Column: Menopause: Everything you need to know  


Commentary by Dr. Linda Witham

Menopause occurs when a woman permanently stops having menstrual periods. Here you can find out what menopause is, how it is diagnosed, the symptoms and treatment options.

What is menopause? 

Menopause most often occurs gradually, over several years, between ages 45 and 55. This stage signals the end of your ability to have children. As women age, the amount of estrogen produced by the ovaries decreases. This is the perimenopausal transition. Eventually, the ovaries stop making enough estrogen to thicken the uterine lining. To diagnose menopause, a woman must go a full 365 days without a menstrual cycle. It is not necessary to have blood work to confirm.    

What are the symptoms of menopause? 

The symptoms of menopause include hot flashes, night sweats, sleep problems, excess fatigue, brain fog, joint pain, mood swings, irregular bleeding, vaginal dryness and painful intercourse from vaginal atrophy. If you experience any of these symptoms, talk to your medical provider. If you have any abnormal uterine bleeding, which would include longer, heavier or irregular periods, follow up with your medical provider.

What are treatment options for menopause? 

There are many commercially prepared hormone products approved by the Food and Drug Administration that can be prescribed for menopause symptoms. FDA approved indications for hormone replacement therapy are vasomotor symptoms, including hot flashes and night sweats as well as prevention of bone loss and to reduce bone fractures.

HRT involves taking estrogen and progestin or estrogen alone if the uterus has been surgically removed. Perimenopausal and postmenopausal women who take estrogen have fewer hot flashes, better bone health, less cardiovascular disease, better sex lives, less insomnia, improvement in urinary symptoms, better mood, a reduction in type two diabetes, lower risk of colon cancer, decreased joint pain, better skin, better quality of life and less chance of dying. A woman’s personal risk of breast cancer should be evaluated before deciding if HRT is for her.

Women who have a history of deep vein thrombosis, cardiovascular disease, or have had or are at an elevated risk of breast cancer should avoid estrogen. Talk to your provider about non-hormonal treatments for hot flashes, such as antidepressants and vaginal moisturizers for vaginal symptoms.

For more information, visit

Dr. Linda Witham is an OB/GYN nurse practitioner at IU Health North Hospital in Carmel.


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