Menopause signals the the end of a woman's fertility, and is a natural phase in the cycle of her life. But for many, it is still a period fraught with anxiety, as well as a number of very real and problematic physical symptoms.

Menopause “officially” begins 12 months after your last period ends. The average age for this to occur in the U.S. is 51, but it can happen anytime in your 40s or 50s.

About 1 percent of women experience premature menopause– that is, menopause before age 40. Menopause may result from primary ovarian insufficiency — when your ovaries fail to produce normal levels of reproductive hormones — stemming from genetic factors or autoimmune disease. For these women, hormone therapy is typically recommended at least until the natural age of menopause in order to protect the brain, heart and bones.

The period leading up to menopause is known as perimenopause, during which time you may experience the following symptoms:

·         Vaginal dryness

·         Hot flashes

·         Night sweats

·         Sleep problems

·         Mood changes

·         Weight gain and slowed metabolism

·         Thinning hair and dry skin

·         Loss of breast fullness

Of course, skipping periods during perimenopause is to be expected, by definition. In the last couple of years leading up to menopause, expect to menstruate only every two to four months. But note: during these irregular periods, you may still become pregnant.

You should also view perimenopause as a signal to begin seeing your doctor regularly, especially if you had not been already. A number of screenings are recommended at this time of your life, including mammography, thyroid testing, a colonoscopy, and a pelvic exam.

Menopause normally requires no medical treatment, per se, but your doctor may offer treatments to relieve your symptoms and manage the chronic conditions which coincide with aging. These treatments can include:

Estrogen therapy is the most effective option for relieving menopausal hot flashes. Depending on your personal and family medical history, your doctor may recommend estrogen in the lowest dose needed to provide symptom relief for you. Estrogen also helps prevent bone loss.

Estrogen is sometimes administered directly to the vagina using a vaginal cream, tablet or ring, to relieve dryness. discomfort with intercourse and some urinary symptoms.

Certain antidepressants may be prescribed to decrease menopausal hot flashes. A low-dose antidepressant for management of hot flashes may be useful for women who can't take estrogen for health reasons or for women who need an antidepressant for a mood disorder.

Gabapentin is primarily a seizure medication, but it has also been shown to help reduce hot flashes. This drug is useful in women who can't use estrogen therapy and in those who also have migraines.

Doctors may also recommend medication to prevent or treat osteoporosis. Several medications are available that help reduce bone loss and risk of fractures.