Menopause at Age 44


Going through menopause--especially the early stages--at age 44 is a normal occurrence. As a matter of fact, women as early as their late 30s begin to feel the effects of impending menopause. This stage is called perimenopause, or menopause transition. Menopause is a natural transition from your childbearing years, and is in no way considered a disease or illness.

What Is Menopause?

  • Menopause is the stage women go into after they can no longer ovulate or have a menstrual cycle. It is brought on by declining levels of the female hormone estrogen. Estrogen is responsible for ovulation and basic ovarian functioning. Once this level is low enough, ovulation and menses stop completely. This usually happens between the ages of 45 and 55, but for some women, menopause can begin earlier than this. This is called premature menopause. Most women go through a two- to eight-year transition into menopause, called perimenopause, which can also occur in your 40s.

Signs and Symptoms

  • Some women have little to no discomfort during menopause, and others have major discomfort. The most commonly experienced symptoms of menopause are hot flashes, night sweats, heart pounding or racing, skin flushing and insomnia. Less common symptoms include decreased interest in sex, decreased sexual stimulation, vaginal dryness, urine leakage, forgetfulness, mood swings, irritability, depression and anxiety. During perimenopause, women may experience some of the same symptoms along with irregular menstrual cycles brought on by lowering estrogen levels.

Diagnosing and Testing

  • Diagnosing menopause is done by the use of blood and urine tests used to measure hormone levels. Some of the hormones tested will be estradiol, follicle-stimulating hormone (FHS) and luteinizing hormone (LH). All of these hormones work together to run all aspects of your menstrual cycle. In addition to these tests, your physician will give you a pelvic exam, which will indicate changes in the vagina. Vaginal changes such as dryness and thinning of the lining are caused by low estrogen levels.

Treatment Options

  • If you are perimenopausal, and still have a menstrual cycle, you may be offered the use of oral contraceptives (birth control pills) to regulate the cycle, lessen symptoms associated with estrogen decline and to prevent pregnancy. For women who no longer have a menstrual cycle, you may be offered hormone replacement therapy (HRT). Hormone replacement therapy is used to regulate estrogen levels in order to stave off some of the symptoms that are associated with hormonal imbalance. Women who have not had a hysterectomy may be offered the use of replacement progesterone in conjunction with HRT--this is called combined HRT. The use of HRT may raise the risks for breast cancer, heart attacks, strokes and blood clots. To reduce these risks, you may request the use of an estrogen cream instead of a pill and schedule frequent pelvic exams and Pap smears, as well as breast exams.

Special Considerations

  • During menopause, some women have mood swings and depression. These can be treated with antidepressants such as paroxetine (Paxil), venlafaxine (Effexor), bupropion (Wellburtin) and fluoxetine (Prozac). Also, you may experience postmenopausal bleeding; in small amounts (spotting), it's generally nothing to worry about, but in some cases it may signal health problems. Talking it over with your physician is the only way to be sure whether this occurrence is normal.

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