What to Expect During Menopause
Unless it is the result of the surgical removal of both ovaries (in which case menopause will begin immediately afterwards), menopause is a transition that has three stages. Here is a guide to these stages, when they will approximately occur, and what you can expect during each. But remember, menopause is different for every woman.
During this time of your life, your body will usually move through three gradual stages:
Perimenopause: Perimenopause is the time when estrogen production from your ovaries starts to decline and symptoms such as erratic periods, hot flashes, and vaginal dryness may begin. Most women reach this stage of the process in their late 40s.
Menopause: Menopause is identified by the passing of your final menstrual period. Of course, you will not be able to pinpoint your final period until you've been completely free from menstruation for some time. Once you've gone a full 12 months without having your period, count back to the time of your last period and that date is the date of your menopause. While the time of menopause is different from woman to woman, most begin between the ages of 45 and 55.
Postmenopause: Postmenopause is the stage of life after your final menstrual period.
Postmenopausal health issues
The change in your body's estrogen levels may have implications for your general health. For example, during menopause some women experience an increased risk of cardiovascular disease, weight gain, and bone loss.
Menopausal bone loss can lead to postmenopausal osteoporosis. Osteoporosis is a disease in which the amount of bone is decreased and the structural integrity of the bone is impaired. Under a microscope, normal bone looks like a dense sponge. Osteoporosis increases the size of the holes in the sponge-like structure, and makes the material that surrounds the holes finer, more delicate, and more easily broken.
It's important to share any information about your menopausal symptoms and general medical condition with your health care professional. Together, you can make the best treatment decisions, monitor your progress, and periodically review your treatment plan.
Important Safety Information
What is the most important information you should know about PREMARIN (estrogens), PREMPRO (a combination of estrogens and a progestin), or PREMARIN Vaginal Cream (a cream of estrogens)?
Estrogens increase the chances of getting cancer of the uterus.
Report any unusual vaginal bleeding right away while you are using these products. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb). Your health care provider should check any unusual vaginal bleeding to find out the cause.
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, strokes, or dementia.
Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens, with or without progestins, may increase your risk of dementia, based on a study of women age 65 years or older. You and your health care provider should talk regularly about whether you still need treatment with estrogens.
PREMARIN® (conjugated estrogens tablets, USP) is used after menopause to reduce moderate to severe hot flashes; to treat moderate to severe dryness, itching, and burning, in and around the vagina; and to help reduce your chances of getting osteoporosis (thin weak bones).
PREMPRO® (conjugated estrogens/medroxyprogesterone acetate tablets) is used after menopause in women with a uterus to reduce moderate to severe hot flashes; to treat moderate to severe dryness, itching, and burning, in and around the vagina; and to help reduce your chances of getting osteoporosis (thin weak bones).
PREMARIN® (conjugated estrogens) Vaginal Cream is used after menopause to treat dryness, itching, and burning, in and around the vagina.
PREMARIN and PREMPRO should be used at the lowest effective dose and for the shortest duration consistent with your treatment goals and risks. If using PREMARIN or PREMPRO only to treat your symptoms of vaginal dryness, consider topical therapies first. If you do not have symptoms, non-estrogen treatments should be carefully considered before taking PREMARIN and PREMPRO solely for the prevention of postmenopausal osteoporosis.
In a clinical trial, the most commonly reported (≥5%) side effects that occurred more frequently with PREMARIN than with placebo were vaginitis due to yeast or other causes, vaginal bleeding, painful menstruation, and leg cramps.
In a clinical trial, the most commonly reported (≥5%) side effects that occurred more frequently with PREMPRO 0.45 mg/1.5 mg and PREMPRO 0.625 mg/2.5 mg than with placebo were breast pain/enlargement, vaginitis due to yeast or other causes, leg cramps, vaginal spotting/bleeding, and painful menstruation. In a clinical trial, there was no difference in the commonly reported (≥5%) side effects for women taking PREMPRO 0.3 mg/1.5 mg compared to those taking placebo.
The most commonly reported side effects of PREMARIN Vaginal Cream include vaginal discomfort or pain, breast pain, vaginitis, and itching.
PREMARIN, PREMPRO, and PREMARIN Vaginal Cream should not be used if you have unusual vaginal bleeding, have or had cancer of the breast or uterus, had a stroke or heart attack in the past year, have or had blood clots, have liver problems, are allergic to any of the ingredients in PREMARIN, PREMPRO, or PREMARIN Vaginal Cream, or think you may be pregnant. In general, the addition of a progestin is recommended for women with a uterus to reduce the chance of getting cancer of the uterus.
