Menopause (pre, early): what it is, symptoms, treatment and +

Menstruation is associated with female reproductive capacity. In general, the beginning and the end of cycles, called menarche and menopause respectively, lead to significant changes in a woman’s life, even among those who do not want to have children.

When you have your first period, a monthly period begins that, for many women, involves cramps, mood swings, hormonal changes and, of course, bleeding.

Likewise, when the reproductive phase ends, at the average age of 51 years old, this menstrual routine ceases definitively.

In general, the period is accompanied by significant changes in the woman’s well-being, mainly due to psychosocial factors.

This is because, according to the Ministry of Health, menstruation and menopause are physiological processes in a woman’s life, but they have been treated as a nuisance and even as a disease for many years.

Today, this relationship still persists in many cultures, making leaving the fertile life fraught with more difficulties than it should.

Therefore, the phase can – and should – be seen as a natural process and needs to be conducted in a healthy way physically and mentally.


What is menopause?

Menopause is defined as the date of the last menstruation, characterizing the final completion of the woman’s reproductive phase .

Truly, it can only be confirmed after 12 months without bleeding, as menstrual irregularities can occur. That is, menopause is, clinically, the last menstruation.

Several concepts have already been developed for this period of female life. But the definition adopted today was based on an article published in 1816, which described menstrual absence as “La ménopause”.

The term comes from the Latin menopausis , which means mēn = month or moons, and paûsis = end, that is, something like the end of monthly periods.

Although the term refers essentially to the last menstrual period, a number of changes and changes are usually noticed beforehand. In fact, a few years earlier, featuring a pre-menopause.

Well-known as climacteric , pre-menopause can show signs when, around the age of 40, fertility begins to decrease and the symptoms attributed to menopause can present themselves, usually in a slightly milder way.

Hot flashes, menstrual irregularity, decreased or increased blood flow, as well as changes in the skin are some signs that can occur and tend to be more present as time goes by.

But it is when menopause is close to occurring – that is, when the last menstrual period comes down – that these symptoms intensify and reach their peak.

The period also has a name: perimenopause and comprises about 2 years before and 1 year after bleeding.

At this stage, the hormonal amounts in the body are no longer sufficient for menstrual regularity.

Remembering that, every month, the body is prepared to fertilize and generate a life. When this does not happen, the uterus flakes and menstruation comes down.

But without the balanced hormones to prepare the body for pregnancy, the woman may have a very large irregularity of cycles: a few months without menstruation or even more than 1 bleeding in less than 30 days.

The lack of bleeding occurs because the woman’s eggs are depleted and, along with this, the production of the hormones estrogen and progesterone occurs . However, the absence of menstruation is only one of the signs of the non-reproductive period.

There is an intense hormonal fluctuation in this phase, which is responsible for the unpleasant symptoms and usually experienced by the patients – including symptoms that are not so common, such as headaches, tiredness and agitation.

In addition to some signs of well-being, it is the taboos that permeate and still frighten many women. The idea that there will inevitably be a reduction in sexual desire or the abandonment of affective and sexual life is quite wrong.

Signs in the body can appear and, at first, hinder the maintenance of the sexual routine – among them, the greatest delay in lubrication, vaginal dryness and intimate irritation. But they have treatment and should not sound like an impediment to quality of life.

In addition, symptoms do not last forever in most cases. Until about 12 months after menopause, they are still intense, because it is in this phase (perimenopause) that the hormonal oscillation is at its peak.

After that, most women have a reduction – which may be gradual or more abrupt – of signs and symptoms.

Postmenopause extends to 65 years, when the woman enters the third age. Hot flashes, irritation, intense sweating and changes in mood, in general, are replaced by greater risks of osteoporosis , breast cancer and cardiovascular diseases.

But it is noteworthy that even far from menopause, some women in old age can still live with some symptoms.

What are the phases of menstruation?

Unlike some cells and hormones that can be produced throughout life, eggs have a limited number. They are born with women and the body depends on that number for the rest of their lives. Well, actually more or less.

At birth, the woman’s body has about 2 million follicles and about one thousand of them are used for each menstruation. As these follicles used in each cycle cannot be replaced or reused, the number decreases with each menstruation.

The very high number could last for long years – approximately 160 years or 1920 menstruations – but the amount of follicles drops significantly even before the first menstruation and the female body starts the reproductive phase (menarche) with around 400 thousand.

That is, doing the math, there are approximately 400 periods or 33 years of reproductive life.

When the body enters puberty, menarche occurs, that is, the first menstruation that marks the beginning of female reproductive life.

After stabilizing hormonal indexes, in general, every month, the body promotes conditions to generate a life and, for this, intense hormonal changes occur.

But if there is no fertilization, the result is bleeding or menstruation. This routine will accompany most women for long years.

The first day of menstruation is considered the follicular phase, that is, the first day of the cycle. The hormones estrogen and progesterone are low and the uterus has a very thin wall (called the endometrium).

The pituitary, located in the central nervous system (CNS), produces the hormone FSH or follicle stimulating hormone, responsible for causing the production of estrogen.

A hormonal peak occurs 1 day before ovulation, causing the pituitary to release LH (luteinizing hormone) and progesterone production also begins. This hormone is responsible for inhibiting the secretion of LH by the pituitary gland.

If the egg is not fertilized, there is a drop in the production of the hormones progesterone and estrogen, causing the endometrium to degrade (characterizing menstruation and restarting the cycle).

The process occurs throughout the woman’s fertile period , until pre-menopause begins to manifest symptoms due to hormonal changes.

The stages of menopause

Although the term menopause is generally used to designate the end of menstruation, the period is clinically only the last bleeding. The phases that involve symptoms or the transition to menopause are divided into:


In general, it occurs between 35 and 48 years, but the period still generates debates among specialists who do not always agree with that age.

The rates of estrogen and progesterone begin to change, although not always noticeable.

The most striking feature of pre-menopause is the drop in fertility, which can be reduced to 20% after the age group between 35 and 40 years.

That is, the pre-menopause is a phase that can start very early and that few women, in fact, feel the arrival, because it is usually marked by a subtle hormonal reduction, without major symptoms to the body – different from the climacteric, more common and most reported by women.

Perimenopause (climacteric)

Perimenopause, or more popularly known as climacteric, in general, begins between the ages of 45 and 50, and this is the transition phase to menopause ( peri = around). It is also the period when symptoms related to the end of menstruation are more present and accentuated.

For most women, perimenopause begins about 2 years before the last menstruation and extends to 1 years after it.

Estrogen levels before menopause are falling, but quite unevenly. It is even possible that they will rise more than in previous periods.

In this phase, hot flashes (called hot flushes), excessive sweating, irregular menstrual cycle, mood swings (irritability, anxiety and depression ) begin to manifest themselves with more intensity and, in general, tend to become more and more accentuated until menopause occurs.

