.

•  Mood changes.

•  Lack of concentration. Memory problems.

•  Tension, anxiety, depression.

•  Insomnia. Hot flashes can interrupt sleep.

Hormone changes that come with aging cause menopause. The body makes less estrogen and progesterone.

Self-care may be all that is needed. Just estrogen can be prescribed. This is estrogen therapy (ET). Estrogen plus progestogen can be prescribed. This is called EPT. The term hormone therapy (HT) is used for both ET and EPT. Hormone therapy helps protect against osteoporosis, but has health risks. Each women should discuss the benefits and risks of HT and non-estrogen treatments with her doctor.

This website is not meant to substitute for expert medical advice or treatment. Follow your doctor’s or health care provider’s advice if it differs from what is given in this guide.


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