- FAQ / Menopause
- Menopause
Your questions, answered.
- Do you have questions about your mid-life health?
We have gathered a list of the most common questions women ask regarding topics that affect your overall health and well-being.
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- What Is Menopause?
By definition, menopause has occurred when your menstrual period has stopped for 12 months (no more periods!), which means your ovaries are no longer functioning. When women say they are “menopausal”, most often they are experiencing symptoms of the transition to menopause, called the perimenopause.
- Are There Different Types Of Menopause?
- There are three types of menopause:
- Natural menopause occurs naturally as women age. This gradual ending of the menstrual period is not caused by an illness, disease or interference.
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Surgical menopause occurs:
• When the ovaries are removed (bilateral oophorectomy) menopause occurs immediately.
• Women who have had their uterus removed (hysterectomy) but their ovaries are left in place may experience menopause around 2-3 years earlier than the average age.
• Chemotherapy can also activate menopause earlier. These symptoms may be temporary and the functions of the ovaries may return, including a menstrual cycle. Sometimes the ovaries are surgically removed to stop their biological function of releasing hormones, especially in cases of hormone sensitive cancers.
- Premature Menopause occurs when a women experiences menopause under the age of 40, either naturally or surgically. The main cause for premature menopause is unknown, but studies suggest that autoimmune diseases, genetics, injury of the ovarian tissues and chemotherapy may contribute to the cause.
For more information:
- What Is Perimenopause?
- Perimenopause is the period of a woman’s life when physical and psychological changes indicate the approach of menopause, the end of women’s reproductive capacity;
- These signs may begin 10 or more years before menopause. The average age of natural menopause is 51 years, so symptoms of perimenopause may start as early as 41 years of age;
- Fluctuations in estrogen levels cause symptoms such as hotflashes, breast tenderness, and decreased vaginal lubrication;
- Menopause caused by surgery or chemotherapy may cause a sudden drop in estrogen resulting in sudden often intense symptoms.
Premature (early) menopause occurs naturally or is induced before the age of 40. Induced menopause occurs when periods are stopped by an intervention such as chemotherapy, radiation or surgical removal of the ovaries.
Premature ovarian failure occurs when periods stop for several months or years, long before the typical age of menopause. Temporary premature ovarian failure may be caused by drastic weight loss, an eating disorder, excessive exercise or stress. Permanent premature ovarian failure may be related to genetic abnormalities or certain autoimmune diseases.
- What Are The Symptoms Of Menopause?
- How do I know if I am experiencing perimenopause (the time of life approaching menopause)?
- The most commonly experienced symptoms include:
- Changes in menstrual cycle (longer or shorter periods, heavier or lighter flow, clotting, missing periods, or any combination
- Hot flashes, power surges, tropical moments: a sudden flash of heat from your chest to your head
- Night sweats: hot flashes that occur when you are sleeping and disturb your sleep
- Fatigue
- Interrupted sleep
- Vaginal dryness
- Vision changes
- Mood swings, depression, irritability
- Loss of desire for sex, painful intercourse
- Increased body fat around your waist
- Weight gain
- Rogue chin hairs
- Problems with memory and concentration
- Wrinkles when you smile (and when you don't)
- Other less common symptoms include:
- Crawly feeling under the skin (formication)
- Bouts of rapid heart beat
- Chills or periods of extreme warmth (other than during a hot flash)
- Bloating, gas pains, flatulence
- Anxiety and panic attacks
- Sensitivity to being touched by others
- Aching ankles, knees, wrists, shoulders
- Urinary leakage (when you laugh, cough, sneeze or when the urge is too great)
- Acne
- Vaginal or urinary tract infections
- Thinning hair on scalp
- Migraine headaches
- Easily hurt feelings
- Sudden, innapropriate bursts of anger
- How Do I Get Relief From Perimenopause Symptoms?
- You can relieve symptoms of perimenopause by:
- Talk to your health care provider about the physical and emotional changes you are experiencing, including anxiety or depression
- Keep a diary of your menstruation dates, flow, clots, pain, etc.
- Keep track in your diary of any other symptoms you may be experiencing, when they occur and the circumstances (ie. hot flashes every evening after you have had red wine, more night sweats following an evening in the hot tub)
- See if there is a pattern or triggers for your symptoms. You can change or avoid these triggers and thereby avoid or reduce the symptoms
- Do some form of brisk physical activity for 30-60 minutes per day. Find physical activites you enjoy and commit to doing them
- Limit caffeine, nicotine and alcohol
- Dress in layers so you can peel off and put on layers as needed
- Wear cotton - man-made fibers are hot and don't breathe or absorb perspiration during a hot flash or night sweat
- Eat healthy foods
- Talk to friends about what you are going through. Chances are some of them have had or will have similar experiences. It is a good time to get togehter with other women and share some laughter and some tears.
