What is Menopause

While menopause is a natural phase of life, some may experience menopausal symptoms that impact their physical and emotional well-being. Symptoms may occur with the onset of perimenopause, the years in which the hormones that regulate menstruation decline and last for several years following menopause.

NewYork-Presbyterian physicians who are experts in treating menopausal symptoms and provide their patients with a range of treatment options and lifestyle recommendations.

What is Menopause?

Menopause is considered to have occurred twelve months after a woman has her last period. In most women, the condition occurs naturally due to age-related changes in hormone levels in the body. Menopause marks the end of a woman’s childbearing years.


Stages of Menopause

Menopause happens in three phases. It can be helpful to understand what is happening before, during, and after the cessation of menstruation.


Perimenopause begins during the years leading up to menopause when the estrogen levels produced by the ovaries begin to fluctuate. One common sign of perimenopause is a change in your menstrual cycle, with cycles becoming longer or shorter than usual or the amount of flow becoming lighter or heavier than before. Perimenopause typically begins in a person's mid-40s and lasts between 2 to 8 years.


As described above, a woman is said to be in menopause when she has not had a menstrual period for 12 months in a row. Sometimes the term is used to describe the entire period from perimenopause into menopause and up to the beginning of the postmenopausal years.


Postmenopause describes the phase that follows menopause and lasts for the duration of a person’s lifespan. Menopause symptoms may persist during this period but often become milder. Because they produce less estrogen — which protects against certain conditions, including heart disease and osteoporosis — postmenopausal persons should maintain a healthy lifestyle and see their doctor for regular check-ups. 


Symptoms of Menopause

The experience of perimenopause and menopause varies from individual to individual. While some have mild or no menopausal symptoms, others may seek care for a range of issues that affect their quality of life, including:  

  • Irregular periods
  • Hot flashes, including night sweats
  • Difficulty sleeping, including insomnia (trouble falling asleep), or waking up earlier or later than usual
  • Vaginal dryness  
  • Urinary incontinence
  • Pelvic floor prolapse
  • Memory problems
  • Decreased concentration or focus
  • Mood or emotional changes
  • Decreased libido (sex drive)
  • Weight gain or difficulty losing weight
  • Joint pain

When a physician talks about signs of menopause, they are referring to evidence that can be observed or measured, such as fluctuating hormone levels. (Signs differ from symptoms, which the patient experiences, such as hot flashes.)


Causes of Menopause

In most, menopause is a natural part of aging that occurs when the amount of estrogen produced by their ovaries decreases. Estrogen, together with progesterone, are the two hormones that regulate menstruation and fertility. When production falls below a certain level, women no longer experience their monthly periods.  

Menopause may also occur due to certain medical conditions and surgical or non-surgical treatment of these diseases (which is sometimes referred to as induced menopause). Causes include:

  • Bilateral oophorectomy: removal of both ovaries due to diagnoses including cancer, benign growths, or endometriosis. (If only one ovary is removed, menstruation will continue.)
  • Chemotherapy/radiation therapy as a treatment for cancer
  • Premature menopause: a condition in which menopause occurs before age 40. This condition may be genetic or due to an autoimmune disease.

Complications of Menopause

Without the protective effects of estrogen, postmenopausal individuals are at increased risk for various chronic diseases, including cardiovascular disease (heart disease and stroke),  bone loss (low bone mass and osteoporosis), and certain cancers. As people age, health conditions such as high cholesterol, high blood pressure, being overweight, or being physically inactive can increase the risk for these chronic diseases. 

Those in their menopausal years may not have any symptoms. Still, some struggle with challenges, such as urogynecological disorders (such as incontinence and pelvic floor prolapse), sleep problems, weight gain, memory problems, and mood disorders.

Get Menopause Relief from NewYork-Presbyterian

At NewYork-Presbyterian, our experienced gynecologists have a thorough understanding of the physical and emotional impact that menopause can have. We view menopause as a time to evaluate one’s health, identify risks, and initiate strategies to prevent the chronic diseases that menopause and the aging process may bring. Early planning and lifestyle changes can help lessen the symptoms of menopause and ensure that your body is functioning at optimum levels so you can enjoy this time of life.

Care is available through our convenient locations in Manhattan, Brooklyn, and Queens, as well as in Westchester. Find a NewYork-Presbyterian doctor with expertise in the treatment of menopausal symptoms and conditions or contact us to make an appointment.