10 Things You Should Know About Menopause

Amy Hendel | Nov 2, 2012

Reviewed by Peter J. Chen, MD, FACOG

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It’s been called the a time of renewal or the start of the next half of your life. However you think of menopause, there are plenty of questions women have about this milestone. It is important to know that menopause is not a disease but rather a phase in the life cycle. Here are 10 things you should know.

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You no longer need birth control

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You no longer need birth control once menopause is complete, but how do you know when that is? You most certainly need to use birth control until you have missed your menstrual cycle for 12 consecutive months. It is not unusual for women to miss several menstrual cycles only to have a period and then have to start counting missed cycles again. You can get pregnant during these “start and stop” moments, so only give up birth control after the 12th-consecutive missed cycle, or as instructed by your doctor.

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Not all women get hot flashes

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Not all women get hot flashes as they move into their menopausal stage. Most women will experience some hot flashes (and sweats), particularly at night.  Experiencing hot flashes can continue up until five years post menopause.

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Weight gain around your mid-section is typical

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Weight gain around your mid-section is typical and is often due to the fact that you may need to adjust your daily total calories downward in response to a slightly slower metabolic rate (and loss of muscle mass).

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You may experience vulvar and vaginal atrophy

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Vaginal atrophy is when the skin and tissues in and around your vagina become drier, thinner, and less elastic. You may experience vulvar and vaginal atrophy during menopause, which can result in dryness and painful intercourse. Talk to your gynecologist about treatment options.

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Hormone therapy a treatment option only for severe hot flashes

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Hormone therapy (HT) is currently considered a medical treatment option only for severe, unrelenting hot flashes, due to the increased risk of breast cancer associated with HT. The safest options, such as lifestyle changes, should be explored first. Prescribed medical therapy then may be considered as needed.

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Sleep difficulties, anxiety among common complaints

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Sleep difficulties, anxiety, depression, forgetfulness, and irritability are common complaints of women who have experienced menopause.

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There are alternatives to HT

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If you prefer to try therapies other than HT for hot flashes, they can include vitamin B complex, vitamin E, or certain drugs, including paroxetine, clonidine, or gabapentin. Some women also respond to black cohosh, adding soy foods to their diet, using evening primrose oil, or combining some of these treatments.

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Osteoporosis risk increases after menopause

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Beginning at age 65, DEXA screening for bone density is recommended. If you are younger than 65, you may get this screening if you are postmenopausal and have other risk factors such as weighing less than 126 pounds, you smoke, or you have medical conditions and risks for bone loss for fracture. Alternatively, a tool called the FRAX assessment can be used in women younger than 65 years to determine which women should have a DEXA scan.

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Heart disease risk increases after menopause

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Heart disease risk increases after menopause due to the decrease of estrogen levels.

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Your voice may change

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A small subset of women can experience a voice change after menopause, though most do not. Facial hair may also increase.