Women Veterans Health Care
Menopause is a normal change in a woman's life when her menstrual period stops. That's why some people call menopause "the change of life" or "the change." During menopause a woman's body slowly produces less of the hormones estrogen and progesterone.
Menopause is a gradual process that can take 3-5 years. A woman has reached menopause when she has not had a menstrual period for 12 months in a row. Usually, menopause is natural; that means it happens on its own, and a woman doesn't need medical treatment unless her symptoms bother her.
The timing of menopause is different for each woman. The average age for women to have their last menstrual period is about 51, but it can happen at any time in their 40s or 50s. A woman often goes through menopause at about the same age as her mother. If a woman stops having menstrual periods early (before age 40) her doctor can do a blood test to see if she is actually going through menopause or if there is another cause for her missed menstrual periods.
Stages of Menopause
During a woman's mid to late 40s, certain indicators hint that menopause is right around the corner. These clues can start a few years before the last menstrual period. This time is called the perimenopause stage, and it happens when the female hormone levels begin to slowly decrease. Hormone levels become unbalanced and the amount produced can vary, and menstrual periods become irregular. Women may experience hot flashes, night sweats, sleep problems and mood swings. Women should be careful to consistently use contraception during this stage as pregnancy can still occur.
Menopause is the permanent ending of menstrual periods. The average age of natural menopause for women living in the United States is 51, but the timing may vary depending on genetics and health behaviors. For example, smoking can make women begin menopause as much as two years earlier than normal. Some women can begin menopause early because of certain medications they have taken or from surgery to remove their ovaries and/or uterus (hysterectomy).
This is the period of time after menopause. During this time, a woman's body makes only very small amounts of estrogen. Some women continue to have symptoms of menopause, such as hot flashes and vaginal dryness, and these can sometimes occur for years after the menstrual periods stop. After menopause, a woman's risk of heart disease and weaker bones ("osteoporosis") increases.
Signs and Symptoms
Menopause affects every woman differently. Some women have no symptoms, but some women have changes in several areas of their lives. It's not always possible to tell if these changes are related to aging, menopause, or both.
Some changes that might start in the years around perimenopause and menopause include:
- Irregular menstrual periods
- Vaginal dryness
- Hot flashes
- Night sweats
- Sleep problems
- Mood changes
- Weight gain and slowed metabolism
- Thinning hair and dry skin
- Loss of breast fullness
When to talk to your doctor
If you are having bothersome symptoms, talk to your health care provider for help deciding how to best manage menopause. You can see a gynecologist, geriatrician, or general practitioner. Make sure the doctor knows your medical history and your family medical history. This includes whether you are at risk for heart disease, osteoporosis, and breast cancer.
Talk to your doctor if you have:
- A change in your monthly cycle
- Heavier bleeding
- Bleeding that lasts longer than usual
- Bleeding more often than every 3 weeks
- Bleeding after sexual intercourse
- Any blood spotting between menstrual periods
- Any vaginal bleeding after (your periods have stopped for 12 months or more)
VA health care services available for women Veterans include menopausal support (e.g. hormone replacement therapy or other non-hormonal treatments for menopausal symptoms). Women Veterans who are interested in receiving care at VA and want more information on menopausal support, should contact the nearest VA Medical Center and ask for the Women Veterans Program Manager (WVPM). The WVPM can help coordinate all the services you may need.
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