Glossary

The massive fluctuations in hormone levels during the menopause transition may cause or exacerbate anxiety, a persistent and excessive worry that cannot be put to the side. Physical symptoms of anxiety may include increased irritability, fatigue, muscle tension, trouble falling and staying asleep, avoiding one's usual routine, and/or a sense of impending doom.

Estrogen is essential to good bone density, meaning bones that are saturated with minerals and therefore less likely to break. As estrogen levels fall during menopause, bones can become weaker, leading to a greater risk of fracture, osteopenia (low bone mass), and osteoporosis (weak, brittle bones). A DEXA body scan, which measures bone-mineral density, can indicate whether someone is at risk for developing osteoporosis or experiencing a fracture.

Perimenopausal women may experience a noticeable decline in their ability to think clearly thanks to dropping estrogen levels. Estrogen supports the part of your brain where memories are processed. Cognitively, women may be more forgetful, especially in terms of short-term memory, and even struggle with remembering everyday words.

Breast cancer treatments such as chemotherapy; hormone therapy, i.e., aromatase inhibitors (including Tamoxifen, Anastrozole, Letrozole, Exemestane); or ovarian suppression, which stops the ovaries from working either permanently or temporarily, can trigger menopause symptoms. Aromatase inhibitors can, in fact, make the menopause symptoms more intense. Menopause is not a cause of breast cancer, but the risk of breast cancer increases with age.

Cardiovascular disease (CVD) is the number-one cause of death for women in America. CVD is an umbrella term for a range of conditions that affect your heart including high blood pressure/hypertension, heart attacks, higher LDL (or bad) cholesterol, heart failure, coronary artery disease, arrhythmia (irregular heart rhythm), arterial blockage, strokes, and heart valve issues.

Perimenopause triggers a roller coaster of hormonal changes that may cause depression, even for women with no history of depressive episodes.

The medical term for recurring or continuing pain during or just after sexual intercourse.

Early menopause is when women stop getting their period for 12 consecutive months between the ages of 40 and 45.

Estrogen is one of the two main female sex hormones; the other is progesterone. Estrogen is produced mostly in a woman’s ovaries and courses through the bloodstream to reach all parts of the body. When women enter the menopause transition, whether naturally, surgically, or medically, their levels of estrogen fluctuate, ultimately causing the cessation of menstruation.

A hormone that helps grow eggs for release from the ovaries as part of the menstrual cycle. High levels of FSH may indicate dysfunction in the ovaries and are often used to test for premature ovarian insufficiency. FSH levels at 30 mIU/mL or higher, along with 12 months of no menstruation, generally mean that a woman has reached menopause.

GSM (previously called vaginal atrophy) includes genital, sexual, and urinary symptoms associated with menopause. Genital symptoms range from genital dryness to burning, irritation, and/or discharge. Sexual symptoms include decreased vaginal lubrication, low libido, and painful/uncomfortable sex. Urinary symptoms include urinary tract infections (UTIs), increased urinary leaks, and incontinence. All GSM symptoms are caused by a decline in estrogen that leads to a thinning of the vulva-vaginal wall, including the urethra and bladder.

Hormone Replacement Therapy (HRT) is the former term for medication containing female hormones prescribed to women to alleviate menopause symptoms. The treatment is now called Menopause Hormone Therapy (MHT).

Intense waves of heat around the head, face, chest, and neck—which may cause the skin to redden, blotch, and perspire. See Vasomotor Symptoms.

A partial hysterectomy is the surgical removal of part or all of the uterus. A total hysterectomy includes the removal of the cervix. Neither procedure leads to menopause unless accompanied by the removal of both ovaries (see oophorectomy). A radical hysterectomy does trigger menopause, as it involves the removal of not only the uterus and the cervix, but also both ovaries, both fallopian tubes, and nearby tissue.

Because estrogen helps to reduce inflammation in the body, many women experience stiff or swollen joints before and after menopause as levels of the hormone decline. Pain, heat, or inflammation in the knees, neck, ankles, fingers, elbows, jaw, and back joints are most common.

When a woman has her final period after the age of 55.

A declining interest in having sex and/or becoming aroused. The North American Menopause Society (NAMS) reports that one-third to one-half of perimenopausal and postmenopausal women experience low libido.

Menopause that is triggered by medical treatments such as chemotherapy, radiation, and ovarian suppression therapy. Medical menopause may be permanent or temporary depending on the treatment. Because it happens immediately after surgery or treatment, not gradually as with natural menopause, medical menopause is often accompanied by severe menopause symptoms.

Menopause is when a woman has not had her period for 12 consecutive months. If a woman skips a period for several months but begins to bleed/menstruate again, she has to begin counting all over again.The menopause experience is a longer transition that begins with perimenopause and ends with postmenopause.

Formerly known as Hormone Replacement Therapy (HRT), Menopause Hormone Therapy is medication containing female hormones prescribed to women to alleviate menopause symptoms.

Noticeably heavy menstrual bleeding or menstrual bleeding that lasts longer than one week.

The majority of women in the U.S. go through what is called natural menopause between the ages of 45 and 55, with the average age being 51 for non-Hispanic white women. For Black, Asian, and Latina women, menopause starts earlier, between 49 and 50. Studies show that Black women spend more time in the menopause transition than white women do.

Neurological diseases include cognitive impairment, memory loss, ischemic stroke, and Alzheimer’s disease. Postmenopausal women are at greater risk for these neurological conditions because of changing hormone levels.

Night sweats are hot flashes that occur during sleep. See Vasomotor Symptoms.

A licensed healthcare provider who has achieved certification in the field of menopause from the North American Menopause Society. Their vision is “to serve as the definitive, independent, evidence-based resource on midlife women’s health, menopause, and healthy aging for healthcare professionals, researchers, the media, and the general public."

