Menopause: Frequently asked questions

Menopause is the point in time when a woman's menstrual period stops and she can no longer get pregnant. A woman has reached menopause after a full year without periods. The years around the menopause when symptoms can be bothersome are called perimenopause.

Finding the right provider who will work with you to create a personalized care plan may not get rid of all menopause symptoms, but it can make this time a lot easier.

What are the symptoms of menopause?

The hormone changes that happen around menopause affect every woman differently. Some of these changes may lead to: 

• Irregular periods
• Hot flashes
• Trouble sleeping
• Vaginal dryness
• Sexual problems
• Mood changes
• Forgetfulness
• Weight gain
• Headaches
• Joint aches and pain

Why do menopause symptoms occur?

Every woman experiences menopause differently. Some women may not experience any noticeable symptoms, while others may feel as if they are experiencing every listed symptom of menopause. Symptoms can last for a few months or for several years and are caused by changes in the female hormones estrogen and progesterone. 

Recent studies show that 15 percent of females have bothersome hot flashes into their 80s. Changes in hormones are a result of aging, or are medically induced through medication or an operation.

When can I expect to experience menopause?

Women are usually in their late 40s or early 50s when the menopause transition starts. However, an earlier menopause can be the result of surgery, cancer treatment, or family genetics.

Will having a hysterectomy cause menopause?

A woman who has a hysterectomy, but keeps her ovaries does not have menopause right away. Because your uterus is removed, you no longer have periods and cannot get pregnant. However, your ovaries might still make hormones, so you might not have other signs of menopause. Later on, you might have natural menopause a year or two earlier than usually expected.

A woman who has both ovaries removed at the same time that the hysterectomy is done reaches menopause right away. Having both ovaries removed is called a bilateral oophorectomy. Women who have this operation no longer have periods and may have menopausal symptoms right away.

How can I prevent hot flashes?

Avoid triggers, such as:

• Spicy foods
• Alcohol
• Caffeine
• Stress

Keep a fan in your home or workplace and try taking slow, deep breaths when you feel a hot flash starting.

Does menopause cause bone loss?

Lower estrogen around the time of menopause leads to bone loss in women. Bone loss can cause bones to weaken, which can cause bones to break more easily. When bones weaken a lot, the condition is called osteoporosis.

To keep your bones strong, women need weight-bearing exercise, such as walking, climbing stairs, or using weights. You can also protect bone health by eating foods rich in calcium and vitamin D, or if needed, taking calcium and vitamin D supplements. Not smoking also helps protect your bones.

Does menopause increase risk of heart disease?

Yes. After menopause, women are more likely to have cardiovascular problems, like heart attacks and strokes. Changes in estrogen levels may be part of the cause, but so is getting older.

That’s because as you get older, you may gain weight and develop other health problems that increase your risk of cardiovascular disease. Ask your doctor about important tests like those for cholesterol and high blood pressure.

Do women have sexual problems after menopause?

Yes, problems with sexual function occur in women of all ages. These include problems with sexual interest, arousal, orgasm function, and pain.

Doctors with the University of Iowa Health Care Menopause and Sexual Health Clinic work with their patients to design an individualized care plan targeted to each woman’s specific needs. The clinic sees women of all ages who have sexual health concerns.

What can be done about vaginal dryness?

Try using a plant-based vaginal lubricant coconut or olive oil to help make sex more comfortable. You can also try using an over-the-counter vaginal moisturizer like Replens to help keep needed moisture in your vagina. 

If the dryness is severe, the most effective treatment may be vaginal DHEA or estrogen therapy. 

How are sexual problems after menopause evaluated?

A professional will ask you to share detailed information about your symptoms, general health, past operations, and any medications you might be taking. This initial evaluation is a conversation where you are fully clothed. Everything you share is held in confidence. 

If a gynecologic exam is needed, arrangements can be made when you are ready. The exam can be performed in the sitting position with a mirror in order to explain your anatomy and any findings that might be contributing to pain.

What can I do if I have trouble sleeping?

You’re not alone–50 percent of women ages 40 to 59 report poor sleep quality. Try following these tips to improve your sleep hygiene: 

• Be physically active during the day.
• Avoid large meals, smoking, and working right before bed.
• Keep your bedroom dark, quiet, and cool.
• Avoid napping.
• Establish a bedtime routine.
• Limit the bedroom to sleep and intimacy.
• Wear lightweight clothing.

Can hormone therapy (HT) help treat menopause symptoms?

For females with a uterus, HT involves the hormones estrogen and a progestogen. Women who don’t have a uterus anymore use estrogen alone.

Most of the estrogen prescribed is bioidentical estradiol and is delivered through the skin to improve safety. HT can be very good at relieving moderate to severe menopausal symptoms and preventing hip fractures.

However, HT isn’t for everybody. A professional will perform an individual risk assessment and counsel you on how to reduce the risk of blood clots, heart attack, stroke, breast cancer, and gallbladder disease, which can be associated with HT. 

You should not take HT if you:

• Think you are pregnant
• Have undiagnosed vaginal bleeding
• Have had breast cancer or uterine cancer
• Have had a stroke or heart attack
• Have had blood clots
• Have liver disease or heart disease

What can I do to improve mood swings from menopause?

Getting enough sleep and staying physically active may help prevent mood swings. You can also try learning new ways to deal with stress, like meditating or journaling. If you need somebody to talk to, consider joining a support group or seeing a therapist.

Why does forgetfulness occur during menopause?

Many women report cognitive changes during menopause. Getting enough sleep and being active may help. However, if forgetfulness is affecting your daily life, see your doctor.