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Menopause is the time in a woman’s life when the ovaries stop to function hence, the absence of menstrual periods for 12 months. The ovary is the female gonad, the reproductive gland in women. There are two ovaries, one in each side of the uterus, located in the pelvic cavity. The ovaries produce the eggs (ovum) and the female hormones (estrogen and progesterone). A mature egg is released from one ovary monthly during in each menstrual cycle. The egg that is released is picked up by the finger-like projections called fimbriae which are located the end of each fallopian tube.


The female hormones control the development of female secondary sex characteristics such as the breasts, body shape, and body hair. The hormones also regulate the monthly menstrual cycle and sustains the thickened inner lining of the uterus known as endometrium during pregnancy.

The average age of onset of menopause is 51 years old. There is no single diagnostic method to predict when will a woman enter menopause. Early menarche (first menses) is also not related to early onset of menopause. A transition period known as perimenopause, meaning “around the time of menopause” is different for each woman. Menopause does not happen abruptly but a gradual process of transition period. In perimenopausal phase, a woman may experience abnormal vaginal bleeding such as abnormal bleeding patterns until her periods completely stops. If a woman’s period completely ceases for a period of 12 months and has no other medical reasons for her menses to stop then this is the onset of menopause. Therefore, a woman has to be evaluated by her doctor to exclude other medical underlying causes of missed menses before considering menopause as the reason for its cessation. Postmenopause encompasses the entire period of time that comes after the last menstrual period (LMP).

The most common sign of a dawning menopause for women is hot flashes, or a hot flushing sensation. For many women, hot flashes occur during the day sometimes they come primarily at night causing a woman to awaken feeling hot and drenched with perspiration called “night sweats”. Hot flashes are due to motor instability. The most common theory is that the body’s thermostat in the thermoregulatory center in the hypothalamus is undergoing hormonal fluctuations. An average of 60 to 80% of menopausal women is troubled by hot flashes for a period of 5 years or more. Some experience them for 10 to 20 years. For some women, early onset symptoms such as irregular vaginal bleeding and hot flushing may also include the sensation of skin “crawling”, dizziness, heart palpitations, faintness and mood swings. Late onset symptoms are vaginal symptoms and osteoporosis. Estrogen also protect the bone. Therefore, a woman with estrogen deficiency can develop osteoporosis because of increasing bone resorption leading to pathologic fractures because of thinning of bone in later life. Common sites of fracture are: femur (most common), radius (wrist bone) and vertebrae.

Treatment of early onset symptoms depends on whether a woman is still having periods or not. For women without periods, hot flashes can be treated with either oral (by mouth) or transdermal (vaginal ring, patch, prescription gel) forms of estrogen. These therapies are available either as estrogen alone, or estrogen combined with progesterone and they are effective both in reducing the frequency and severity of hot flashes. Oral contraceptive pills are commonly used for women experiencing unpredictable bleeding and hot flashes during perimenopausal transition period. It is also important to determine if the moodiness, irritability and tearfulness are attributed to menopause versus other conditions such as medical depression. A true major depression require antidepressant medications. For vaginal symptoms, a complete pelvic examination should be done first to exclude other medical causes of vaginal irritation such as vaginitis (bacterial, trichomonas, gardnerella) and to verify that the symptoms are really due to estrogen deficiency. Local (vaginal estrogen ring, estrogen cream, vaginal estrogen tablets) and oral estrogen treatments are both effective in relieving the vaginal symptoms. In osteoporosis, the goal of treatment is the prevention of bone fractures and slowing down bone loss and increasing bone density and strength. The following are some preventive measures and medications used in osteoporosis treatment: Lifestyle changes (quit cigarette smoking, moderation of alcohol intake, exercising regularly, balanced diet intake and adequate vitamin D and calcium intake); Estrogen replacement therapy; medications that stop bone loss and increase bone strength (alendronate, risedronate, ibandronate, raloxifene, calcitonin). There is no evidence that estrogen replacement therapy provides protection against heart disease.

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Lortab tablet


Combination medicines like Lortab contain narcotic analgesics (Hydrocodone) and Acetaminophen, and are used to relieve pain. This combination may provide better pain relief than either medicine used alone. In some cases, relief of pai more...

Premarin tablets


Premarin contains Conjugated Estrogens, or female hormones. Premarin helps relieve signs of menopause, such as hot flashes and unusual sweating, chills, faintness, or dizziness; to help prevent osteoporosis in women past menopause; in the treatment of som more...

Vicodin tablet


Combination medicines like Vicodin contain narcotic analgesics (Hydrocodone) and Acetaminophen, and are used to relieve pain. This combination may provide better pain relief than either medicine used alone. In some cases, relief of pain may come at lower more...

Climara patches


Climara, also called Estradiol, is female hormones that are produced by the body and necessary for normal sexual development. It is prescribed for several reasons: to provide additional hormone when the body does not produce enough of its own; a genital more...

Evista tablet


Evista, also known as Raloxifene, is an Estrogen Receptor Modulator, and Osteoporosis Prophylactic, and is used to help prevent and treat thinning of the bones. Evista is used only in postmenopausal women, and works like an estrogen to stop bone loss that more...

Raloxifene pill


Raloxifene alters the cycle of bone formation and breakdown in the body. It reduces loss of bone tissue or decreases bone demineralization. Although studies are not complete, raloxifene appears to work without increasing the risk of breast or uterine canc more...

Loestrin tablet


Loestrin FE, a combination of Norethindrone Acetate and Ethinyl Estradiol, is one of a group of drugs called Oral Contraceptives, and are used to prevent pregnancy when taken properly. Loestrin FE contains two types of hormones, estrogens and progestins, more...

Prempro tablets


Prempro, a combination of Conjugated Estrogens and Medroxyprogesterone, are estrogen and progestin hormones. Progestin lowers the effect of estrogen on the uterus and keeps problems from developing. Estrogens are given to: relieve the signs of menopause, more...

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