Menopause is a normal, natural event—defined as the cessation of menses and usually confirmed when a woman has missed her periods for 12 consecutive months (in the absence of other causes). Menopause is associated with reduced functioning of the ovaries due to aging, resulting in lower levels of estrogen and other hormones. Marking the permanent end of fertility, menopause occurs in the U.S. on average, at age 51.
Physical signs of menopause begin many years before the final menstrual period. This menopause transition phase is called perimenopause (literally meaning “around menopause”). Perimenopausal changes are brought on by changing levels of ovarian hormones such as estrogen. Irregular menstrual periods, hot flashes, sleep disturbances, and mood swings are common signs. Some women experience low libido (sex drive) and/or vaginal dryness. During perimenopause, a woman may be able to conceive, although fertility is very low. If pregnancy is not desired, contraception is necessary until menopause is reached.
What about testing for follicle-stimulating hormone (FSH)? Sometimes, elevated FSH levels are used to confirm menopause. FSH is a hormone produced by the pituitary gland in the brain that triggers the ovaries to secrete estrogen. As the ovaries’ production of estrogen declines around menopause, the pituitary gland releases more FSH into the blood to try to stimulate estrogen production. So, when a woman’s FSH blood level is consistently elevated, and she is no longer having menstrual periods, it is generally accepted that she has reached menopause. However, a single FSH level can be misleading in perimenopause because estrogen production doesn’t fall at a steady rate from day to day. Instead, both estrogen and FSH levels fluctuate from fairly high to fairly low during perimenopause. Also, if a woman is using certain hormone therapies (such as birth control pills), an FSH test is not valid.
The decision to use hormonal treatment during menopause is not straightforward and should be discussed with a qualified physician that is familiar with menopause and with the consequences of using hormonal therapy. Only after a detailed discussion and learning about the pros and cons of hormonal therapy should a woman make a decision about using treatment or not.
Austin South OBGYN servicing
Buda, Kyle, South Austin, Dripping Springs
Phone | (512) 444-1811
South Austin OBGYN:
4316 James Casey, Bld. F, Suite 200
Austin, TX 78745