T I M E F O R A C H A N G E
National Institutes of Health
U.S. Department of Health & Human Services
Table of Contents
AN INTRODUCTION TO MENOPAUSE . . . . . . . . . 2
Understanding the transition through
menopause and why menopause
happens early in some women
SIGNS OF THE MENOPAUSAL TRANSITION . . . . 7
Hot flashes and other symptoms
WHAT YOU CAN DO FOR HOT FLASHES
AND OTHER MENOPAUSAL SYMPTOMS . . . . . . 11
How some women find help
POSTMENOPAUSAL HEALTH CONCERNS . . . . . 18
disease, and urinary incontinence
STAYING HEALTHY . . . . . . . . . . . . . . . . . . . . . . . . . 26
Nutrition, health care, and lifestyle
suggestions to follow during and
FOR MORE INFORMATION . . . . . . . . . . . . . . . . . . 35
you are a woman in her mid forties or early fifties, you may feel like your body is changing, but you If may not know what is happening. Maybe your periods are not the same. You don’t sleep as well as you always have. Or your waist is getting thicker. You may not be paying much attention to these changes until one day, if you’re like many women, it happens—a hot flash! One minute you feel perfectly comfortable, and the next you are sweating and flushed—for no apparent reason. You may be surprised.
You may feel “too young.” You ask yourself—could this be the start of my transition through menopause?
This booklet begins with an explanation of what is happening during the menopausal transition. It will tell you about some of the common signs that you are beginning this transition and give you information about handling bothersome symptoms. There is a discussion of some health problems that become more common after menopause, as well as suggestions for staying healthy.
There is a resource list for more information. This booklet, based on research conducted by scientists, represents what we know now about the menopausal transition.
A N I N T R O D U C T I O N T O
Menopause, also known as “the
change” or “change of life,” is a
normal part of a woman’s life.
It is a point in time—the last
menstrual cycle, the last period.
The years leading up to that
last period, when women might
be experiencing menopausal
symptoms like changes in their
monthly cycles or hot flashes, are
called the menopausal transition.
It is a common mistake to use
the word menopause to describe
this whole transition.
A N I N T R O D U C T I O N T O M E N O P A U S E
occurs at a time in a woman’s
reproductive life when the production
of estrogen and progesterone, two
dryness, are caused by changes in her
hormones made by the ovaries, may
hormone levels. As a woman ages and
vary dramatically and unpredictably.
especially as she gets closer to menopause, The ovaries are two small glands found
her ovaries get smaller. This time of changes on either side of the top of the uterus or in hormone levels and menstrual cycles
womb. Before menopause, they hold
is called the menopausal transition. You
eggs, one or more of which are released
might also hear it called perimenopause.
during a menstrual cycle. If the egg then It usually lasts several years until 12 months joins with sperm following sexual inter-after your last period. Once a woman has
course and attaches itself inside the uterus, gone a full 12 months without a period,
pregnancy is the result. Ovaries also
she can be fairly sure that she has been
produce chemical substances known as
through menopause and is now in post-
hormones, which travel through the blood
menopause. The chart on page 5 shows
to other tissues to control how cells work.
how the patterns of hormone production
One of these, estrogen, has effects on cells change as women go from their reproductive in many parts of the body including the
years through the menopausal transition to reproductive organs, brain, heart and
postmenopause. Postmenopause lasts the
blood vessels, and bone.
rest of a woman’s life.
Usually in her forties, a woman’s body
Going through menopause is a little
starts changing. Some differences, such as like driving on an unfamiliar, twisting road a thickening waist, can happen because
with an unclear destination. You may not
she is getting older, but others, like vaginal be sure of all that is happening, where you 3
M E N O P A U S E : T I M E F O R A C H A N G E
R E P R O D U C T I V E A G I N G I N W O M E N
R e p r o d u c t i v e Ye a r s
M e n o p a u s a l
Tr a n s i t i o n