Menopause & HRT Patient Information Fact Sheet

What is menopause?
Menopause is defined as the time of a woman’s last menstrual period. This is the time in a woman’s life when fertility ends, although the loss of fertility is not a sudden event. Fertility begins to decline gradually as the number of eggs in the ovaries falls. This fall is associated with reduced levels of the reproductive hormones estrogen and progesterone.

Every woman is different but menopause usually occurs between the ages of 40 and 58. In some women it may occur as early as 40—this is often a hereditary trait passed from mother to daughter. There is some evidence to suggest that the earlier a woman starts her periods, the later her menopause will be. Menopause occurs naturally but may also be induced by surgery, such as the removal of the ovaries, or by damage to the ovaries caused by chemotherapy or radiation.

A woman is described as postmenopausal if it has been more than a year since her last menstrual period. A woman is described as perimenopausal from the time that symptoms of the approaching menopause begin until 12 months after her last period.

What causes menopause?
During a woman’s reproductive life, the ovaries produce two hormones, estrogen and progesterone. These are both necessary for the normal reproductive cycle to happen. As the number of eggs in the ovaries diminishes, the level of hormones produced starts to decrease. It is the marked loss of estrogen at menopause that is responsible for most of the physical signs and symptoms.

What are the symptoms of menopause?
Menopause affects every woman differently—while some may suffer no symptoms at all others may suffer effects severe enough to cause them to seek medical advice. Some of the more common symptoms are listed below.

  • Periods become irregular and eventually stop (changes may start as early as six years before the menopause). Sometimes the periods become heavier in the years before menopause—seek medical advice if this occurs because fibroids may also cause heavy periods. Heavy and prolonged periods may cause anemia.
  • Hot flashes may occur before or during menopause, causing sweating, blushing and night sweats. These symptoms may last from a few months or up to five years.
  • Vaginal dryness, caused by a decrease in secretions, may make sexual intercourse uncomfortable and also increases susceptibility to infections or cystitis.
  • Mood changes are common and may be the result of menopause itself or the result of other life changes going on at the same time.
  • Osteoporosis: after menopause bone mass begins to decrease making the bones thinner and more prone to fracture. Women who are small-boned, heavy drinkers, smokers or taking medicines such as levothyroxine or corticosteroids are at greater risk for osteoporosis.
  • Postmenopausal women are at an increased risk for cardiovascular disease, including stroke.