An oophorectomy is the surgical removal of an ovary. Bilateral oophorectomies, in which both ovaries are removed, result in immediate menopause—often with intense symptoms—for premenopausal or perimenopausal women, as their bodies can no longer produce estrogen. A unilateral oophorectomy, by contrast, does not lead to instant menopause, as one ovary remains and can continue estrogen production.

Decreased bone density that is lower than normal but has not reached osteoporosis levels. Osteopenia makes bones less strong, increasing the risk of fracture. People diagnosed with this condition are at greater risk of developing osteoporosis later.

Osteoporosis (“porous bone”) is a disease that results in weak, frail bones that are far more susceptible to fractures, especially in the hip, wrist, or spine. It affects both men and women, but women are at increased risk of developing osteoporosis after menopause. The disease is progressive, but some treatment options are available. A DEXA body scan, which measures bone-mineral density, can indicate whether someone is at risk for developing osteoporosis or experiencing a fracture. If you break a bone after 50, talk to your doctor.

Perimenopause is the 4-to-10-year stretch before menopause when estrogen and progesterone levels, which regulate a woman’s reproductive cycle, begin to fluctuate and ultimately decrease. This phase—it generally begins in a woman’s 40s, but can start as early as her 30s—is typically when women will experience symptoms, such as increased irritability, vaginal dryness, hot flashes, etc.

Although the term postpartum depression is often used, there is a spectrum of mood and anxiety disorders that can affect women during pregnancy and the postpartum period. Women who have a PMAD are at increased risk for perimenopausal depression and anxiety.

After 12 months without a period, a woman reaches menopause and is then considered postmenopausal. Experiences vary, but many women continue to experience menopause symptoms for 4 to 10 years following menopause. Regardless of frequency, intensity, or absence of symptoms, long-term health risks remain. As the average age for entering postmenopause is between 49 and 51 and most women today live into their 80s, many view their postmenopausal years as an exciting, period-free chapter.

POI, formerly known as Premature Ovarian Failure, occurs when a woman’s ovaries stop functioning properly before she turns 40. The ovaries stop producing estrogen and progesterone, thus ceasing the process of egg release, causing a woman’s periods to become irregular and ultimately stop. Occasionally, the ovaries may restart, temporarily producing hormones and releasing eggs. POI is rare, affecting approximately 1 percent of women, and often leads to infertility.

Premenopause is the beginning of a woman’s reproductive life cycle, which begins with her first period and ends with perimenopause.

PMDD, which presents as an intense case of PMS with irritability and mood changes, is caused by hormonal shifts in the final week before your period, also known as the luteal phase. Symptoms usually diminish after your period arrives. PMDD affects between 5 and 10 percent of women. It is important to note that women with PMDD have an increased risk of mood symptoms during perimenopause.

Premenstrual syndrome (PMS) is both physical and emotional symptoms such as bloating, tender breasts, food cravings, fatigue, irritability, and mood swings. These symptoms usually start in the two-week period after ovulation and before menstruation, due to estrogen and progesterone levels falling. Symptoms often go away once the period starts. Severe PMS symptoms may be a sign of premenstrual dysphoric disorder (PMDD). During perimenopause, both PMS and PMDD often get worse. Once a woman is postmenopausal, symptoms of PMS resolve.

One of the two main female sex hormones, the other being estrogen. Progesterone’s primary job is to help a woman get pregnant. When women enter the menopause transition, their progesterone levels plummet. During perimenopause, this hormonal decline may cause periods to become irregular, often with heavier bleeding.

Surgical menopause occurs as the result of either a bilateral oophorectomy (when both ovaries are removed) or a total hysterectomy (when the uterus and ovaries are removed), both of which eliminate the body’s hormone-producing organs. Women entering menopause as the result of surgery often experience more severe symptoms than women who come to menopause naturally, due to the sudden and extreme shift in hormone levels.

As estrogen declines during menopause, so does the lining of the urethra, the short tube that channels urine from the bladder out of the body, making it harder to control urine flow when the bladder is ready to release. Urinary incontinence can range from slight leakage (i.e., upon laughing or sneezing) to an inability to reach the toilet on time. See Long-Term Health Risks.

A UTI results when bacteria enter the urethra and multiply inside the bladder. During menopause, falling estrogen levels can upend the vagina’s bacterial balance, making it more susceptible to infection. UTIs generally present with urinary urgency, a burning sensation when passing urine, a change in the color or odor or urine, and/or pain in the pelvic region. Fever and/or nausea may occur. UTIs must be treated as quickly as possible to avoid kidney damage. See Long-Term Health Risks.

Hot flashes and night sweats are the most recognizable vasomotor symptoms associated with menopause. These intense waves of heat around the head, face, chest, and neck—which may cause the skin to redden, blotch, and perspire—are triggered when hormone fluctuations cause blood vessels to constrict and dilate erratically. Hot flashes can be accompanied by a racing heart. VMS experiences differ among racial and ethnic groups.

The Women’s Health Initiative is a long-term national health study focused on women. In 2002, the WHI released a report stating that Hormone Replacement Therapy or HRT (now called Menopause Hormone Therapy or MHT) increased a woman’s risk of breast cancer, heart disease, and stroke. The WHI has since clarified its findings. Its initial study focused solely on older women but its results were mistakenly applied to women of all ages. As a result, doctors stopped prescribing hormone therapy, believing it to be dangerous. Having subsequently analyzed the findings in terms of age, the WHI now says younger women may benefit from hormone therapy, but that this course of treatment should be an individualized decision based on a woman’s health profile, including age, symptoms, and family history.