- Nurture yourself, breath deeply, meditate
- For vaginal dryness, try using a vaginal lubricant. If this isn't help enough, talk to your health care provider
- Remember, this is all new for you, so give yourself permission to go through it your way, with a little help from your friends
- Are There Alternative Treatments For Hot Flash Relief?
- Symptoms include:
- Feeling hot in the upper body, face and head
- Sweating
- Heart palpitations (rapid heart beating)
- Apprehension or anxiety
- What may be helpful?
- Lifestyle changes:
- Keep cool: use fans, control room temperature, wear cotton clothing in layers so you can adjust your body temperature by removing layers
- Regular exercise: 30 minutes of brisk activity daily
- Maintain a healthy weight
- Quit smoking and avoide second-hand smoke
- Avoid triggers such as hot beverages, caffeine, alcohol, hot sauces/spices
- Pace your breathing with relaxation techniques such as Tai Chi and yoga
- Over-the-counter products:
- See natural remedies by MedSask
- Acupuncture - mixed clinical review about effectiveness
- Prescription medications:
- Hormone therapy (HT)
- Estrogen, progesterone, used together or separately; taken by mouth (oral) or by skin patch (transdermal)
- Antidepressants: Venlafaxine, Fluoxetine, Paroxitine
- Anticonvulsant: Gabapentin - effective for hot flash treatment
- Antihypertensive: Clonidine - effective for mild hot flashes
- When Does Post-Menopause Start?
These are all the years following the 12 months of being without a period. The life style choices we make in our forties and fifties will have a direct impact on our older age.
Many women find that the years after menopause are the richest years of their lives because they experience more confidence about themselves and feel a certain zest for life.
“By the age of 50 you have made yourself what you are, and if it is good, it is better than your youth.” – quote by Marya Mannes.
- Are There Health Concerns Post-Menopause?
- Common health concerns are:
- Heart disease (the number one killer of women in North America)
- Osteoporosis (bone loss is rapid in the first 5 years post-menopause)
- Cancer (breast, lung, colorectal, uterus, ovarian)
Check out these websites to find out how:
- Cognitive Behavioural Therapy For Menopause Symptoms
Cognitive behavioural therapy (CBT) is a low-risk, psychological treatment approach that was initially used to treat the emotional symptoms of depression and anxiety. CBT aims to challenge and change destructive thoughts, negative beliefs, and problematic behaviours into positive thought patterns that will help you respond to your symptoms in a productive way. Research has shown that this same approach can be highly effective in treating your symptoms of menopause such as:
- Hot Flashes
- Night Sweats
- Insomnia
- Depression
- Anxiety
- Is CBT right for me?
- CBT is recommended for people who:
- Can be used alongside medical management
- Have been recommended not to use medical treatments
- Are not satisfied with the effectiveness of medical treatment
- Have severe symptoms despite using other treatments
- Prefer self-management techniques over medication
- What can I expect from CBT?
- You can expect to:
- Gain knowledge about menopause
- Learn techniques for relaxation, coping, resilience, stress management, assertiveness
- Identify maladaptive behaviours
- Reshape these behaviours
- Confidentiality from the therapist
- How can I get started?
- Purchase “The Cognitive Behavioural Workbook for Menopause” by Sheryl Green, Randi McCabe, and Claudio Soares, 2012. This self-help book will take you through a step-by-step guide of how to change your thought patterns and help give you immediate relief with the symptoms you are struggling with most.
- Ask your doctor to reommend a CBT therapist
- Check to see if the cost is covered under your third party health plan, your Employee Assistance Plan or other employee benefits plan, etc.
- References
Green, S., Haber, E., McCabe, R., & Soares, C. (2013). Cognitive-behavioral group treatment for menopausal symptoms: a pilot study. Archives Of Women’s Mental Health, 16(4), 325-332 8p. doi:10.1007/s00737-013-0339-x
Green, S., McCabe, R., & Soares, C. (2012). The cognitive behavioural workbook for menopause. A step by step guide for overcoming hot flashes, mood swings, insomnia, anxiety, depression, and other symptoms. Oakland, CA: New Harbinger Publications, Inc.
Hunter, M., Coventry, S., Hamed, H., Fentiman, I., & Grunfeld, E. (2009). Evaluation of a group cognitive behavioural intervention for women suffering from menopausal symptoms following breast cancer treatment. Psycho-Oncology, 18(5), 560-563 4p. doi:10.1002/pon.1414
North American Menopause Society (2015). Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society. Menopause, 22(11), 1155-1174. doi:10.1097/GME.0000000000000546
Created by Katie Cotter for:
The Women’s Mid-life Health Program
Saskatchewan Collaborative Bachelor of Science in Nursing. March 2016