Menopause Overview

Menopause is the period of time when menstruation stops for at least 12 consecutive months because the ovaries are no longer producing estrogen, progesterone, and other hormones. Menopause usually occurs naturally between 45 and 56 years of age, but it can also be caused by surgical procedures or the treatments for certain conditions (e.g., chemotherapy).¹ Women will experience changes in their menstrual cycles long before menopause; the time between the start of significant fluctuations in a person’s ovarian function and 1 year after the final menstrual period is known as perimenopause.^{1 , 2}

The most common symptoms of menopause are vasomotor symptoms (e.g., hot flashes, night sweats), sleep and mood disturbances, and significant changes in the urogenital system.³ The prevalence and severity of menopause symptoms can vary widely. For example, studies have reported a higher prevalence and a longer duration for vasomotor symptoms in Black women than in Asian, White, or Hispanic women.² The hormonal changes that occur during menopause can also increase the risk of cardiovascular disease, osteoporosis, diabetes mellitus, and certain cancers.^{1 , 3}

Not all women require treatment for menopause-related symptoms. However, in more severe cases, these symptoms can often be managed using hormonal or nonhormonal therapies. Hormone therapy with oral or transdermal estrogen remains the most effective therapy for menopausal symptoms, and research suggests that it may provide metabolic and vascular benefits as well.^{3 , 4} However, because the use of estrogen alone can increase the risk of uterine cancer, women with an intact uterus who are receiving estrogen should also receive a progestogen.¹ Women who experience menopause before the age of 40, a condition known as premature ovarian insufficiency or POI, can receive hormone therapy until the normal age of menopause to prevent the health risks associated with premature menopause.⁵ Some nonhormonal therapies, such as certain antidepressants, gabapentin, oxybutynin, and neurokinin 3 receptor antagonists, have been shown to be effective in treating vasomotor symptoms.^{1 , 6}

More work is needed to address the gaps in menopause research. Researchers are still investigating the long-term effects of vasomotor symptoms on the cardiovascular system and the brain, better strategies for treating symptoms during perimenopause, the safety and efficacy of new hormone therapies, the impact of menopause on conditions such as endometriosis and uterine fibroids, and many more areas of interest.

The Study of Women's Health Across the Nation (SWAN) is a long-term study that is investigating the many ways that aging affects women's health. The NIH-funded researchers who work on this study are exploring how menopause can impact a variety of health issues, including cardiovascular health and cognitive function.^{7 , 8}