Menopause is the cessation of menstrual cycles, occurring for most women between the ages of 47 and 55 years. During perimenopause, as estrogen levels decrease, women often experience hot flashes, night sweats, vaginal dryness, and mood swings. While some women experience debilitating symptoms, others transition through this time with few complaints. Unless precipitated by surgery or illness, menopause is part of the natural aging process. As such, women should be reminded to consider this time as an opportunity to celebrate their beauty, strength, and vitality by recommitting to a healthy lifestyle.

Diagnosis

Menopause is a retrospective, clinical diagnosis made after 12 months of amenorrhea, resulting from the cessation of ovarian follicle production. At this time, follicle-stimulating hormone (FSH) levels rise significantly in an attempt to stimulate follicle production. Although an elevated FSH level is diagnostic of menopause, FSH levels are not routinely checked, as the level varies greatly in the months leading up to menopause due to irregular and missed menstruation. Clinicians should consider checking FSH and estradiol levels for symptomatic women less than 40 years old with missed periods, in whom premature ovarian failure is suspected.^1-3

Controversy exists regarding the practice of measuring hormone levels for the diagnosis, treatment, and monitoring of menopause and its symptoms. Testing may not be reliable depending on the source (serum, saliva, or urine) and the method of hormone replacement administration. Because of the lack of research, routine testing is likely unnecessary for most women.⁴  The diagnosis of menopause should be made based on clinical findings; treatment is based on symptoms.

A Healthy, Comprehensive Approach to Menopause

Before addressing specific symptoms, clinicians should review the importance of a comprehensive approach to wellness during the menopausal transition. Cardiac and bone health should be addressed because of the increased risk of coronary artery disease and osteoporosis.

Diet

A healthy diet is always important, especially during menopause.

·         Review a healthy diet to maintain an optimal body weight. For many, this diet incorporates whole, unprocessed foods consisting of primarily fruits and vegetables; whole grains, and low-fat protein.  For more information, see the “Nutrition,” overview.