In addition, the following may occur:

  • Amenorrhea: absence of menstruation or menstrual irregularities;
  • Vasomotor disorders: heat, chills and night sweats;
  • Sleep disorders;
  • Irritability, anguish and depressive states.

But it is worth mentioning that each organism is unique and that there are different manifestations, including no symptomatic perception for some women.


It is, in fact, the last menstruation. However, it is only after 1 year that it is possible to determine that the bleeding was the menopause. Therefore, it is, in fact, a very punctual event.

A wide margin considers that menopause occurs between 45 and 55 years, but the average for Brazilian women is 51 years.

Approximately 5% of women experience late menopause, which occurs after age 55, and another 5% of women experience early menopause, which occurs before age 45.

Clinically, natural menopause is characterized by amenorrhea (absence of menstruation) for 12 months in women over 45 years old, with hormonal rates of high follicle stimulating hormone and gradually lower estrogen.

But estrogen rates are not always the hallmarks of the period, as the reduction is gradual and not always regular, and it may take a few months to stabilize and show consistently low rates.


Postmenopause ranges from the last menstruation to 65 years old, when the woman reaches old age. However, after menopause, for approximately 1 year, the patient is still in perimenopause, and the phases occur together.

Signs of irritation in the intimate area, dry mucous membranes, infections and urinary incontinence, reduced sexual interest, difficulty in vaginal lubrication, pain and discomfort during sex tend to occur more predominantly in this phase.

It is in this period that late manifestations tend to appear. Between them:

  • Changes in the skin : wrinkles, loss of elasticity and skin resistance;
  • Intimate problems : vaginal dryness, infections, irritation and difficulty lubricating;
  • Urinary dysfunctions : cystitis and urinary incontinence;
  • Neuromental problems : increased risk of Alzheimer’s disease, stroke, deficit in concentration, difficulty concentrating and reduced memory;
  • Cardiovascular diseases : increased risk of acute myocardial infarction;
  • Bone dysfunction : increased risk of osteoporosis.

What is early menopause?

Menopause can be considered early when it occurs before the age of 45 for some specialists or before the age of 40 for others. The reasons that can stop menstruation early are diverse, involving natural or induced factors.

Among the causes of natural early menopause are genetic aspects, like other women in the family with early reproductive age pause and primary ovarian failure.

For induced menopause, factors like medical treatments (like chemotherapy or radiation), ovarian surgery, cysts, autoimmune diseases and even some medications (like isotretinoin , used to reduce acne) can be the cause.

But it is not only the shorter reproduction time that early menopause causes, as the impacts of reduced estrogen production may involve a greater predisposition to late health problems, such as osteoporosis and heart disease.

The symptoms are, in general, the same as those of natural menopause, involving a menstrual irregularity, decreased blood flow and, after the bleeding stops, hot flushes, hair loss , reduced lubrication and mood changes can occur, for example. example.

Women with induced menopause, in general, have more intense and severe symptoms than those who go through the natural process.

In addition, it is necessary to highlight the emotional impact that can be generated in the patient’s life. More than the mood changes caused by hormonal fluctuations, a series of emotional aggravations can occur due to the loss of reproductive possibilities.

Young women who, even wishing to experience motherhood, but have not yet become pregnant, may suffer intense personal, family and social demands. Being that professional and family attention and assistance are fundamental.

Causes of menopause

Menopause is a physiological and natural process, but some factors or conditions can trigger or accelerate the interruption of the female reproductive phase.

Natural hormone reduction

From the age of 30, in general, the body begins to suffer a drop in the production of hormones.

Even though it seems like a short time, at this age the organism can show significant changes in disposition, cell production, metabolism and functioning in general.

Observing other women in the family, such as mother and sisters, can give hints about the hormonal phases, as there is a tendency for menopause to occur at approximate ages among family members.

Early menstrual interruption, even before the age of 30, can also be the result of this natural hormonal decrease, without other associated disorders.

Primary ovarian failure

Women who have primary ovarian failure (IOP) have only a few occasional periods or no bleeding.

Levels of follicle stimulating hormone are higher, causing a decrease in the number of eggs in the body. Some patients may not suffer from menstrual changes or dysregulations, but it is possible for early menopause to occur.

In these cases, patients must undergo medical monitoring and be attentive to symptoms resulting from the lack of estrogen, such as bone, brain and sexual health.

Among the main causes of primary ovarian failure are enzyme deficiencies, genetic defects and immune disorders (such as sarcoidosis , diabetes , smoking , viral infection, Addison’s disease, pernicious anemia and adrenal insufficiency).


The Hysterectomy is the surgical removal of the uterus which can be accompanied by the removal of the ovaries (total) or not (partial).

In partial hysterectomy, the woman will no longer have the monthly bleeding (as soon as there is no longer the uterine layer to peel), but the ovaries are maintained and, therefore, remain producing hormones.

In this case, there is no menstruation, but neither is there necessarily menopause. Therefore, the main characteristic of the phase – the absence of menstruation – cannot indicate the beginning of the period. Only the other symptoms and hormonal dosage tests can indicate the end of the reproductive phase.

If the woman undergoes a total hysterectomy (both the uterus and the ovaries are removed), menopause is induced immediately. Symptoms can occur more intensely, depending on each organism.

Chemotherapy and radiation therapy

Treatments to destroy cancer cells can also damage healthy cells.

Chemotherapy consists of ingesting drugs that circulate through the body and destroy damaged cells, however, as it is not possible to restrict the action, other cells may be damaged during treatment, including those in the ovary.

Radiotherapy, on the other hand, uses high intensity waves or frequencies to destroy cells in specific regions. Despite being well defined, the therapy can affect regions close to those of the destroyed cells.

It is mainly the radiotherapy of the pelvic region that is most likely to cause the induced menopause.

Treatments that use less intense waves may have a temporary effect, causing limited amenorrhea, in which the woman’s reproductive functions can be recovered after some time without menstruating.


Most women have some sign of climacteric, which can vary in intensity or mechanism of action. For example, lighter, more typical or more comprehensive (such as muscle pain).

In general, they start to manifest 2 years before and last for up to 1 year after menopause.

The farther or farther away from menopause, the more subtle and mild they tend to be, just as, in general, they are more intense when they are close to the date of the last menstruation.

Not all women experience this transition or experience any or all of the manifestations. There are those who go through menstrual termination without showing any symptomatic aspect, other than menstrual absence.

Some of the most common pictures can be:


The fatigue constant may be indicative of the approach of menopause. In general, women over 30 years of age who complain of constant and exaggerated tiredness, reduced productivity and mental tiredness may be initiating symptomatic pre-menopausal conditions.

In addition, fatigue can be the result of anemias, hypoglycemia and hypothyroidism , which are conditions with a higher risk of developing with the approach of menopause. These frameworks, then, need to be evaluated and monitored.


Characterized by dysfunction of the thyroid gland, the disease is quite common among women, especially over 65 years of age.

