The word "Menopause" comes from two Greek words, Meno meaning, "month" and pausis, meaning, "to halt". Literally, it means "the end of menstruation".

Why does menstruation stop? Menstruation is directly connected to the production of the female hormones (estrogen and progesterone) by the ovaries. During the pre-menopausal years, generally between ages 40 and 50, the ovaries gradually reduce production and secretion of these two hormones. By the end of this 5 to 10 year period, ovarian function - as well as menstruation - has stopped altogether. After being menstruation free for 12 months, a woman is considered menopausal.

Symptoms

Menopause is a natural phenomenon, almost a "rite of passage", for women. Although approximately 10% of women experience no symptoms, most experience one or more of a multitude of symptoms directly related to the loss of estrogen and progesterone. These symptoms are often described as short, mid and long term.

Short Term

• Hot Flashes (also known as hot flushes or night sweats). About 75% of menopausal women will experience hot flashes, most for about a year, some for longer than five. Hot Flashes occur when blood vessels expand and blood comes to the body surface, giving a sensation of warmth. Body temperature rises, the heart races, and sweat pours from the skin; but blood pressure doesn't rise. It is not dangerous, but it is a nuisance.

• Psychological Symptoms. These include mood changes, irritability, sleep disturbances and depression. It is felt that the night sweats cause the sleep problems, which cause the irritability, mood changes and later, depression. Resolve the hot flashes and resolve most of the other symptoms, too.

Mid Term

Mid Term symptoms occur from a few months to a year after menopause begins and are generally more serious than the initial, short terms symptoms. They include:

• Vaginal Dryness. Sexual intercourse becomes difficult and painful.
• Bladder irritation. Increased likelihood of urinary tract infections and stress incontinence.
• Wrinkles. Skin becomes less elastic and springy.
• Aches and pains. Mostly in the joints.

Long Term

The following Long Term symptoms tend to show up many years after the onset of menopause. They also tend to be the most serious, and the hardest to treat; however for the most part, they are preventable.

• Osteoporosis. Bones become porous quite quickly after menopause and by 80 years of age, the average female will have lost 47% of her bone mass. By comparison, at the same age, men will have only lost about 14% of their bone mass. It's no wonder that 85% of hip fractures occur in post-menopausal women!
• Heart Disease. Prior to menopause, women are at significantly less risk of having a heart attack or stroke than men, which is believed to be due to high estrogen levels in pre-menopausal women. After menopause, estrogen levels decrease and the risk of heart problems increases dramatically for women, catching up to, and even overtaking, the risk for men.

Treatment

There are three different theories that inform the treatment of menopause:

1. It is a natural phenomenon, therefore leave it alone and let it run its course.
2. Treat each symptom separately, if and when, they occur.
3. The problems are caused by loss of estrogen and progesterone; therefore treat by replacing those hormones - Hormone Replacement Therapy (HRT).

Please read our article about Hormone Replacement Therapy for an in-depth look at this type of treatment for menopause.

Compiled by Dale Dodge
The Medicine Centre, Oliver, B.C.
Edited by Megan Stiles
Last Reviewed: September 2001