Throughout her life, a woman will go through several different reproductive stages including puberty, the fertile period, and menopause. Menopause is the stage that signals the end of a woman’s reproductive years.


Menopause is caused when the ovaries stop producing reproductive hormones. Without these hormones, ovulation and menstruation both stop. Menopause is a retrospective diagnosis, and id defined by the absence of a period for one year.

Menopause can occur naturally as a woman ages, or it can be brought on early by certain medical conditions or surgical procedures. Most women will go through menopause between the ages of 45 and 58. According to the American College of Obstetricians and Gynecologists (ACOG), the average age for natural menopause in the US is 51.

Menopause can occur before the average ages. When menopause occurs before a woman is 40, it is considered premature. When it occurs before age 45, it is considered early. Factors that can cause premature or early menopause include:

  • Heredity
  • Surgical removal of both ovaries (bilateral oophorectomy)
  • Chemotherapy
  • Radiation therapy in the pelvic region
  • Autoimmune diseases
  • Missing chromosomes
  • HIV and AIDs 
  • Smoking

Signs and Symptoms

Before menopause begins, women go through a transitional stage called perimenopause, or the menopausal transition. During the menopausal transition, your period will become irregular. It may increase or decrease in frequency, and periods may be either lighter or heavier. Some women begin to experience the symptoms listed below while others will not have noticeable symptoms. 

After perimenopause, when you have not had a menstrual period for 12 consecutive months, you are in menopause. 

menopause symptoms illustration

During menopause, you may experience the following symptoms:

  • Hot flashes
  • Vaginal and urinary tract changes
  • Decreased sex drive
  • Sleep problems
  • Mood swings or irritability


In most cases, the signs and symptoms of menopause are enough for your doctor to make a diagnosis. Testing is not usually required, but in certain cases, your doctor may order hormone testing to rule out other conditions that may be causing your symptoms.

Treatment and Management

Many women go through their menopausal transition with minimal symptoms, but for some women, these symptoms can be quite bothersome, and treatment is indicated. 

  • Hormone Therapy

Hormone therapy is the most effective treatment for menopause symptoms. Estrogen is the primary hormone used in hormone replacement therapy to manage menopause, but progesterone may also be added to the therapy if you still have your uterus. Estrogen is used to relieve hot flashes and protect against complications like osteoporosis.

Hormone therapy can be administered both orally or in formulations that are absorbed through the skin. A variety of vaginal estrogen formulations are also available to provide relief from symptoms of vaginal dryness or pain with intercourse. 

Talk to your doctor about the risks and benefits of hormone therapy to decide what’s right for you.

  • Other Medications

Your doctor may also prescribe non-hormonal medication instead of or in addition to hormone replacement therapy. These medications may include SSRI antidepressants for managing hot flashes without hormones and treating mood disorders, blood pressure medication to control hot flashes or medications to prevent or treat osteoporosis.

Risks and Complications

During menopause, you are at a higher risk of developing certain conditions. This is because hormones like estrogen protect organs like your heart, blood vessels, brain, and bones. Therefore, during menopause, you may be more likely to experience osteoporosis (bone loss), heart attack or stroke.

Make an Appointment at Raleigh OB/GYN

The physicians and staff at Raleigh OB/GYN Centre have decades of experience providing women with full-scope obstetric and gynecological care. Our services include menopause management, so if you have questions or concerns about menopause, call (919) 876-8225 to make an appointment