Among the symptoms, indisposition, menstrual dysregulation, slow metabolism, weight gain, drowsiness, hair loss can manifest.

In addition to the very similar symptoms, menopause can affect thyroid hormone rates and favor hypothyroidism.

Hormonal changes

Among the classic symptoms is hypoestrogenism, which is the drop in estrogen production. But, especially in periods close to menopause, there may still be an increase or oscillation of the hormone.

The increase can be one of the factors that cause bloating and mastalgia (pain in the breasts).

Menstrual changes

The regularity of menstruation tends to be affected. Although menopause is the last menstrual period, before it occurs, in general, there is irregularity of the cycles, which may present a reduction in blood flow, minimization of monthly periods or even an increase in menstruation in a short period of time.

Hot flushes (heat waves)

According to a survey by the University of Pittsburgh, about 80% of women suffer from hot flashes during the climacteric.

Hot flushes are transient manifestations of intense heat on the skin, especially in the upper part of the body (arm, waist, neck and face). The frequency is quite varied, and may occur randomly or even several times a day.

Most women experience hot flushes for periods between 3 and 5 years close to menopause, but there are those who experience hot flashes until they are 70 years old.

In general, they can start with the arms or torso, affecting the whole body, and include chills, tremors, palpitations and feelings of anxiety.

The exact cause of the symptom is not known, but studies suggest that hot flashes are caused by changes in the hypothalamus due to reduced estrogen. The brain region is responsible, among other things, for controlling body temperature.

These changes cause the hypothalamus to perceive the body as hotter than it really is and initiate processes to cool it down.

As with physical activity, blood vessels dilate so that blood flow is favored and heat is mitigated. In addition, sweating occurs to lower the body surface temperature.

Thus, this set of reactions is possibly the mechanism of hot flushes.

Excessive sweating and night sweat

Sweating is a variation of hot flushes, which can be prevalent at night or during the day. Some women may experience excessive sweating throughout the day or only when hot flushes occur.

In addition, the manifestation can be so intense that it creates obstacles to routine, sleep and social activities.

Psychological disorders

The emotional changes are quite intense in the phase close to menopause and researches indicate that during the periods that precede it, there are 2 times more chances of the woman to go into depression.

As progesterone rates drop, neurotransmitters that act on the Central Nervous System (CNS) can be affected and result in psychic changes, such as more irritation, sound sensitivity, depression, anxiety, agitation or apathy.

That is, the lack of estrogen can prevent these neurotransmitters from acting properly and, thus, interfere with the action and release of serotonin , GABA acid and endorphins, responsible for pleasure and mood controls, for example.

The hormonal variations are intensified by the pressure and social demand that occur during the aging process.

The aesthetic, functional and independent aspects can be affected and changes in the body and routine are not always well accepted.

Especially if there are previous cases of depression and anxiety, the risks of psychological damage are high.

In addition, women who still wish to become pregnant may have the most intense emotional conditions due to self-collection or family and social.

Interrupting the desire to experience motherhood can be very harmful to mental health , especially because there is an intense demand for female reproductive function.

Vaginal dryness

The mucous membranes of the vagina need lubrication, especially during sex. The tissue depends on estrogen rates to maintain lubrication and hydration. But when the hormone drops, atrophy of the vagina and vaginal dryness begin to occur.

As tissue friction is greater, itching, injury, irritation and pain occur more frequently. Even the dryness of the intimate region generates great discomfort during sex which, if left untreated, can affect the woman’s sexual life and worsen emotional conditions.

Weight gain

Many women experience weight gain when they are close to menopause, but there is no direct relationship between the drop in hormone estrogen and the numbers on the scale.

Research carried out at Monash University and published in the medical journal Climacteric suggests that putting on weight, in fact, is a sum of factors resulting from routine changes, the drop in metabolism by age and changes in fat distribution due to menopause.

That is, the end of menstruation affects the way the body stores fat, causing it to concentrate mainly on the hips and waist.

This factor, together with changes in diet, in the pace of physical activities and in the emotional state, can cause an increase in weight.

The Hospital de Clínicas de São Paulo carried out a study for 10 years with about 6 thousand Brazilian women, over 40 years old, and pointed out that more than half of the participants were obese or overweight at the age of menopause.

According to the survey, weight gain during menopause can aggravate the symptoms of hot flashes and depression, as well as joint or muscle pain.

Urinary infections

With the aging process, problems related to the urinary tract tend to be more frequent. But with the hormonal drop, cases of urinary tract infection and cystitis can become more accentuated.

Mood changes

Without characterizing psychological disorders (such as anxiety and depression), feelings of sadness, agitation, irritability, mental tiredness and lethargy can be accentuated and occur constantly.

Emotional symptoms can be quite similar to those of PMS, but in a more pronounced and intense way.

Sleep disorders

The insomnia can manifest in periods near menopause, especially when hot flashes and sweats occur at night.

Some women experience hot flashes so intense that they can result in impediments to sleep, discomfort and even interruption of sleep in the middle of the night, resulting in changes in all activities during the day.

Changes in concentration and memory

In addition, difficulties in concentration, reduced memory and mental tiredness can also occur due to hormonal changes.

The brain has several receptors that interact with estrogen and, therefore, hormonal reduction can lead to changes in memory, focus, memorization and the ability to perform multiple tasks.

As there is, for most women, changes in mood and sleep, the functional impairment can be even greater. That is, if the woman sleeps badly and feels irritated in the daily tasks, for example, the dispersion can be even more intense.

Facial Hair

Hormonal changes can cause changes in the amount of hair on the body, but especially on the face.

The woman’s body produces a small amount of androgen hormones, which are considered male hormones, but which have the effects controlled by the action of estrogen.

But with the fall of the female hormone, the action of androgens cannot be inhibited and, therefore, hair can grow more easily.


Some studies indicate that female hormones may be associated with migraine . Women who experienced headaches during premenstrual periods or while using contraceptives have higher rates of migraine in periods close to menopause.

Although some patients may continue to experience headache after menopause, a significant number report that the pain ceases when the last menstruation occurs.

Tissue changes

The lack of estrogen can have a direct action on skin tissues, nails and hair. The layers of the skin may have more dryness, flaking and, especially on the face, more wrinkles may appear.

The hair can suffer weakening and dryness, causing more fall and difficulty in growth. Fingernails, on the other hand, can chip and break more easily, and also have difficulties with growth.


The period of transition to menopause must be monitored by a gynecologist , in order to refer treatments, hormone replacement and clarifications to the patient.

Clinically, it is possible to diagnose menopause by ordering some tests, including hormonal ones, such as follicle-stimulating hormone (FSH) and estrogen, because during menopause, FSH levels increase, while estrogen levels decrease.

The main point in the diagnosis of menopause is to differentiate amenorrhea from other conditions, as menstrual absence can sometimes be a secondary occurrence, pointing out other dysfunctions or changes.

