The average age for women to have their last period is about 50.But it's normal for menopause to occur any time from age 41 to 59. A woman often goes through menopause at about the same age as her mother. Women who have both ovaries removed will go through "surgical menopause" at the time of their surgery. If the uterus is taken out but the ovaries are left, a woman won't have periods but she will only go through menopause when her ovaries stop making estrogen. If you stop having periods early--before age 40--your doctor can do a blood test to see if you're going through menopause. Menopause is a gradual process that can take several years. You're not really through menopause until you haven't had a period for 12 months. (During this time, keep using birth control if you don't want to become pregnant.)

Hot flashes are a sudden feeling of heat in the body. This feeling comes when blood vessels open up and let a lot of blood flow through the skin. Your face may turn red and you will suddenly feel hot. The feeling lasts 1 to 5 minutes. Then you may feel very cold and even wet (clammy) as your sweat dries and you return to normal.
The best way to treat hot flashes is to replace the estrogen your body is losing. Your doctor can prescribe an estrogen pill or other medications such as SSRI drugs (mostly used as antidepressants), Neurontin, megestrol acetate, or medroxyprogesterone acetate. NOTE: Some women who cannot take estrogen or don't want to take estrogen can try other medications. Some women who take estrogen may have a higher risk of getting breast cancer and cancer of the uterus.

Sex & hormones: Hormone changes can affect the vagina, because estrogen loss leads to thinner tissues in those areas. When the tissues that line the vagina get thinner, you may feel pain during sex. You may feel dryness or itching in the vagina. You can buy vaginal moisturizing medications that relieve dryness in the vagina. Drug stores sell these products. If these products don't work, replacing your body's estrogen may help. In this case, estrogen can be delivered in the vagina in smaller doses so that very little will get into the body through the blood stream. This estrogen can be in the form of a cream, a tablet, or a ring worn in the vagina that releases estrogen. Some women lose their urge to have sex at this time of life.

Sudden Mood Changes: In some women, menopause is associated with mood changes or deep feelings of sadness (depression). If your mood changes seem to be mild, then discussing any sad or stressful life events with your doctor may help. If you still have mood swings, you can also try to replace the estrogen your body is losing. Some women who cannot take estrogen or don't want to take estrogen can try other medications. The SSRI drugs also are very good at treating medium and high levels of depression.

Bladder Problems: When tissues near the bladder become thin, you may have changes in urination. You may feel pain when you urinate or a need to urinate more often. You may also have a sudden loss of urine that you cannot control. Trying Kegel exercises (for example, holding the urine flow back a few times while you are going, or tightening these muscles often during each day) to make the muscles near your bladder and vagina stronger. Some medications act on the muscles near your bladder to keep it emptying more fully or not as often. Other medications tighten muscles at the bladder opening to prevent leaks. If medications don't help, surgery to support the bladder may be an answer.

Heart Disease: Women who have gone through menopause have a higher risk of heart attacks than younger women. A heart attack hits when blood vessels around the heart are so clogged with fat that oxygen cannot reach all parts of the heart. At about age 60, half of the deaths in women are caused by heart disease. See your doctor if you are having chest pain, shortness of breath or pain radiating down your arm. Also see your doctor if you have a family history of heart attacks or strokes.

Bone Weakness: One body change you may not notice is that your bones become weak. If this happens, you might get a "widow's hump," which makes you look bent over. When your bones become weak they are more likely to break. Breaks in your backbone or hip bone can happen when you fall. You may find it hard to recover from broken bones as you get older. First, you may want to learn how strong your bones really are. A DEXA scan or bone density test can show if you have lost bone or are at risk of losing bone. Estrogen can help to prevent bone loss and broken bones. SERMs (Selective Estrogen Receptor Modulators), such as raloxifene, can do some of the things that estrogen does, including keeping your bones strong. In some ways, SERMs are safer than natural estrogen because they may lower the risk of breast cancer. 8 BONE WEAKNESS You can also try medications called bisphosphonates. Some of the drugs in this family are alendronate, risedronate, and ibandronate. Another medication you can take is calcitonin, which also blocks the breakdown of bone. It is safe, and can be taken through your nose in spray form. (This medication is only approved for use by women who are 5 years past the time of menopause.) Again, please make sure to discuss the possible side effects of these medications with your doctor before taking them.

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