Menopause is the time in a woman’s life when her menstrual periods stop because the ovaries have depleted their supply of eggs. It is a normal change in a woman’s body. Menopause usually happens between the ages of 45 and 55 years with the mean age being 51 years. A woman does not reach menopause until she has completed 12 full months of no menstrual periods. During the time leading up to menopause (called peri menopause), a woman’s body makes varying amounts of the hormones estrogen and progesterone.


As a woman nears menopause, she may have symptoms from the hormonal changes. Common signs and symptoms of menopause or perimenopause include:

  • Change in menstrual periods
  • Hot flashes
  • Night sweats (sometimes followed by a chill)
  • Trouble sleeping through the night (with or without night sweats)
  • Vaginal dryness
  • Mood swings, feeling crabby, crying spells
  • Trouble focusing, feeling confused
  • Hair loss or thinning of hair on the head
  • Hair growth on the face


Eating a healthy diet and exercising at menopause and beyond are important. Most women do not need any special treatment for menopause, but some women have menopausal symptoms that interfere with their life and thus require treatment. There is no one treatment that is good for all women. Most menopausal symptoms go away over time without treatment, but there is no way of knowing how long that will take. Vaginal dryness increases throughout menopause.

The most effective treatment of menopausal symptoms is prescription hormone therapy (HT.). There are many different types of HT including pills, gels, patches and vaginal rings. Herbal therapy may be effective for some women especially those with mild symptoms, but scientific studies are inconclusive regarding their ability to relieve troublesome symptoms. For patients desiring prescription medications but who are unable or unwilling to use hormones several other medications are available such as serotonin reuptake inhibitors, gabapentin, and clonidine.

Menopause and Bone Loss

When a woman is young, estrogen helps to keep bones strong. When estrogen levels fall at menopause, bones gradually weaken. When bones weaken significantly, the condition is called osteoporosis. Osteoporosis increases the chances of a woman developing a fracture (break) in one of her bones. Weight bearing exercise and getting adequate calcium and Vitamin D can help prevent osteoporosis.

Hormone therapy is one of the many prescription options for osteoporosis. Bisphosphonates are the most common type of drug used for treatment. The biphosponates come in pill and intra-venous formulations. Other effective medications for osteoporosis are denosumab (Prolia) which is a twice yearly injection, and Teriparatide (Forteo.). Exercises that improve strength, flexibility, and balance are extremely important in preventing falls and thus preventing fractures with osteoporosis.