For this, the doctor needs to assess whether the interruption of menstruation is not due, for example, to:

  • Hyperthyroidism (dysfunction of the thyroid gland);
  • Hyperprolactinemia (increased prolactin hormone production);
  • Pregnancy;
  • Medications;
  • Carcinoid syndrome (tumors in hormone-producing cells);
  • Pheochromocytoma (tumor in the adrenal cells).

In addition, women who, before menopause, choose contraceptive methods to avoid menstruating (such as patching contraceptive packs), may take longer to notice the onset of symptoms or menstrual absence.

In such cases, it is important that hormonal follow-up examinations are performed and that the contraceptive suspension or treatment change is conducted by the specialist.

Exams, monitoring and driving

After suspicions of the onset of perimenopause or approaching menopause, it is necessary to follow up for changes that may occur in the body.

Clinical and physiological assessment in pre-menopause or climacteric can be essential to monitor the condition of women. In general, it is a delicate period with significant changes in the organism.

Many patients may feel fragile or helpless, and it is the role of the health professional to assist and assist the changes, providing clinical and informational support. Among the measures that the doctor can take are:

Physical exams

Weight and height are fees that must be closely monitored by the doctor. The BMI (body mass index) may indicate the need for dietary changes or adoption of a more active life physically.

Measuring blood pressure and waist circumference is also necessary, because in addition to weight, the functioning of the organism needs to be considered as a whole.

Gynecological exams, breast evaluation and intimate examination (checking the mucosal roughness, lubrication of the cervix and vagina) are necessary to evaluate and refer the patient to drug therapies.

Clinical exams

Some tests that can be ordered to check the health of the organism are:

  • Laboratory tests (including blood count, TSH, blood glucose, cholesterol and liver functions);
  • Mammography and breast ultrasound (for breast cancer evaluation);
  • Examinations and cervix (cancer preventive);
  • Transvaginal ultrasound;
  • Bone densitometry (evaluation of bone mass health).

Treatment of menopause

Treatment of menopausal symptoms may begin before it occurs, but it is not always recommended or necessary. It is important that not only the gynecologist is consulted at this stage, but also other specialties so that health care is complete.

Due to aging, metabolic changes can lead to weight gain, which is why the endocrinologist and nutritionist are needed to assess metabolic and dietary conditions. In addition, the endocrine may accompany other conditions or diseases, such as diabetes, high blood pressure or cholesterol.

Gastroenterologists and cardiologists are other specialties recommended for general check-up, which must be performed annually.

In addition, it is always recommended to assess the need for psychological counseling. It is worth remembering that not everyone needs psychiatric medication, but therapy is a measure of maintaining health and mental quality.

Improving quality of life and well-being is the main point of treatment, which should always be discussed and evaluated with the doctor.

Hormonal and non-hormonal drug alternatives can be used, in addition to other therapeutic practices.

Drug treatments should be considered as short-term resources, with the aim of controlling symptoms.

Complementary or alternative therapies can be adopted without a determined time, since non-chemical measures to improve the quality of life must extend throughout life.

Currently, hormone replacement for disease or long-term prevention is no longer recommended.

Learn a little more about some options:

Hormone therapy (hormone replacement)

Hormone therapy aims to combat the most debilitating symptoms caused by the hormonal drop. Vaginal dryness, skin changes, impaired bone mass, sleep and mood changes are some of the symptoms that most benefit from replacement.

The presentation of hormones is varied, and may be by oral intake (tablets), gel or topical creams, adhesives or injectables, for example.

When there are limited symptoms, such as vaginal dryness, there is the possibility of administering estrogen-based drugs directly into the vagina, through a cream, pill or vaginal ring.

In this procedure, small doses of the hormone are released so that the dryness in the region relieves, decreasing the friction of the vaginal mucosa.

Dosages should be as small as possible, aiming only at establishing the patient’s balance and comfort, always considering the risks that the therapy may offer.

In general, menopause therapy should be planned with the shortest possible time. In other words, according to the Ministry of Health, the medications must remedy the woman’s discomfort and improve the quality of life, returning the patient’s well-being.

For women who decide to start hormonal treatment, the average time of use should be 4 years and always considering the possible adverse effects. In addition, other remedies may be combined or used in isolation to alleviate symptoms.

When the patient presents with diabetes, endometriosis and uterine fibroids or pre-disposition for any type of cancer, hormone replacement should be properly discussed and evaluated with the doctor.

But hormonal use can pose health risks and, according to the Ministry of Health, therapy is discouraged when there are:

  • Breast cancer;
  • Endometrial cancer;
  • Severe liver disease;
  • Unclear genital bleeding;
  • History of acute and recurrent thromboembolism;
  • Porphyria.

However, some studies evaluate the risks and benefits of adopting hormonal therapy before the end of menstruation, thus, replacement begins as a preventive and symptom-reducing method.

The method is known as resetting in the window of opportunity. That is, take advantage of the fact that the symptoms have not yet manifested and the woman has not yet suffered the effects of age and the lack of estrogen, to offer hormones.

The window of opportunity, according to supporters, could reduce the risks of complications caused by the hormonal drop.

However, several experts and studies, such as a review published in the Brazilian Archives of Endocrinology and Metabology, point out that, considering the current knowledge about the effects of hormone therapy, there is no evidence that it is safe or beneficial to start hormone-based drugs as a preventive method.

Non-hormonal treatment

Some symptoms, such as heat, excessive sweating, fatigue and emotional changes can be alleviated with the use of non-hormonal therapies, which can be through the use of antidepressants, antidopaminergics, vasoactive and hypnosedatives.

In addition, medications necessary to treat or stabilize other illnesses, such as diabetes, high blood pressure or osteoporosis (which can be triggered or worsened with the onset of menopause) must be maintained or initiated.

Alternative therapies


The Ministry of Health also considers natural medicine, complementary practices and herbal medicine as part of non-hormonal drug treatment.

Resorting to alternative and natural measures to alleviate the symptoms is a valid and recognized practice, which can bring benefits to the organism and quality of life, as long as they are properly accompanied by qualified professionals.

Some options that can bring good results to the well-being of women are:


Women interested in adopting phytotherapy during climacteric or after menopause can make this transition between reproductive phases much more smoothly. The measures are supported by studies that point out the benefits and the action of some herbal medicines, including teas or manipulated supplements, according to the professional’s recommendation.


Considering the patient in its entirety, acupuncture aims to resolve or alleviate the symptoms by working on specific points of the body. The practice promotes relaxation, improves breathing and can be functional to ease psychological and organic conditions.

Associated with drug treatments, if necessary, acupuncture can bring benefits to the routine, being also an activity to maintain and stimulate activities outside the family or domestic axis.

Food in menopause

Food has a great impact on the health of the body at any stage of life, so in menopause, they can be allies in health and the pursuit of well-being.

