Common Questions About Menopause

Emily Duncan's picture
By Emily Duncan on December 5, 2018

There is more to menopause than the end of a woman's menstrual cycle. However, it isn’t talked about openly, so the experience can feel overwhelming and isolating.

I spoke with Carilion Clinic's Elizabeth McCuin, M.D., an Obstetrics & Gynecology specialist and certified menopause practitioner, to learn more about menopause symptoms and treatments.

She recommended that women consider the sources of information they find online. 

“I encourage women to look only at reputable sites for information online like the American College of OB/GYN or the North American Menopause Society (NAMS).”

Every woman's experience is different so online information can be a first step, but should not be the only step.

"Some women breeze through the menopause transition, but other women have significant problems with the symptoms," said Dr. McCuin. "I encourage women to talk to their health care provider about their concerns and possible therapeutic options if needed."

Read on for more from Dr. McCuin. 
 
Living: What is menopause?

Dr. McCuin: Menopause is defined as the final menstrual period and usually confirmed when a woman has missed her periods for 12 consecutive months (in the absence of other obvious causes). It is a normal, natural event that marks the permanent end of fertility.

Menopause occurs, on average, at age 51, but it occurs most often between ages 45 and 55. NAMS describes perimenopause as the "gradual transition" from a woman's child-bearing years to menopause, when you may begin to see sights and symptoms of the end of your cycle. Perimenopause can last for many years.

Living: What are the signs and symptoms of menopause?

Dr. McCuin: As a woman approaches menopause, she may start to notice her periods spacing out, or skipping months. Some women have hot flashes and night sweats even before their period stops. 

Each woman’s experience will be different. Some will have no difficulties, while others can experience everything from hot flashes, vaginal dryness, depression, mood swings and difficulty sleeping.
 
Living: What are hot flashes? 

Dr. McCuin: The most common menopause-related discomfort is the hot flash (sometimes called a hot flush). Although their exact cause still isn’t fully understood, hot flashes are thought to be the result of changes in the hypothalamus, the part of the brain that regulates the body’s temperature. 

Not every woman experiences hot flashes, but those who do can experience perspiration, a quicker heartbeat and a red, flushed look to the face and neck. Hot flashes are often followed by a cold chill.

Living: How long will hot flashes last?

Dr. McCuin: Most women experience hot flashes for six months to two years, but they can last as long as 10 years. Hot flashes can reoccur more than 10 years after menopause, even into a woman’s 70s or beyond.

A small proportion of women experience them for the remainder of their lives. There is no reliable way of predicting when they will start—or stop.

Living: How can my doctor help with my hot flashes?

Dr. McCuin: There is no cure for hot flashes, and no treatment is necessary unless they are bothersome. Prescription therapy using hormone replacement therapy is the most effective treatment for hot flashes. There are other non-hormonal prescription therapies that can also be used such as certain antidepressants.

Living: What can I do at home to manage my symptoms?

Dr. McCuin: Lifestyle changes can help with hot flashes. Some women will find some relief with over-the-counter products, but many women do not and will need to see a provider.

Living: What are the risks of hormone therapy?

Dr. McCuin: Hormone replacement therapy (HRT) is associated with some potential risks. There is a small risk of developing a blood clot or having a stroke. There is also a small increase in the risk of breast cancer (about 1 more case in 1,000 women per year). It is important to review your medical history with your provider when considering HRT.

Vaginal estrogen (local therapy) can often be used in women to treat genitourinary syndrome of menopause (vaginal dryness) who should not or choose not to use HRT. But vaginal estrogen will not help with hot flashes.

Living: Does menopause cause moodiness and depression?

Dr. McCuin: A wide range of psychological symptoms can accompany perimenopause and menopause, from irritability and sadness to the recurrence of major depression. Women who experience mood changes should talk with their primary care provider or OB/GYN, whether their symptoms are related to menopause or not.

If you have questions or concerns about these or other menopause symptoms, make an appointment to discuss them with your OB/GYN or your primary care provider.