Menopause

Menopause is a normal and natural biological process that often occurs during a woman’s midlife. It is a transition—defined by the final menstrual period—that happens when the number of eggs in the ovaries declines, and the production of hormones fluctuates.   

In the United States, the average age for the final menstrual period is 51.5 years. Symptoms of menopause vary: some women experience symptoms that can begin a few years before menopause and continue for years after the last period. Other women are asymptomatic. 

Because women can have such varied experiences throughout menopause, it’s important to receive medical care from an attentive, experienced gynecologist who understands that your symptoms and treatments are unique.  

That’s where the gynecologists at Weill Cornell Medicine come into the picture. 

We are committed to understanding and improving your individual symptoms and addressing your concerns long-term. We offer you collaborative, multi-disciplinary, and compassionate care so you can enjoy life fully, and in good health, at every stage and transition.  

Stages and Symptoms of Menopause

Throughout your life, the number of eggs in the ovary gradually declines. As you near menopause, this loss of eggs reaches a point at which the production of hormones by the ovary is affected. This process can cause different symptoms at different times. 

There are three stages to natural menopause: perimenopause, menopause, and post-menopause.  

Stages of Menopause 

There are three stages to natural menopause: perimenopause, menopause and postmenopause. 

Perimenopause (before menopause): As hormone production by the ovaries becomes less regular in the years leading up to the final menstrual period, you may begin to experience various physical changes. Some women also may experience symptoms that occur because of unpredictable and variable hormone production by the ovaries that cause irregularities in periods before they stop. Menstrual symptoms such as heavy bleeding, pain or premenstrual syndrome may worsen or improve.  

Common perimenopausal symptoms may include:  

- skipped, late, and then returning periods 

- shorter menstrual cycles with bleeding episodes that are closer together 

- hot flashes 

- vaginal dryness.

Despite irregular periods pregnancy is still possible (though less likely) during perimenopause. 

Menopause: Menopause refers to the date of the final menstrual period, (defined after you have gone 12 consecutive months without a menstrual period with no other apparent cause, such as breastfeeding or illness).  

When menopause occurs, ovaries stop releasing eggs, and pregnancy is no longer possible. 

Symptoms that occur after this time tend to be associated with declining estrogen hormone from the ovary. 

Each woman’s menopause experience is unique and the symptoms can vary widely. Symptoms that might have started before menopause can continue through menopause. 

Postmenopause (after menopause): Because menopause is the cessation of menstrual periods for 12 straight months, please let your physician know if you experience bleeding.   

Menopausal symptoms may fade after menopause, but some women may experience them for years. 

After menopause, and throughout the natural course of aging, women are typically at greater risk for certain conditions: 

- heart disease,

- breast cancer,

- bone loss (osteopenia and osteoporosis) and 

- urogynecologic disorders (incontinence and pelvic floor prolapse). 

Weill Cornell Medicine offers comprehensive preventative care during and after menopause, which includes health screening tests, from colonoscopy and mammography, to bone density and cardiac screening. These screenings—and getting regular check-ups—can help reduce risk.

Premature and early menopause: Premature menopause is when menopause occurs before age 40; early menopause happens before age 45. Both premature and early menopause may cause symptoms similar to natural menopause. 

The cause of premature or early menopause is not always known. However, it can be due to genetics, illness, and medical treatments (such as radiation, chemotherapy, or surgical removal of the ovaries). 

Physicians are often able to diagnose premature and early menopause when a patient is unable to become pregnant, or is experiencing menopausal symptoms. In addition to taking a complete family history and performing a thorough physical exam, your physician will test your hormone levels (estrogen and gonadotropin) to determine if you have gone through menopause. 

Patients who experience premature or early menopause may face additional physical and emotional concerns, such as being at higher risk of osteoporosis or heart disease.  

Our gynecologists will help you navigate premature and early menopause and the impact may have on your overall wellbeing.  

Menopausal Symptoms 

Different women experience menopause differently. Fluctuations and changes in hormone levels, can cause a number of symptoms. The severity of these symptoms may vary with genetics, race, ethnicity and other factors. If you experience menopausal symptoms that negatively affect your life, you do not need to suffer or live with discomfort.  

Our doctors will help you manage your symptoms and live the vibrant life you want. 

During perimenopause and menopause, you may experience: 

- irregular, heavy, or prolonged periods 

- hot flashes 

- night sweats 

- chills 

- vaginal dryness 

- decreased sex drive (libido) 

- difficulty falling or staying asleep 

- mood or emotional changes 

- thinning hair 

- urinary incontinence 

- weight gain. 

Treatment and Care Options for Menopause Symptoms 

If your menopausal symptoms cause discomfort, your Weill Cornell physician is available to offer and explain a wide variety of treatment options. We focus on understanding and managing your specific symptoms to improve your comfort and quality of life.

Lifestyle changes: You can often improve your overall comfort by making simple lifestyle changes, which can include getting more sleep, eating a balanced diet, exercising, practicing relaxation techniques, strengthening your pelvic floor, or using over-the-counter lubricants to ease vaginal dryness. 

Personalized hormone therapy: For some patients, hormone therapy can relieve hot flashes and other symptoms, as well as prevent bone loss. Hormone treatment also can be used to treat premature or early menopause. 

Your doctor will discuss the benefits and risks of hormone therapy with you before developing a customized plan.  

Vaginal estrogen: To relieve vaginal dryness and discomfort, estrogen or DHEA therapy can be applied directly to the vagina in the form of a cream, ring, suppository, or tablet. 

Other medications: Your physician also can tell you about medications used to lessen the severity of hot flashes, bone loss and other menopausal symptoms. 

Integrative health: An increasing body of research shows that integrative health practices—when used in conjunction with your physician’s care plan—can improve menopausal symptoms and long-term health. The Weill Cornell Medicine Integrative Health and Wellbeing Program offers expertise about nutrition, herbal supplements, and plant-based hormones. The team also offers acupuncture, mind-body therapies, and relaxation techniques.   

Multidisciplinary Preventative Care for Long-Term Health

Weill Cornell’s menopause program involves a multidisciplinary team that collaborates to deliver comprehensive care during your midlife. As our patient, you will receive personalized care as you experience menopause. Your physician will connect you with other Weill Cornell Medicine specialists who can help you with any health concerns you may have, including:

- Integrative Health and Wellbeing

- Center for Female Pelvic Health

- Iris Cantor Women’s Center

- Cardiology

- Endocrinology

- Psychiatry

- Neurology

- Urogynecology

Comprehensive Care Founded on Cutting-Edge Research 

In addition to caring for our patients, the doctors at Weill Cornell are on the forefront of research efforts to better understand menopause and its symptoms. As a scientifically-based academic institution, Weill Cornell Medicine seeks to offer you the most effective treatments and therapies based on the most up-to-date research and findings. 

Meet Our Physicians

At Weill Cornell Medicine, we deliver the highest level of care at every stage of life, from adolescence to childbearing, to menopause and the post-menopausal years. Our team focuses on preventative care and patient education, empowering you to achieve your optimum level of health.