Menopause occurs when the ovaries naturally decreases the production of the sex hormones estrogens and progesterone. If there are no menstrual periods for 12 consecutive months without any other biological or physiological cause then the woman is in menopause. Menopause is the end of the childbearing years. The 12 months without periods are important to note, otherwise there is still a chance to become pregnant.

A woman can feel the changes in her body if she is approaching menopause. In this period of menopause transition or perimenopause her menstrual periods start changing. The changes begin several years before the menopause. This is because of the fluctuation of the production of the sexual hormones by the aging ovaries. Irregularity in the length of the period, the time between periods and the level of flow can be seen in the irregular periods. A sudden warm feeling with blushing, the hot flashes can also accompany the irregular periods.

The changes associated with the menopause include:

• Hot flashes
• Irregular bleeding
• Night sweats
• Mood swings
• Forgetfulness
• Problems in sleeping
• Tiredness
• Irritability
• Memory problems
• Depression
• Fluctuation in sexual desire
• Vaginal dryness, itching or irritation
• Increased risk of urinary tract infection or urinary incontinence, leakage of urine
• Weight gain
• Changes in skin texture including wrinkles
• May have some hair growth on the chin, upper lip, chest or abdomen
• Can worsen adult acne

Woman’s race, height, number of children or use of oral contraceptives has no influence on the age at menopause. The age of menopause is variable. It is 40 to 60 years normally. For most of the women it is between 45 to 55 years.

Menopause is not a disease that needs to be cured and it is a natural life-stage transition. However, treatment of associated symptoms is possible if these become substantial or severe. But, the protective effect of estrogen against osteoporosis and atherosclerosis is lost. The risks of fracture and coronary heart disease increase.

The possible treatments include:

• Hormone therapy or hormone replacement therapy or postmenopausal hormone therapy with estrogen and progesterone
• Oral contraceptive pills
• Vaginal hormone and non-hormone treatments

Combination of estrogen and progesterone increases the risk for heart attack, stroke and breast cancer compared with women without hormone therapy. Estrogen therapy increases the risk for stroke and endometrial cancer, cancer of the lining of the uterus. You must consult with your doctor and he must consider your entire medical records as well as hereditary risk factors before deciding hormone therapy.

The alternative therapy uses food and herbs and they include:

• Phytoestrogens from soy bean, chick peas and lentils. Do not use the concentrated pills, but foods containing these must be eaten regularly
• Vitamin E also helps to reduce hot flashes
• Black Cohosh herbal preparations
• Green tea and pomegranate
• Dried roots and rhizomes of Licorice
• Roots of Dong quai
• Wild yam
• Dried fruit of Chaste tree
• Dried leaves of Damiana
• Leaves, roots and tops of Dandelion
• Dried roots and rhizomes of False unicorn root
• Leaves of Ginkgo
• Roots of Ginseng, avoid if you have high blood pressure
• Dried Liferoot plant
• Fresh or dried leaves and fruit of Raspberry
• Red clover, dried flower heads and fresh plant
• Fresh or dried leaves of Sage
• St. John’s Wort, fresh or dried flowering plant

There are not many scientific studies about the alternative therapies. Much more research is still needed.

There is a direct relationship between the lack of estrogen after menopause and the development of osteoporosis. Eat healthy food with enough calcium and vitamin D. Ask your doctor whether calcium and vitamin D must be supplemented or for other treatments. A good lifestyle and enough physical activity are very important.