Menopause: Your GoodRx Guide

What is menopause?

Menopause is the end of your menstrual cycles. As you age, your ovaries gradually stop producing hormones and releasing eggs, leading to menopause. 

For most people, menopause happens naturally sometime between the ages of 45 and 55. It can happen earlier or later in life. Or it can be caused by a medical illness or surgery. 

For most people, menopause has three stages:

• Perimenopause: During this time, your hormone levels begin to decline. You still have a period, but it may be more irregular. You may also begin to have menopause symptoms.

• Menopause: This is the time when your period slows down and stops. You may experience more menopause symptoms. After you’ve gone without a period for 12 months in a row (without this being caused by another condition, like pregnancy or a medical illness), you’ve completed menopause.

• Postmenopause: These are the years after menopause. Though many people continue to be sexually active, you no longer have a period and can’t get pregnant. You may still have menopause symptoms during this time, especially in the first decade after menopause.

What causes menopause?

Menopause is a normal part of aging. As early as your 30s and 40s, your ovaries gradually start making smaller amounts of estrogen and progesterone. This is called “natural menopause.” Eventually, periods stop. In the U.S., the average age when natural menopause occurs is 51 years old. 

Some people experience menopause at a younger age. Early menopause is when your periods stop before age 45. Premature menopause is when they stop before age 40. This happens naturally in about 3% of women. 

Causes of early and premature menopause include:

• Surgery to remove your ovaries (bilateral oophorectomy)

• Surgery to remove your uterus (hysterectomy)

• Cancer treatments

• Family history of early or premature menopause

• Smoking

• Autoimmune conditions

• Other medical conditions

Menopause symptoms

Menopause symptoms are the result of your reproductive hormone levels gradually decreasing in your body. 

Two hormones, estrogen and progesterone, are especially important. These hormones are normally made by your ovaries. And they help to control your menstrual cycle. Because these hormones have so many jobs in your body, they can cause many different types of symptoms. 

With menopause, many people experience:

• Hot flashes and night sweats (in more than 80% of people)

• Sleep problems

• Vaginal thinning and loss of elasticity

• Vaginal dryness and irritation

• Dry eyes, skin, or mouth

• Urinary tract infections (UTIs)

• Irritability

• Anxiety

• Poor concentration or “brain fog”

• Low libido

• Muscle and joint pain

• Fatigue 

Symptoms can range from mild to severe. And they can happen before, during, and even after menopause. That said, some people feel better during this time because they're not dealing with regular periods.

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How is menopause diagnosed?

There’s no simple test that can confirm whether you’re in menopause. Most people are able to tell they’re going through menopause on the basis of their age and symptoms. And if you’ve gone 12 months or more without a period (without another cause), you may have already completed menopause. 

When to seek care for menopause

For most people, menopause is a natural part of aging. You don’t need medical treatment to go through menopause. But if your menopause symptoms are bothersome, you may want to consider talking to a healthcare professional. They can help you figure out the best way to treat those symptoms.

In some cases, a healthcare professional may suggest blood tests to check your hormone levels. This isn’t necessary for everyone. But it can help rule out other causes for your symptoms, like thyroid problems. These tests may include checking your levels of:

• Follicle-stimulating hormone (FSH) 

• Estrogen (estradiol) 

• Thyroid-stimulating hormone (TSH)

Finally, you should always see a healthcare professional if you have bleeding from your vagina after menopause. Postmenopausal bleeding can be an early warning sign of a serious health condition, like uterine cancer.

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How can you relieve menopause symptoms?

The good news for anyone going through menopause is that there’s no need to suffer through symptoms for years. There are many medications and natural remedies available to provide some relief. 

Medications

Menopausal hormone therapy (MHT) — previously known as hormone replacement therapy (HRT) — is the most effective overall treatment for menopause symptoms. MHT can help with bodywide symptoms like: 

• Hot flashes

• Night sweats

• Mood changes

• Vaginal dryness

• Poor attention

• Sleep problems

Hormone therapy replaces the hormones that your ovaries were making before menopause. It’s generally considered safe for people without certain risk factors and who are under age 60 (or within 10 years of completing menopause).

Other prescription medications can also help:

• Vaginal suppositories: Vaginal creams, tablets, and rings can help relieve vaginal and urinary symptoms.

• Low-dose antidepressants: Low doses of certain antidepressants can help with hot flashes. These medications can also be used at higher doses to help with mood or anxiety. 

• Gabapentin: This anti-seizure medication can be used off-label to reduce hot flashes.

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Natural remedies

There are many non-medication treatments that can help support you during menopause and beyond. People who can’t or don’t want to take hormone therapy often seek out natural treatments during menopause. Examples include:

• Phytoestrogen foods or supplements: Phytoestrogens are plant compounds that have estrogen-like effects in your body. They’re found in many different foods and supplements, including soy, flaxseed, and red clover. But there isn’t consistent evidence that they work for menopause symptoms.

• Herbal supplements: There are many different supplements marketed for use during menopause. Our guide to natural treatments reviews the evidence for what’s effective and what’s not.

• Diet and lifestyle changes: Sleep, exercise, eating well, and cutting down on smoking and alcohol can all help with menopause symptoms. These changes can also protect your bones and heart and support your long-term health. 

• Mind-body treatments: Acupuncture, hypnosis, and mindfulness-based stress reduction can all potentially have benefits during menopause.

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Living through menopause

Though menopause is a natural part of getting older, it can still affect your overall health. It’s important to keep up with preventive care during and after menopause, by seeing a healthcare professional regularly for a wellness exam. 

During and after menopause, it’s especially important to take care of your:

• Heart and blood vessels: Protect yourself from heart disease by eating heart-healthy foods, exercising, and maintaining a comfortable body weight.

• Bones: Support healthy bones by eating a calcium-rich diet, getting enough vitamin D, and exercising. If you have osteoporosis, medications can help reduce bone loss and protect you from fractures. 

• Pelvic muscles: Pelvic floor therapy can strengthen the muscles in your genital area and pelvic floor. Surgery or special devices can also help in some cases. 

• Sexual health: Water- or silicone-based lubricants and moisturizers can help with comfort and pleasure.

• Weight: Many people gain weight after menopause. If weight is a concern, consider adding more physical movement into your daily life or making nutritional changes.

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