Balanced and diversified meals help to maintain weight and provide more disposition, since there is more supply of nutrients in a natural way.

In addition, preferring less industrialized and fresher foods – such as fruits and vegetables – assists in the control of blood glucose and blood pressure, also reflecting on the functioning and balance of body systems.

The way of eating can also impact the body, so avoid spending long hours without eating or overeating, eating very large meals (as excess calories can accentuate hot flushes).

What nutrients to consume?

Below you will find some foods that can compose the diet and alleviate some symptoms or deficiencies that menopause can cause:

Vitamin D

It is found in red meats, chicken, cheeses, eggs, milk and dairy products and fish. The vitamin participates in the metabolism and absorption of calcium, maintaining bone health, in addition to acting on neuronal activities.

Vitamin C

It is found in citrus fruits, such as orange and lemon, as well as vegetables.

The vitamin acts in maintaining the college, stabilizing cholesterol and helps the immune system (reduces infections, protects the body and acts as an anti-inflammatory).

Vitamin E

It is found in vegetable oils, whole grains, nuts, seeds (like flaxseed), avocado and green leaves.

The vitamin acts as an antioxidant and acts by reducing hot flushes and atheromatosis. In addition, it has direct action on tissues, helping to support the skin and health of hair and nails.


Found in fruits, vegetables, meats, milks and whole grains, chromium participates in the action of insulin and in the metabolism of lipids.

Unsaturated fatty acids

Found mainly in flax seeds and olive oil.

This substance can decrease hot flashes, minimize anxiety and protect neuronal activity. In addition, the atrophy of the vagina and skin tissue can be minimized. In tumor cases, fatty acids can reduce the proliferation or growth of altered cells.


Foods like chickpeas, white beans and lentils are sources of copper.

The substance is essential to prevent anemia, improve symptoms of physical and mental tiredness, in addition to acting on the health of tissues, such as skin and cartilage.

B complex

The B complex is made up of 12 vitamins that can be found in foods such as sunflower seed, liver, beans, whole grains, milk, eggs and wheat germ, tuna, chicken and red meat.

Due to the diversity of the B complex, vitamins act in different mechanisms and participate in numerous functions in the body.

The reinforcement of the B complex can help to reduce anxiety, depression, hot flushes, improve bone and tissue health, in addition to improving cell formation and preventing symptoms and resulting diseases (such as enemies or weaknesses).


Some foods, like soy, contain isoflavones, which are considered natural or plant estrogens, a weak form of the hormone.

Some experts and studies indicate that the consumption of isoflavones can help to alleviate or control the uncomfortable symptoms of menopause. In addition, tofu, which is a soy cheese, and soy milk also contain the substance.

Although there is no scientific evidence on the effects of isoflavones during menopause, health institutes have been conducting research to ascertain the safety of consumption.


Sources of protein and low in carbohydrates , milk and its derivatives are foods that should be included in meals, as they are rich in calcium, which helps in maintaining bone health.

The nutrient can also be found in foods of plant origin, such as dark vegetables (broccoli, arugula and spinach).

Natural yogurts are easy to consume and provide a culture of microorganisms beneficial to the functioning of the intestine.

In addition, fish are good sources of omega 3.


The fibers help in the health of the intestine and help in satiety. Vegetables and vegetables, in addition to being rich in fiber, promote nutrition and assist in the health of tissues (such as skin and hair).

Oilseeds that are rich in fiber, such as nuts and flaxseed, can also help reduce hot flashes and, especially due to selenium, improve brain capacity and memory.

What not to consume?

Due to hot flashes (hot flushes) and excessive sweating, it is better to avoid strong spices or thermogenic foods, such as peppers, ginger and high calorie meals (as they can cause more heat sensation, in addition to favoring weight gain ).

It is also ideal to reduce processed foods , which are high in sodium and can promote fluid retention and swelling.

Fatty meats or high-fat foods, such as yellow cheeses, can impact cholesterol and triglyceride rates.

It is also indicated to moderate the consumption of soft drinks and coffee, due to caffeine, as they can impair the quality of sleep and favor anxiety and agitation.

Natural Remedies

Some natural measures can be adopted to alleviate the symptoms of menopause, whether or not they are combined with drug treatment.

In general, ingestion is safe and brings benefits to the body, but it is important to remember that even the use of teas or natural supplements should be discussed with specialists.

Even though natural, the treatments below can cause side effects and overdoses can lead to poisoning. Therefore, use should always follow the professional’s recommendations.

Vitamin D and E Supplements

Vitamin D and E can reduce hot flashes and control the discomfort of menopause, also helping to maintain bone health. In addition to the reinforcement in the diet, it is possible to find them in manipulated or ready supplements.

Sage oil

The product can assist in hormonal regulation due to its estrogenic properties. It is possible to use it in massages, topically (passing through the skin) or taking inhalations (mixing the oil in the water and heating it).


Ginseng is a plant used to relieve anxiety symptoms, improve mood, treat insomnia and depression. In addition, during menopause ginseng can be consumed to improve intimate lubrication, improve sexual desire and stimulate libido.

Black cohosh

The product can help maintain sleep, balance mood and reduce pain and inflammation. Therefore, in menopause, the herb can minimize hot flushes, maintain the quality of sleep and decrease emotional variations.

In patients who experience improvements with regular consumption, the herb tea may be more suitable than isoflavones, as it becomes safer for patients who have a history of breast cancer.

Red clover

The plant has several isoflavones and, therefore, acts in a similar way to estrogens. In addition, the tea or supplement, consumed regularly, can help with bone health and balance cholesterol. The recommendation for menopausal symptoms is up to 60mg per day, mostly relieving hot flushes.


The plant acts mainly by reducing the symptoms of hot flushes and in the vaginal mucosa, easing the atrophy. The recommended dose is up to 80mg per day.


The herb is used mainly for actions on the nervous system and improves emotional conditions, acting as a tranquilizer and antidepressant. To help balance serotonin (a mood-related neurotransmitter), up to 900mg per day is recommended.


The plant is indicated mainly for emotional and psychological treatments, due to its calming and sleep-facilitating effect. Recommended doses are up to 400mg per day for anxiety disorders, depression and insomnia.


Melissa is used to improve emotional conditions related to anxiety, insomnia and restlessness, but also for digestive symptoms. The intake should be up to 240mg per day.

Coconut oil

Helps to minimize vaginal dryness and can be used after or during the bath. It also helps in moisturizing the skin and hair.

Mint oil

It can improve headaches and reduce anxiety, helping with emotional control. The product can be found in health food stores and should be used topically (on the skin).

Ylang ylang oil

The plant is used as a relaxing and aphrodisiac therapy, increasing libido and sexual stimuli. The product is extracted from the ylang ylang plant, resulting in an oily liquid, with a very striking aroma. In general, topical use is recommended, massaging the skin in the belly area.

Patchouli oil

Patchouli extract is found in health food stores and can be used to reduce mood swings, relieve symptoms of depression and anxiety, and can act as a sexual stimulant.

