Menopause

Learn more about menopause and how it is treated.

Overview

Menopause is the stage of life that begins after your last menstrual period. The years leading up to this point are called perimenopause.

You are born with approximately 700,000 eggs, which are gradually used up over a lifetime. Menopause occurs when these eggs run out. Menopause can also be brought on by surgery or chemotherapy.

More than 90 per cent of people experience menopause by the age of 56. However, for five per cent of people menopause occurs earlier, between the ages of 40-45. The average age of menopause is 51.

Visit our Menopause Clinic for information about our clinic-based care.

For more information on menopause, please visit the following websites:

Our care

Learn more about the specialized care provided at Mount Sinai Hospital for Gynaecology.

This content is intended for informational purposes only and is not intended to be used or relied upon for any diagnostic or treatment purposes. It does not replace the need for consultation with a health-care professional. Please speak with your health-care professional for questions about your health.

Symptoms

Common signs of menopause and perimenopause include the following:

Hot flashes
Night sweats
Vaginal dryness
New sleep difficulties
New or exacerbated mood changes
Changes in sexual desire
Newly painful intercourse
New non-deforming joint pain

Diagnosis

Menopause is diagnosed when you have not had a menstrual period for 12 straight months. However, symptoms often begin several years before.

Approximately 20 per cent of people experience severe symptoms.

Treatment

While menopause is a normal phase of life, treatments can help minimize severe symptoms. Talk to your health-care provider if your symptoms are affecting your quality of life.

Your treatment plan will depend on your specific symptoms and your personal and family medical history. Current treatment options include the following:

Lifestyle changes
Over-the-counter medication
Psychotherapy
Prescription non-hormonal and hormonal medication (hormone therapy)
Lubricants, moisturizers or local estrogen therapies for vaginal and sexual symptoms

Hormone therapy

Hormone therapy is replacement estrogen (or estrogen and progesterone) that gives you the same hormone levels that are produced before perimenopause. For people with a uterus, hormone therapy should include both estrogen and progesterone to prevent uterine cancer. If a hysterectomy, has been performed, only estrogen is needed.

The primary purpose of hormone therapy during menopause is to treat symptoms related to estrogen deficiency.

Hormone therapy is the most effective treatment for hot flashes and night sweats. It can improve sleep quality and joint pain. It is also helpful for mild mood symptoms associated with menopause and can work together with antidepressants.

There is evidence suggesting that hormone therapy can have positive effects on bone and heart health for people in their 50s without underlying heart disease.

Hormone therapy and cancer risk 

There is a lot of disagreement about hormone therapy and cancer risks. The largest prospective randomized trial done in the U.S. showed that those who took a specific type of estrogen hormone actually had fewer cases of breast cancer. However, those who took estrogen and progestin (a synthetic form of progesterone) had an additional one to two breast cancer cases in 1,000 women after five years.

Other studies on hormone therapy in menopause and cancer risk have had mixed findings.

The decision to take hormone therapy should consider a person's specific symptoms, risks, benefits and wishes.