Menopause Causes, Complications And Treatment Options


During menopause, your menstrual periods come to an end. It is discovered after a 12-month time without periods. Although menopause can start in your 40s or 50s, the typical age is 51.

Menopause is a normal biological process. Yet, menopause's physical and mental symptoms, such as hot flashes, can cause sleep disturbances, low energy levels, and emotional health issues. Several effective treatments are available, ranging from hormone medication to lifestyle modifications.


Menopause may be caused by:

  • Reproductive hormones naturally decline. Your ovaries begin producing less estrogen and progesterone as you approach your late 30s, which results in a drop in fertility.
  • Your menstrual cycles may lengthen or shorten throughout your 40s, get heavier or lighter, and occur more frequently or less frequently. Eventually, on average at age 51, your ovaries stop producing eggs, and you cease having periods.
  • An operation to remove the ovaries (oophorectomy). The hormones that control the menstrual cycle are produced by your ovaries and include oestrogen and progesterone. Menopause sets in right away after ovary removal surgery. Your periods end, and you are probably going to start having hot flashes and other menopausal symptoms. As hormonal changes happen suddenly rather than gradually, the signs and symptoms might be severe.

Menopause may be brought on by:

  • Surgery that removes your uterus but not your ovaries (hysterectomy) normally does not produce instant menopause. Your ovaries continue to release eggs and generate oestrogen and progesterone even though you no longer have periods.
  • Radiation treatment and chemotherapy. Certain cancer treatments have the potential to cause menopause, resulting in symptoms like hot flashes either during or right after the course of therapy. After chemotherapy, menstruation (and fertility) may not always stop, therefore birth control may still be preferred. Only when radiation is focused on the ovaries does radiation therapy have an impact on ovarian function. Menopause will not be impacted by radiation therapy administered to the head and neck, breast tissue, or other areas of the body.
  • Primary insufficiency of the ovaries. Menopause affects 1% of women in the world.
  • Prior to age 40 (premature menopause). Primary ovarian insufficiency, which can be brought on by autoimmune disease or hereditary causes, is a condition in which your ovaries are unable to generate the appropriate amounts of reproductive hormones, which can lead to premature menopause. Very frequently, there is no known cause for premature menopause. In order to save the brain, heart, and bones of these women, hormone therapy is often advised at least until the age of menopause naturally.

How to check if you have Menopause?

Maintain routine doctor's appointments for any medical issues and preventive care. Continue obtaining these checkups during and after menopause.

As you get older, suggested health screening tests including a colonoscopy, mammography, and triglyceride screening may be part of your preventive health care. Also, depending on your medical history, your doctor might advise thyroid testing as well as breast and pelvic checks.

Please consult a doctor if you experience vaginal bleeding after menopause.


The following signs and symptoms of perimenopause, which occurs in the months or years before menopause, may appear:

  • Irregular cycles
  • Virility
  • Dryness
  • A hot flash
  • Chills
  • Sweats at night
  • Issues with sleep
  • Mood shifts
  • Added pounds and a sluggish metabolism
  • Hair loss and dry skin
  • Breast fullness decline

Women can have a range of indications and symptoms, including changes in menstruation. You will probably detect some irregularity before your periods end.

It is natural for women in perimenopause to skip periods often. Menstrual cycles frequently stop for a month, return, or stop for a few months, and then continue. Also, because periods often occur on shorter cycles, they are more common. If you are not sure if you skipped a period, you should consider taking a pregnancy test now that you have started the menopausal transition.


No medical care is necessary during menopause. Instead, therapies focus on managing or preventing chronic diseases that might arise with ageing in addition to treating your signs and symptoms. Treatments could consist of:

Hormone treatment. Estrogen therapy is the most efficient way to treat menopausal heat flashes. According to your personal and family medical history, your doctor may recommend oestrogen in the lowest dose for the shortest time period necessary to treat your symptoms. You will require progestin in addition to estrogen if your uterus is still present. Estrogen also helps stop bone thinning. Although initiating hormone therapy around menopause has proven benefits for some women, long-term usage of hormone therapy may carry some cardiovascular and breast cancer concerns. Consult your doctor about hormone therapy's benefits, drawbacks, and safety for you as a person.

Female oestrogen. With a vaginal lotion, pill, or ring, oestrogen can be directly delivered to the vagina to treat vaginal dryness. Only a tiny amount of oestrogen is released during this procedure, and it is absorbed by the vaginal tissues. Vaginal dryness, discomfort during sexual activity, and some urinary symptoms can all be helped by it.

Antidepressants in low doses. A class of antidepressants called selective serotonin reuptake inhibitors may reduce menopausal hot flashes (SSRIs). Women who need an antidepressant for a mood condition or who are unable to take oestrogen may find relief from hot flashes with a low-dose antidepressant.

Clonidine (Catapres, Kapvay). Hot flashes may be somewhat alleviated by clonidine, a tablet or patch generally used to treat high blood pressure.

Medications for osteoporosis treatment or prevention. Depending on the needs of the patient, doctors may prescribe medication to prevent or treat osteoporosis. Many medications have the potential to reduce the risk of fractures and bone loss. Your doctor can suggest vitamin D tablets to help strengthen your bones.

Consult your doctor about your options and the risks and benefits of each before deciding on a course of therapy. 

Complications of Menopause

Your risk of developing some medical disorders rises after menopause. Examples comprise:

Cardiovascular disease (heart and blood vessel disease). Your risk of developing cardiovascular disease increases when your oestrogen levels drop. Both in men and women, heart disease is the leading cause of death. So, it is crucial to keep a normal weight, engage in regular exercise, and consume a healthy diet. Ask your doctor for tips on how to keep your heart healthy, such as how to lower your blood pressure or cholesterol if it is too high.

Osteoporosis. This disorder makes bones weak and brittle, which increases the chance of fractures. You may experience rapid bone density loss in the first few years following menopause, which raises your risk of osteoporosis.Those who have osteoporosis are more prone to wrist, hip, and spine fractures.

Incontinence of the urine. You may have frequent, sudden, strong urges to urinate, followed by an uncontrollable loss of urine (urge incontinence), or the loss of urine with coughing, laughing, or raising as the tissues of your vagina and urethra lose their suppleness (stress incontinence). Urinary tract infections might occur more frequently for you.

Incontinence symptoms may be reduced by strengthening pelvic floor muscles with Kegel exercises and applying a topical vaginal oestrogen. Menopausal vaginal and urinary tract abnormalities that might cause urine incontinence may also be successfully treated with hormone therapy.

Sexual activity. During sexual activity, vaginal dryness brought on by decreased moisture production and elasticity loss can cause discomfort and very minor bleeding. Also, your desire for sexual activity could decline as your sensation declines (libido).

Vaginal lubricants and moisturisers with water bases may be beneficial. Many women find it helpful to use local vaginal oestrogen treatment, which comes in the form of a vaginal cream, pill, or ring if a vaginal lubricant is not sufficient.

Gaining weight. Because of a slowed metabolism, many women put on weight throughout the menopausal transition and later. To keep your weight stable, you might need to eat less and move more.

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Page last reviewed: Mar 30, 2023

Next review due: Mar 30, 2025

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