Just like ylang ylang oil, the product must be used externally, massaging the skin, especially in the belly area.


Medicines must always be prescribed by the doctor and treatment is constantly monitored, with each patient needing an individualized assessment to define the best treatment methods.

Some of the medications used for menopausal symptoms are:


Estrogenic therapy (ET) may be indicated for women who have had a hysterectomy (removal of the uterus), including:

  • Conjugated estrogens : Menoporin and Premarin ;
  • Estradiol : Estrofem , Natifa , Primogyna .

The topical options may include: Estreva Gel , Oestrogel and Sandrena Gel .

In strroprogestagenic therapy (PTE), the use of an estrogen associated with a progestogen is prescribed to reduce the risk of endometrial (uterine) cancer for patients who have not had surgery to remove the uterus.

Among the progestin-based drugs are the medroxyprogesterone acetate , nomegestrol acetate , dydrogesterone or gestodene, for example.


Some antidepressants of the class selective serotonin reuptake inhibitors (SSRIs), in low doses, can be used in the treatment of menopausal symptoms.

This type of treatment can be quite effective for women who cannot undergo hormone therapy for health reasons or those who suffer a lot from mood disorders.

Some of the antidepressants used are:

  • Venlafaxine hydrochloride ;
  • Fluoxetine hydrochloride ;
  • Paroxetine hydrochloride ;
  • Sertraline hydrochloride .

The Gabapentin is indicated for the treatment of seizures , but can be useful in controlling some symptoms caused by menopause, especially hot flashes.

For women who are not recommended to consume estrogens, the following can be used:

  • Selective modulators of estrogen receptors : tamoxifen or raloxifene ;
  • Tibolone : a medication derived from noresteroids that can have positive effects on hot flushes, sexuality and the maintenance of bone mass.
  • Antidopaminergics : veralipride and sulpiride;
  • Hypnosedatives : phenobarbital ;
  • Vasoactive : benciclane , cinnarizine and propranolol.

The continuity or frequency must be determined by the doctor, but according to the Brazilian Society of Climacteric, the most used therapeutic regimens are:

  • Isolated cyclic estrogen (takes for a while and stops) or continuous (takes without interruption);
  • Isolated cyclic or continuous progestogen;
  • Cyclic estrogen and cyclic progestogen;
  • Continuous estrogen and cyclic progestogen;
  • Continuous estrogen and cyclic progestogen quarterly or quarterly;
  • Continuous combined estrogen and progestogen;
  • Continuous or cyclic estrogen and androgen;
  • Continuous estrogen and androgen and cyclic progestogens;
  • Continuous Tibolone.


NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

The risks of hormone replacement

For some women, hormone replacement can have numerous benefits in alleviating symptoms. Especially hot flushes, excessive sweating, pain in general and mood swings are more controlled and mild with hormone replacement.

However, it is necessary that the therapeutic adoption is properly discussed with the doctor and the risks are always evaluated.

A survey carried out by the Women’s Health Initiative (WHI) in 2004, pointed out that the estrogen used in hormone replacement can cause 29% more chances of heart disease , 41% more chances of stroke and 30% more risk of breast cancer .

Other studies indicate that hormone replacement may also favor an increase in the risk of endometrial cancer, uterine bleeding, gastrointestinal symptoms and an increase in the risk of venous thromboembolism and pulmonary embolism .

Among the side effects of hormone replacement, they can mainly involve:

  • Uterine bleeding;
  • Breast sensitivity;
  • Nausea;
  • Abdominal swelling;
  • Liquid retention;
  • Blurry vision;
  • Headaches;
  • Dizziness;
  • Mood swings.

How to live with menopause

The best way to live with the changes that will occur in the body is through information and medical and family assistance.

During this period, it is essential to have the support of those close to you and understand that the end of the reproductive phase is a natural process, which should not be complex or harmful to health.

Several measures can be adopted and included in the routine, aiming to improve the acceptance, adaptation and well-being of women.

Practice physical activities

You have probably heard that physical activities are essential during life. The benefits are numerous and the result is a healthier, more willing and stronger body.

Especially women who are going through perimenopause can benefit from the regular adoption of physical activities, because in addition to the benefits already known, the weight gain caused by the hormonal drop can be reduced or avoided.

Intensifying the rhythm helps to eliminate more calories and keep your metabolism active. In addition, as there are greater risks for women to develop high blood pressure and diabetes, staying physically active helps to control these physiological rates.

A study at Pennsylvania State University in the United States indicates that just 30 minutes of exercise a day can reduce hot flashes. In addition to providing more disposition and improving fitness, activities balance mood and reduce symptoms of mental tiredness and depression.

By maintaining a team routine, social interaction is favored and self-esteem is improved. Good options for those who want to continue or start moving are hiking, dancing, gym classes, yoga or team sports.

A study published in the Revista Brasileira de Geriatria e Gerontologia, in 2011, pointed out that the moderate and intense symptoms of menopause were reported by 63% of the monitored women who did not practice physical activities. Among those who maintained exercise routines, conditions were reported by only 33%.

Take care of the food

Just like exercise, it is not only during menopause that you must have heard about the need to keep meals balanced and healthy.

Paying attention to food is a way to prevent disease, improve immunity, balance the balance and reduce complications from diseases such as diabetes or hypertension.

The ideal is to prefer natural foods, reducing preservatives, sodium and processed foods. Maintaining a balance in the dish is, in general, sufficient to supply all nutritional needs and prevent food shortages.

When choosing foods, keep an eye on nutrients. Calcium, iron, folate and fibers must be very present in this stage of life, as they act on the health of bones, muscles and intestines.

Read more : Why eat vegetables?

Hydration is essential for the body to perform its functions well and the appearance of tissues (such as skin and hair) is favored.

The protein lean, such as eggs, fish and chicken are options to balance the plate and reduce the intake of carbohydrates (which, in excess, can favor the accumulation of fat).

There are studies that point to the benefits of isoflavone (which is a weak plant-derived estrogen) for reducing hot flushes. The substance is found in soy and food supplements.

Although there are indications that consumption may improve some symptoms, women who have had breast cancer should talk to the doctor before including food in the routine.

Remember that a balanced menu must always be accompanied by the nutritional recommendations of a specialist.

Keep your body fresh

The discomfort of hot flashes and sweating can be alleviated by adopting some precautions, such as the use of fresh clothes, with light and comfortable fabrics. Constant hydration deserves attention and you can include teas and refreshing drinks, such as natural juices.

Adopt the use of fans and air humidifiers that can refresh the environment and always prioritize air circulation.

Wetting or moistening strategic parts of the body, such as the wrists and the back of the neck, can soothe the feeling of heat. It is possible to spray cold water, apply damp towels with cold water or place cold thermal bags on regions of the body, such as the shoulders.

