Menopause is the time in your life when you naturally stop having menstrual periods. Menopause happens when the ovaries stop making estrogen, the hormone that helps control the menstrual cycle. Menopause marks the end of the reproductive years. The average age that women go through menopause is 51 years.


The years leading up to menopause are called perimenopause. Beginning in your 30s and 40s, the amount of estrogen produced by the ovaries begins to fluctuate. A common sign of perimenopause is a change in your menstrual cycle. Cycles may become longer or shorter than usual. You may begin to skip periods. The amount of flow may become lighter or heavier. Although changes in menstrual bleeding are normal during perimenopause, you still should tell your provider. Abnormal bleeding may be a sign of a problem.


Some women do not have any symptoms of perimenopause or have only a few mild symptoms. Others have many symptoms that can be severe. Common signs and symptoms include:


  • Hot flashes
  • Sleep problems
  • Vaginal and urinary tract changes


Hormone therapy can help relieve the symptoms of — and prevent complications from — perimenopause and menopause. Hormone therapy means taking estrogen and, if you have never had a hysterectomy and still have a uterus, a hormone called progestin. Estrogen plus progestin is called “combined hormone therapy” or simply “hormone therapy.” If you do not have a uterus, estrogen is given without progestin. Estrogen-only therapy is called “estrogen therapy.”


Estrogen can be given in several forms, including pills, skin patches, and gels and sprays applied to the skin. Progestin can be given separately or combined with estrogen in the same pill or patch. Women who only have vaginal dryness may be prescribed “local” estrogen therapy in the form of a vaginal ring, tablet or cream.


Hormone therapy may increase the risk of certain types of cancer and other conditions.