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Menopause involves hormonal changes that occur naturally as a woman ages. Symptoms vary widely, and some women experience few symptoms. Others develop symptoms that interfere with normal activities, including sleep, and a menopause specialist can discuss treatment options for bothersome symptoms.
When Periods Change
Perimenopause is the time leading up to the end of menstrual periods. Menstrual patterns can change during this stage, and missed periods warrant discussion with a menopause specialist because other causes, such as thyroid conditions, need evaluation. Skipped periods before age 45 also require attention, since menopause generally begins between ages 45 and 58.
Some periods remain regular but become heavier or more painful. These changes can signal a need for medical evaluation, and the source identifies several patterns that warrant a provider visit:
- Periods much heavier than usual
- Passing large blood clots
- New or heavy spotting between cycles
- Significant cramping
- Periods lasting longer than a week
- Periods occurring more frequently than every 21 days
- Bleeding or spotting after a year without a period
Heavy bleeding deserves medical attention. These changes can have hormonal causes, but a provider also checks for conditions such as uterine polyps and uterine cancer. A period that returns after months without one also warrants evaluation, especially when it includes heavy bleeding, large clots or painful cramps.
When Vaginal Symptoms Develop
Vaginal dryness is another menopause symptom. Lower estrogen levels affect vaginal tissue, and dryness can cause irritation or pain during everyday activities and intercourse. About half of people who go through menopause experience vaginal dryness that interferes with intercourse, and symptoms generally worsen over time.
Painful sex can occur when vaginal dryness causes irritation. Some people mistake painful intercourse for low sexual desire, but treating the underlying dryness can improve sexual desire as well. Lubricants can ease discomfort, and vaginal hormones delivered through creams, rings or suppositories provide another treatment option.
When Urinary or Sleep Issues Occur
Genitourinary syndrome of menopause affects vaginal and urinary structures. Frequent urinary tract infections, urinary incontinence, increased urination, painful urination and blood in the urine are symptoms that warrant discussion with a provider. Vaginal hormones can also help relieve some urinary symptoms, and persistent problems require evaluation.
Sleep problems also occur during menopause. Night sweats and urinary symptoms can disrupt sleep, and other conditions can contribute to difficulty falling or staying asleep. A menopause specialist can discuss these symptoms with a patient, and treatment options depend on the symptoms and their causes.
When Menopause Starts Early
Menopause before age 45 is uncommon. Primary ovarian insufficiency occurs when the ovaries stop functioning before age 40, and low estrogen levels associated with the condition raise the risk of osteoporosis, heart disease, hypothyroidism and infertility. People experiencing symptoms of perimenopause at a younger age should discuss them with a provider, and hormone replacement therapy is one treatment option for primary ovarian insufficiency.
Hot flashes and night sweats also warrant attention when they interfere with daily activities or sleep. These symptoms are known as vasomotor symptoms, and frequent episodes can affect quality of life. A provider can discuss prescription medication and hormone therapy, depending on the symptoms and medical history.
Visit with a Menopause Specialist
A menopause specialist can evaluate symptoms and discuss available treatments. Hormone therapy has risks and benefits, and a provider can review those factors during an office visit. When symptoms interfere with daily activities or sleep, discussing them with a provider helps identify appropriate treatment options and determine whether follow-up care is needed.
