Menopause

More than a million people in the U.S. experience menopause each year.¹ Blue Cross Blue Shield of Michigan has the resources to help you make a healthier, happier transition.

Two women smile as they walk arm in arm.

What is menopause?

Menopause is when your periods stop permanently. Once you’ve gone without bleeding for 12 straight months, you are considered menopausal.

You stop having periods because your ovaries no longer release eggs. Your ovaries also stop producing most of their estrogen, a sex hormone that develops and regulates the reproductive system. When it starts is different for everyone, but the average age of menopause is about 45 to 55.

Menopause symptoms

The symptoms of menopause vary from person to person. The common ones include:

Sudden hot flashes and night sweats
Vaginal dryness and itching
Painful or uncomfortable sex
Sudden changes in urinary function
Unusual mood swings and fatigue
Sudden weight gain and bloating

Hot flashes

Hot flashes and night sweats are the most common symptoms of menopause. Affecting 80% of people who've had periods,²hot flashes come on suddenly and feel like a burst of heat throughout your body. Some may also experience dizziness, anxiety or notice red blotches on their skin. Although not as common, heart palpitations have also been reported.

These conditions can also cause such intense sweating you may wake from your sleep. Experts aren’t sure what causes hot flashes, but they think there’s a link between changing hormones and your core body temperature.

What is perimenopause?

Perimenopause or early menopause is the transition leading to menopause. It can last five to 14 years and usually begins in your 40s, but can start in your 30s.

During this time, you’ll notice changes in your period. This is because your ovaries are making fewer hormones. You may also experience menopause-type symptoms like vaginal dryness, hot flashes, sleep issues and moodiness. Symptoms generally include:

Longer or shorter cycles
Missed or skipped periods
Unusual heavy bleeding
Light spotting between periods

What is postmenopause?

Postmenopause is when you no longer get monthly periods. During this stage, menopause symptoms will happen less often or go away completely.

The downside is that being postmenopausal puts you at an increased risk of osteoporosis and heart disease. Changing or adjusting your diet, exercise and other lifestyle choices may reduce the risk of these conditions.

Testing for menopause

If you think you may be perimenopausal or menopausal, there are tests that can be done. Before your appointment, make a list of your medications and symptoms. Your provider will use this information to determine which tests you'll need.²

Exam
A physical exam is one way your provider can test for menopause. During this exam, they'll swab your vagina to test its pH levels. Vaginal pH is about 4.5 during your reproductive years. During menopause, vaginal pH rises to a balance of 6.

Blood test
During menopause, your hormone levels will begin to shift up and down. Depending on your symptoms, your provider may order a test to check your follicle-stimulating hormone, or FSH, and estrogen levels. If your FSH is up and your estrogen levels are down, this could be a sign you’re menopausal.

If results show you're not menopausal, there's another test your provider may order. Called the PicoAMH Elisa test,³it measures the amount of anti-mullerian hormone, or AMH, in the blood to determine when you'll enter menopause.

Liver function
Kidney function
Thyroid function
Lipid profile

Menopause treatments

Menopause is a permanent change that cannot be reversed with treatment. But medications and homeopathic remedies* can be prescribed to help alleviate its symptoms.

Medications

Hormone therapy

Hormone therapy is an option for many experiencing menopause. If you’re getting hot flashes, estrogen therapy could help.

Depending on your medical history, your doctor may recommend a low dose of estrogen for a short period of time. If you have a uterus, they'll also put you on Progestin, a synthetic version of progesterone.

In addition to relieving hot flashes and other symptoms, estrogen can also prevent bone loss. There are risks to long-term use of estrogen. Talk to your provider about the benefits and risks of hormone therapy and whether it's a safe choice for you.

Vaginal estrogen

If you're experiencing vaginal dryness, painful intercourse or urinary incontinence, there are non-oral medications you can try.

A vaginal cream, tablet or ring containing a small amount of estrogen can be prescribed. These treatments are applied directly to the vagina and have been reported to be an effective alternative to oral estrogen.

Low-dose antidepressants

Selective serotonin reuptake inhibitors, or SSRIs, are antidepressants used to decrease menopausal hot flashes. Taken at a low-dose, SSRIs are best for those who can't take estrogen for health reasons.

Alternative and home remedies

Acupuncture

Acupuncture has been shown to provide temporary relief from hot flashes. Although still being researched, studies have shown no significant or long-term effects from the treatment.

Black cohosh

Black cohosh root is sometimes recommended for menopausal symptoms. It comes in pill form and can be purchased at most pharmacies. Although recommended by some providers, there's little evidence that it works. It can also harm the liver and may be unsafe for women with a history of breast cancer.

Exercise

Physical activity can help protect against heart disease, diabetes, osteoporosis and other conditions associated with aging. Pelvic floor exercises called Kegels can also improve some forms of urinary incontinence.

Doing yoga, tai chi and Pilates can help prevent injuries and broken bones. But besides strength and coordination, there's no evidence that balance exercises can affect menopausal symptoms. It's recommended that you consult your provider and learn the proper way to do any exercise before beginning a routine.

Hypnosis

The U.S. National Institutes of Health National Center for Complementary and Integrative Health found that hypnotherapy may help to decrease hot flashes for some menopausal women.⁴