Avoid foods that raise body temperature, such as strong spices and peppers, especially around bedtime. Intensifying the intake of liquids, such as water and natural refreshing juices, reducing the intake of stimulating drinks such as soft drinks, coffees and black tea can also help to keep the body fresh.

In addition, some breathing techniques can be effective if the symptoms cause insomnia, as breathing correctly helps to bring more tranquility and favors falling asleep.

Reduce stress and take care of the emotional

Slowing down the pace of life can be effective in easing stress . Changes in mood can be very compromising for productivity and generate severe difficulties in the routine. So, respect your time.

Include relaxing and pleasurable activities in everyday life. It can be a walk, a course or an alternative therapy. Taking a few hours a day to read a book, develop a personal project or take care of a garden can bring more calm and ease anxiety.

In the necessary cases, do not hesitate to start drug treatment to relieve emotional symptoms, always combined with psychological therapy.

Menopause and the reduction of libido

It is quite common to associate menopause with the natural reduction of libido, and this is still one of the factors that deserve more attention in the care of women’s health.

According to the Ministry of Health, most problems that are related to sexual changes in the climacteric are caused by changes in the functionality of the intimate anatomy.

That is, many women have symptoms due to hormonal reduction, resulting in dryness of the mucous membranes, atrophy of the genital system and slower response to sexual stimuli.

Therefore, it is worth mentioning that women in menopause do not necessarily have less sexual desire or needs. Often, there is only a reduction in the speed of the body’s responses.

This factor, added to the discomfort caused by sluggish vaginal lubrication and the reduction in self-esteem, may lead to a departure from sexual activities.

Often, sex causes pain or discomfort, and due to lack of information or fear, women do not resort to available therapies and care.

The result is a compromising health cycle, as there is a tendency for self-esteem to be further undermined, personal relationships (marriage, dating, friendship and family) are also impaired and mental health is worsened.

It is necessary to reinforce that it is necessary and healthy for the woman to maintain a sexual routine similar to the one before the perimenopause and that, when changes occur, the psychological and medication treatment can help to keep the routines balanced.

Some tips to better deal with the menopause period and changes in sexual routine are:

Respect your body

Menopause is a period of change and, just like any new phase, there needs to be an adaptation and acceptance of the changes that can occur. As it is not possible to avoid or revert, it is necessary to seek the best way to deal with the phase.

Understanding the limitations of the body and mind – whether by age or menopause itself – is essential. Therefore, it is often necessary to face changes as belonging to life.

If there is persistent or prolonged disinterest in activities that used to be pleasurable – whether walking, working or having sex – professional help is needed.

Do not hesitate to seek help

Any discomfort or doubt regarding the health and well-being involved in menopause should be discussed with a professional, as there are a number of alternatives to help women maintain a healthy sexual routine.

Often, women see the reduction of libido as inevitable or irremediable, accepting to live with a problem that, many times, is simple to be solved.

It is worth remembering that not every treatment works the same way in all organisms. So it is important that the monitoring is done looking for the best methods for the well-being of each woman.

If you are not satisfied with the sexual routine, feeling discomfort or disinterest, talk to your doctor. Together, you can start or change your medications, add secondary therapies, and probably find a solution.

It is important to remember that menopause, in general, should not negatively affect women’s life and health, and medicinal and therapeutic resources can be combined with routine to maintain quality of life.

Discover products

In addition to hormonal or medication treatments, there are several lubricants that can help during sex to reduce the discomfort and pain caused by vaginal dryness. Talk to your doctor and visit stores specializing in intimate products.

It is worth remembering that the female body may take longer to become aroused if the emotional state is anxious or tense. Therefore, it is necessary to invest in the intimacy and relaxation of the moment, seeking activities, products or routines that stimulate both.

Seek support from people close to you

If the woman is in a marriage or stable relationship, it is important that there is an understanding of the partner about the changes that can occur in this period of perimenopause.

It is important to remember that often, disinterest in sex begins with conflicts or problems in the relationship. The erectile dysfunction and problems affecting erection quality may be triggering factors.

Feeling welcomed is essential even for the health of the relationship.

In addition, it is important that the symptoms and desires are respected. For example, if a woman experiences pain during sex or disinterest, it is critical that the other person is aware and respectful.

It is also essential that relationships that escape the sexual sphere participate in this phase of menopause. Family and friends can compose networks of affection, welcoming and making symptoms easier to deal with.

Take care of health in general

It is not possible to attribute only a lack of sexual interest to menopause, since the whole organism must be working properly.

With age, in general, it is expected that there will be a decrease in libido in most people – including men. But in addition to the passing of the years, some pathologies can be the cause of the lack of libido.

For example, a patient with uncontrolled diabetes may experience problems with circulation or anemia, and the lack of physical activities can cause extreme tiredness, making it difficult for women to stimulate themselves and to excite themselves.

So it’s important to keep your health up to date and take care of your body.


In addition to the symptoms that indicate menopause, especially hot flashes and mood swings, there are medium and long-term manifestations that can develop or be favored by hormonal changes.

Between them:

Urinary tract disorders

Urinary problems are not a necessary condition of age, but they can be greatly favored by the aging process.

With age, the body loses muscle strength, including the pelvic musculature, responsible for controlling urine. Along with this, the reduction of estrogen can favor the relaxation of tone.

In addition to the impacts on routine, urinary incontinence has a great social impact on the woman’s life, as there is usually a compromise in daily activities and the patient tends to avoid many chores, including social life.

Atrophy of the genital mucous membranes

The drop in estrogen can favor a series of changes in the woman’s intimate health, since most of them show some degree of thinning, decreased lubrication and fragility of the tissue, especially impacting sexuality.

Some symptoms such as dysuria (burning when peeing), urethral syndrome, urinary incontinence, urinary infections, pain and difficulties when peeing can occur and worsen over time.

Changes in cholesterol and lipid metabolism

The reduction in the hormone estrogen can also affect the metabolism of cholesterol and triglycerides, resulting in greater risks of elevating bad cholesterol (LDL) and decreasing good cholesterol (HDL).

This condition can result in favoring atherosclerosis (accumulation of cholesterol in the arteries), myocardial infarction, stroke and dyslipidemia (elevation of blood lipids), for example. With the reduction in estrogen rates, the risks are high especially in women with early menopause.

In addition, with the hormonal drop, changes in the rates of elements involved in the coagulation processes (hemostasis) may occur, resulting in greater chances of thromboembolism, especially in climacteric.

Bone effects

Bone structure can be affected by hormonal changes, as both testosterone and estrogen participate in the maturation of bone tissue.

Studies show that the female hormone can act in the repair of bone structure and, therefore, in menopause, bones can suffer from degeneration, weakening and osteoporosis.

On average, there is a decrease in bone mass of 2% to 5% per year in the first 5 years of menopause and, in the following years, from 0.5% to 1% per year.


Several studies seek to investigate the correlation between menopause and depression, but the data are often conflicting.

