Dear Dr Mitchell,
How long does the menopause last? I was under the impression that it lasted from the pause of pregnancy until death — the weird symptoms, that is, but I heard that after a while the symptoms go away, and a woman is basically post-menopausal. Can you explain the stage?
Menopause is defined as the stage at which a woman stops having her monthly period. This tends to happen on average at the age of 51 years for most women. Once the menstrual period stops for a full year then the woman is considered to have reached the menopause. The transition usually starts from age 45 to about 55 years. It tends to last about seven years but can last up to 14 years. During this transition the ovaries decline in the production of oestrogen and progesterone. The frequency of ovulation also decreases significantly. The duration of this perimenopausal phase depends on lifestyle factors such as smoking, age and race. During these years of declining ovarian function, the body begins to use the energy differently and metabolism slows down with increase in fat cells and weight gain. These may also be associated with changes in your bones, heart, body shape and physical function.
The menopause can also be triggered by removing the uterus or the ovaries. The symptoms of the menopause will usually come on immediately once the ovaries are removed by surgery.
In the post-menopausal period women are more at risk for the development of heart disease and thinning of the bones (osteoporosis). A balanced diet with regular exercise and calcium supplements will help to maintain healthy bones.
Many women experience only mild symptoms which can be successfully treated by lifestyle changes. Some women do not require any treatment but when symptoms are severe then treatment may become necessary.
Changes in the menstrual period with variation in length of the cycle or flow may be the first sign of the decline in the function of the ovaries. However, if the menstrual period returns after the bleeding has stopped for more than a year then this needs to be properly investigated to rule out cancer in the uterus or ovaries.
Hot flashes can last for many years after the menopause due to the decline in oestrogen levels. This is a sudden feeling of heat in the upper parts of the body. The face and neck may become flushed and red blotches may be seen on the chest, back and arms. Excessive sweating and cold shivering can follow. These can be very mild or severe enough to cause night sweats and sleeplessness. These usually last between 30 seconds to 10 minutes. The frequency also varies.
Changes in bladder control with incontinence may occur. This may present with a sudden urge to pass urine, leakage of urine during exercise, sneezing or coughing. Bladder infections may also be more frequent.
Changes in sleep pattern with difficulty falling asleep and waking up at intervals may also be an issue.
The vagina may also become drier and cause sexual intercourse to become uncomfortable. There may also be a decrease in the desire for sexual activity. Mood changes with increased irritability may also be a problem around the time of the menopause.
Changes in body image with loss of muscle and increased body fat can occur. The skin can also become thinner. Memory problems, increased joint pain with stiffness in the muscles, headaches and palpitations can also increase.
It is important to have your yearly checks once you are approaching the menopause and discuss the problems so that appropriate treatment options can be undertaken to manage any significant symptoms during the menopausal transition and also in the post menopausal period.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to email@example.com; write to All Woman, 40-42 1/2 Beechwood Avenue, Kingston 5 or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
The contents of this article are for informational purposes only and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
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