Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Women frequently ask what symptoms they can anticipate
during menopause. In reality, each woman experiences menopause
While one woman is certain that insomnia is a symptom of menopause for her,
another is certain that joint aches are her primary symptom of menopause.
Doctors are not even able to tell women what to expect because research into the
symptoms of menopause has not yet established just how menopause causes many of
its symptoms. For example, medical science cannot explain how the declining
hormone levels of menopause
could cause joint aches.
Menopause is not a disease but a natural transition, yet
many of the symptoms of menopause also may be caused by diseases. We are not
always certain which symptoms are due to menopause, and women differ in their
symptoms. How, then, do we decide when women undergoing menopause need treatment
in the first place? The same pattern of hot flashes in two different women can
have a very different psychological impact. For one woman, they can disturb her
daily functioning greatly, but for another, they may hardly be bothersome.
What are hot flashes?
Hot flashes are experienced by many women, but not all women
undergoing menopause experience hot flashes. A hot flash is a feeling of warmth that spreads over the
body, but is often most strongly felt in the head and neck regions. Hot flashes may be accompanied by
perspiration or flushing. Hot flashes usually last from 30 seconds to several
minutes. Although the exact cause of hot flashes is not fully understood, hot
flashes are thought to be due to a combination of hormonal and biochemical
fluctuations brought on by declining estrogen levels.
Hot flashes occur in up to 40% of regularly menstruating women in their
forties, so they often begin before the
menstrual irregularities characteristic
of menopause even begin. About 80% of women will be finished having hot flashes
after five years. Sometimes (in about 10% of women), hot flashes can last as long
as 10 years.
Sometimes hot flashes are accompanied by night sweats (episodes
of drenching sweats at nighttime). This may lead to awakening and difficulty
falling asleep again, resulting in unrefreshing sleep and daytime tiredness.
Medical Author: Melissa Stoppler, M.D.
Dennis Lee, MD
Some of the symptoms of menopause can actually begin years before
menstrual periods stop
occurring. Doctors generally use the term "perimenopause" to refer
to the time period beginning prior to the menopause (when some of the signs and
symptoms of menopause begin to occur) up through the first year following
menopause. Menopause itself is defined as having had 12 consecutive months
without a menstrual period.
Menopause symptoms begin gradually while the ovaries are still functioning
and a woman is still having menstrual periods. These symptoms can begin as early
as the 4th decade of life (when a woman is in her 30s) and may persist for years
until menopause has occurred. The symptoms occur early because the levels of
hormones produced by the ovaries (estrogen and progesterone) decline slowly over
time as a
woman reaches her forties. The severity and duration of symptoms vary widely
among individuals - some women may experience only minimal symptoms for a year
or two, while others may experience at least some of the symptoms for several