Some point out that there are higher rates of depressive disorders before menopause, but that the rate tends to decrease after 1 year of the last menstruation, that is, at the end of the climacteric.

While others indicate that after menopause, especially with advancing age, depression rates tend to remain high.

There are specialists who point out one of the possible causes for the variation of the data being the social impact on the female aging assumes in different places.

As the studies are, in general, done with different communities, the cultural and regional weight can be determinant in the rates of psychological problems.

Since menopause marks the end of reproductive age, it can have a high impact on her personal life and social acceptability.

In addition, age brings physiological changes and can have implications for personal, financial and emotional independence. Thus, combined with hormonal changes, the value that menopause acquires in each society or family center can lead to greater emotional and psychological disorders.

Endocrine changes

In addition to cholesterol levels, decreases in estrogen production, associated with other factors (such as weight gain or dietary changes), may favor diabetes and elevated blood pressure.

Sexual dysfunctions

It is still quite common to associate the reduction of sexual activity with menopause, but there are experts – including the Ministry of Health – who indicate that the biggest determinant to keep women away from healthy sexual life is taboo and prejudice.

In general, the hormonal drop can affect libido, desire and the stimulus response. But it is still the misinformation and social burden on female sexuality and old age that most incapacitates women to maintain a sexually active life.

Common questions

Can pregnancy occur during menopause?

No . After menopause occurs, that is, the last menstrual period, it is naturally not possible for the woman to become pregnant.

It is worth remembering that menstrual blood goes down because the organism, which was preparing to gestate a baby, cannot proceed with the process. That is, there was no fertilization and the endometrium (layer of blood on the wall of the uterus) came off.

Since menopause is the woman’s last period, all the eggs have been released and there will be no more ovulation.

But that does not mean that it is not feasible to become pregnant after menopause, as there are techniques, such as assisted or in vitro reproduction, that can be indicated by the gynecologist and fertilization specialist if there is a desire for pregnancy.

Can you get pregnant during climacteric or perimenopause?

-Yeah . Despite the fact that the fertility index starts to decline a few years before menopause, with a reduction of up to 80% in the fertility rate for some women, ovulation continues to occur in perimenopause.

This means that women must maintain contraception if they do not wish to become pregnant.

It is also important to note that pregnancy close to menopause can be more delicate, representing higher risks to the health of the mother and baby.

Still, women who wish to start the pregnancy process but are in the climacteric, if they carry out the necessary follow-ups, they can have a healthy and safe pregnancy.

How old is menstruation that starts to fail?

It depends on a number of factors, such as genetic, physiological and even external (such as medications or surgical treatments). In general, menopause occurs between the ages of 45 and 55, with the estimated average of Brazilian women at 51 years of age.

How long does the climacteric last?

Climacteric or perimenopause is an estimated period between 2 years before menopause and 1 year after. There is no way to determine the precise beginning and end of this phase, and the presence of symptoms and hormonal changes can be indicative.

But it must be remembered that not all women manifest their symptoms in a similar way, at the same intensity or with the same regularity. It is also possible that the climacteric (or the months before menopause) are totally asymptomatic.

What are the symptoms of menopause before age 50?

Regardless of age, the most common symptoms are hot flashes, excessive sweating, mood swings, headaches, depression, tiredness and hormonal changes.

This is not to say that you will have them all. It also does not mean that you will necessarily feel these, as there are a number of other physical and organic manifestations that can occur according to each woman.

Generally, symptoms of early menopause, before age 45 or 40, tend to be more intense. But this is not a rule.

Is hormone replacement mandatory for all women?

No . A few years ago, hormone replacement therapy was suggested for most women, including as a way to prevent symptoms. The problem is that unnecessary replacement can cause numerous health damage.

The lack of estrogen caused by menopause can cause quite uncomfortable, mild or no symptoms at all. Therefore, treatments should be discussed and evaluated with the doctor.

If possible, it is indicated to treat the symptoms with specific non-hormonal drugs and integrated therapies. But, in the necessary cases, the replacement duly monitored by the doctor can be quite beneficial and bring more quality to the woman’s life.

Does hormone replacement treatment reverse menopause?

No . Menopause is the end of a woman’s fertile age. Although there are artificial possibilities for the patient to become pregnant, menopause cannot be reversed. That is, the treatments are only to alleviate the symptoms of the period.

Does the birth control pill speed up menopause?

No . Women who take the pill for long periods have no change in the age of menopause, and it is defined mainly by genetic factors.

If my first period was too early, will I have early menopause too?

No . Scientifically, there is nothing to prove that women who menstruate early will have menopause earlier as well.

Although there is no scientific proof of the relationship, a study conducted with 50,000 women, by the International Collaborative Research Center on Approach to Reproductive Health and Chronic Diseases (INterLACE Consortium), pointed out that there may be.

The assessment indicated that among participants who had their first menstruation before the age of 11, the risks of early menopause were 80% higher than among women who menstruated after the age of 13.

Regardless of age, the study also found that there was 32% more premature menopause among women who had no children compared to women with 2 or more children.

After menopause, do I still need to go to the gynecologist?

-Yeah . Ideally, gynecological follow-up should be frequent throughout a woman’s life, even (or even above all) after menopause.

All symptoms and changes that the body will face must be monitored by the doctor, who needs to keep the patient informed and aware of its possibilities, such as treatments and hormone replacement.

The ideal is to maintain a frequency of at least one consultation per year. But in the beginning, a more frequent trip may be necessary, especially if any type of treatment is started (hormonal or not).

Is there a relationship between menopause and cancer?

No . Menopause itself does not cause cancer. It is necessary to be attentive only to the predisposition to the disease, especially if there is an intention to initiate hormonal therapy, as the replacement can lead to higher risks of developing cancer, especially those of the breast and uterus.

Hormone replacement fattening?

No . Neither menopause nor hormone therapy actually put on weight. The lack of estrogen can favor the accumulation of fat in the abdominal region, but if physical activities and a balanced diet remain adequate, the tendency is that there will be no variations in weight.

If you experience weight gain after starting any treatment for menopausal symptoms, you should talk to your doctor to evaluate the change of medication.

During life, the body undergoes a series of changes that may be natural or not.

Growth, puberty, disease, surgery or even lifestyle habits can cause changes in body structure or organic functioning.

Some may be easier to accept, others more painful or debilitating, but they will certainly occur during life.

Menstruation and reproductive capacity are, in general, very delicate situations for most women, whether in the first menstruation or in the last.

Not only due to the changes in the organism resulting from these phases, but also due to the social and personal value and weight they carry.

The end of the childbearing age is still permeated by the lack of information, prejudice and the difficulty in dealing with the natural process for the vast majority of women. For this reason, this transition, which is common to the vast majority of women, is not always a simple process, although it is inevitable.

Talk to your doctor, get informed and get to know your body. Well-being and quality of life should always be the priority.