The time before menopause is perimenopause. It may begin several years before the last menstrual period. Signs of perimenopause include first more frequent and then occasional missed periods, periods that last longer or shorter,and changes in the amount of menstrual flow. Eventually the periods will become much less frequent, until they stop completely.
Along with changes in your periods, physical changes in your reproductive tract occur as well.
Aging Changes and Their Effects
Menopause is a normal part of a woman's aging process. Most women experience menopause around age 50, though it can occur before then. The usual age range is 45-55.
As hormone levels fall, other changes occur in the reproductive system, including:
Other common changes include:
Hormone therapy in the form of estrogen or progesterone alone or in combination may help menopause symptoms such as hot flashes or vaginal dryness and pain with intercourse. Hormone therapy has risks, so it is not for every woman. Discuss the risks and benefits of hormone therapy with your health care provider.
To help manage problems such as painful sexual intercourse, using a lubricant during sexual intercourse may help. Vaginal moisturizers are available without a prescription. These can help with vulvar discomfort due to the drying and thinning of the tissues. Topical estrogen applied inside the vagina may help maintain the structure of the vaginal tissues by thickening the tissues and increasing moisture, and sensitivity. Your health care provider can tell you if any of these measures is right for you.
Getting regular exercise, eating healthy foods, and staying involved in activities and with friends and loved ones can help the aging process go more smoothly.
Other Aging Changes to Expect:
Lobo RA. Menopause and care of the mature woman: endocrinology, consequences of estrogen deficiency, effects of hormone replacement therapy, treatment regimens. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 14.
North American Menopause Society. Estrogen and progestogen use in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause. 2010 Mar;17(2):242-55.
Updated by: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.
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