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The Midlife Women’s Health Center at Massachusetts General Hospital brings together experts from more than 15 specialties to improve, promote and advance healthcare for women at menopause and beyond through research, collaboration and education.
Welcome to the Massachusetts General Hospital Center for Women’s Mental Health, a perinatal and reproductive psychiatry information center.
What is menopause?
Menopause is the cessation of the menstrual cycle (periods) in women. Women may have erratic and infrequent periods for several years before periods stop completely.
- Ovaries stop maturing eggs
- Ovaries decrease production of the hormone estrogen and do not produce the hormone progesterone
- Ovaries continue to produce testosterone, which is also a hormone made by the adrenal glands
When does menopause occur?
The average age that a woman experiences menopause is 51 years. Most women experience menopause between the ages of 45 and 55. However, some women have early menopause, which can occur in their late 30s to early 40s. Others may continue to have periods into their late 50s.
The time leading up to menopause is called perimenopause, which can range from 2 to 10 years. During perimenopause, periods can stop and then start again.
Hormone testing generally is not helpful to determine when menopause will occur because estrogen and progesterone levels go up and down during the menstrual cycle and cannot predict when a woman is close to menopause. Levels of follicle stimulating hormone (FSH) increase as a woman nears menopause, but a test cannot predict exactly when menopause will occur.
What are the most common symptoms of menopause?
Each woman may experience the symptoms of menopause differently. Some women have no symptoms before or after their periods stop, while others may have some or all common symptoms.
Symptoms may include:
- Hot flashes, which are a sudden feeling of warmth, especially in the face and upper body
- Night sweats, which can disrupt sleep
- Sleep disturbances, including difficulty falling asleep or waking up in the middle of the night
- Urinary frequency, urgency or leakage
- Mood changes or irritability
- Difficulty concentrating
- Vaginal dryness or discomfort with sexual activity
- Changes in sexual desire
What are treatment options for the symptoms of menopause?
Specific treatment for menopause should be recommended by a health care provider based on a patient’s:
- Overall health and medical history
- Current symptoms
- Tolerance for specific medications or therapies
- Opinion or preference
Medical treatment options for hot flashes and night sweats, also called vasomotor symptoms, may include:
- Hormone therapy using estrogen and progestin
- Various antidepressants
- Gabapentin, an anti-seizure medication
- Clonidine, a medication for high blood pressure
A health care provider may recommend other lifestyle changes to reduce the symptoms of menopause, including:
- Identifying and avoiding the triggers that may lead to vasomotor symptoms
- Dressing in layers, so you can remove some clothing when you are having a hot flash
- Taking slow, deep breaths when a hot flash starts, also called paced respiration
- Eating a healthy diet with plenty of whole grains, fruits and vegetables to maintain a healthy weight, which reduces the frequency of vasomotor symptoms
- Getting plenty of calcium and vitamin D to maintain strong bones
- Exercising regularly to stay healthy and maintain balance
Herbal or other supplements available over the counter for the treatment of menopausal symptoms are not regulated by the Food and Drug Administration (FDA) and have not been tested in FDA-approved clinical trials for their effectiveness. It is important to consult a health care provider and discuss herbal supplements before beginning use.
Evaluation & Treatment of Pelvic Floor Disorders
Emily Von Bargen, DO, a urogynecology specialist in the Female Pelvic Medicine and Reconstructive Surgery program at Mass General discusses the risk factors for pelvic floor disorders and the issues they can bring. Dr. Von Bargen explains that pelvic floor disorders are not a normal part of aging and discusses the various treatment options. This presentation is a part of the Midlife Women's Health Center's annual community conference.
Building Better Bones
Joy N. Tsai, MD, associate director of the Bone Density Center at Mass General, discusses the importance of bone health for women as they age and reviews treatment options for women who need to build back bone density. This presentation is a part of the Midlife Women's Health Center's annual community conference.
Mindfulness at Midlife
John W. Denninger, MD, PhD, director of research at the Benson-Henry Institute for Mind Body Medicine at Mass General, discusses the importance of managing stress and presents mindfulness techniques that can be used to reduce stress. Dr. Denninger discusses how those techniques can also help reduce side effects of menopause. This presentation is a part of the Midlife Women's Health Center's annual community conference.
The Vagina Dialogues: Vulvovaginal Health after Menopause
Caroline Mitchell, MD, MPH, director of the Vulvovaginal Disorders program at Mass General, discusses vaginal and genitourinary health for women after menopause and reviews common treatments for vaginal discomfort—some of which are better supported by research than others.