Menopause is a term used when a woman hasn't had a menstrual period for one year. Premenopause is the time before menstruation stops, perimenopause is the time when periods can be unpredictable, and postmenopause is the time after menopause.

During menopause, the ovaries begin to slow production of estrogen and progesterone. The lowering of these hormones can put a woman at increased risk of developing osteoporosis (thinning of the bone) and heart disease. Menopause can also bring with it, for some but not all women, some very uncomfortable symptoms, including hot flashes, vaginal symptoms, decreased libido, and difficulty sleeping. Understanding menopause and the risks associated with it can help a woman make the best treatment choices for her individual health needs.

Hormone therapy

Hormone therapy (HT) involves replacing the estrogen and progesterone levels lost during menopause. It has been used by women for over 60 years to relieve undesirable symptoms such as hot flashes, vaginal dryness, and urinary problems. Estrogen supplementation is also sometimes used to prevent osteoporosis.

Estrogen and progesterone are available in many different forms, such as oral tablets, skin patches, a gel that is applied to the skin, vaginal preparations, or injections. Only very low doses of estrogen are needed to prevent hot flashes and osteoporosis. High doses can cause problems such as an increased tendency to have migraine headaches.

Some side effects of HT include:

  • abdominal bloating
  • breast discomfort
  • headache
  • mood changes
  • nausea
  • vaginal bleeding

Women who take estrogen without progesterone have an increased risk of endometrial cancer (cancer of the lining of the uterus). That's why a progesterone preparation is prescribed along with the estrogen to minimize this risk in women who have not had a hysterectomy. An increased risk of breast cancer has long been a concern with taking estrogen; and the incidence of gallbladder disease within the first year of HT may also increase.

HT is not generally prescribed to women have or have had:

  • a blood clotting disorder
  • acute liver disease
  • advanced endometrial cancer
  • breast cancer
  • genital bleeding of unknown cause

Non-hormonal therapy

Women who can't take estrogen may want to talk to their doctors about trying other treatment options, such as antidepressant medications, progesterone alone, gabapentin, or clonidine, to reduce the discomfort of hot flashes. For women where vaginal dryness is the most bothersome symptom, estrogen creams, tablets, and rings are available. Women with lowered libido may want to talk to their doctors about treatment options available to them.

A healthy lifestyle can go a long way to improving a woman's overall well-being. Getting regular physical activity, eating a balanced diet (especially with adequate vitamin D and calcium), not smoking, and managing stress can contribute to optimal health and minimizing the symptoms associated with menopause.


Menopause is a natural time in a woman's life. While it may be quite difficult for some women, most women do not suffer long-term disturbances. In fact, many women report an enhanced quality of life - they feel more energized and self-confident.

Written and reviewed by the MediResource Clinical Team