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Define Menopause, Please!

I’m glad you asked. There seems to be some confusion about the term, and how it’s used to define our reproductive state of being. First off, menopause is the permanent cessation of our reproductive hormones, and therefore, the end of our menstrual cycling. The average age of menopause is approximately 51yo in the United States, though some women may end earlier, and some later. For most women it’s not so much the ending of the periods that’s bothersome, but the symptoms that may go along with this “change"...


Most women experience hot flashes during this time, and many women experience noticeable changes in their menstrual period in the few years before the periods actually stop. These changes in their menstrual flow could be anything from…light/spotty or missed periods…to super heavy bleeding…and darn near any pattern in between! We can’t attribute all of the changes in our menstrual flow to “the change” though. You should definitely see your doctor for spotting and bleeding between your monthly period, for very heavy flow (with clots), for symptoms of fatigue or lightheadedness with your period, or missed periods that you may not have reviewed with your doctor yet. You may need a work up to look for other causes, such as fibroids, polyps, or cancers. As well, if you think you’re menopausal (by definition… one year without periods with the onset of hot flashes) and even light spotting or menstrual-like bleeding returns, contact your provider for evaluation.

The hallmark of menopause is the cessation of the menstrual period and the onset of hot flashes. This may be a gradual “change” that happens over a few months to a few years, defined as the ‘peri-menopause’. Some women notice emotional symptoms as well, like irritability and mood swing…Or maybe she just doesn’t feel like herself. Many patients ask me if depression is part of “the change “. We do know that depression is more common in women in this age bracket, but less likely, caused by the menopausal change. I try to get patients to prioritize their symptoms. If hot flashes, night sweats and interrupted sleep (with some noticeable, but more minor mood shifts) are her story, I’d more likely attribute these symptoms to peri/menopausal changes. If her main complaint is major depressed mood, lack of energy/motivation, more serious crying episodes ( and ‘oh-by-the-way’, I’m having hot flashes) I’d have her consider further evaluation for depression as first priority, and offer options for menopausal symptoms secondarily.




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