Menopause

Menopause arrives at the end of a woman’s last menstrual period, which typically happens between ages 45 and 55. But you may start experiencing hot flashes and other symptoms two to eight years before your last period.

Menstrual changes are often the first sign of approaching menopause. In the years before menopause, a woman’s ovaries naturally begin to produce less estrogen. As a result, you may skip periods or have heavier or lighter periods than usual.

Declining estrogen levels may also cause the following:

• Hot flashes, which cause hot, flushed skin and sweating
• Nighttime hot flashes, known as night sweats
• Difficulty falling or staying asleep, which may be related to night sweats
• Vaginal dryness and/or irritation
• Urinary incontinence and/or urinary tract infections
• Moodiness, which may be related to sleep problems or stress

Some of these symptoms may last for several years after a woman’s last period.

The simple lifestyle changes to help relieve menopausal symptoms:

• For hot flashes and night sweats: Avoid common triggers, such as spicy foods, caffeine and alcohol.
• Dress in removable layers. Keep your bedroom cool, and keep cold water on hand. Stay physically fit.
• For vaginal dryness: Try a water-based lubricant.
• For urinary incontinence: Practice pelvic-floor exercises. Tighten and release your bladder muscles as if trying not to urinate.
• For moodiness: Take time for exercise and relaxation.

Certain menopausal symptoms, such as hot flashes and vaginal dryness, respond to hormone replacement therapy (HRT). HRT may also protect against osteoporosis. However, HRT could pose serious health risks. For example, estrogen-only therapy might increase a woman’s risk for stroke and blood clots. And using combination therapy — estrogen plus progestin — is linked with a higher risk for blood clots, breast cancer, stroke and heart disease.

If you’re considering hormone replacement therapy, ask your ob-gyn or primary care physician for help in weighing its pros and cons.