For most women, menstrual periods will slowly stop over time.

• During this time, your periods may become either more closely or more widely spaced. This pattern may last for 1 to 3 years.
• Menopause is complete when you have not had a period for 1 year. After a year has passed without a period, women are considered postmenopausal.

Your menstrual flow may come to a sudden halt after surgeries to remove your ovaries, chemotherapy, or certain hormone treatments for breast cancer.

Symptoms of menopause vary widely. Some women have no symptoms, while others have symptoms that are moderate to severe. Also, some women may have symptoms for 1 to 2 years, and others may have ongoing symptoms.

Common symptoms include:

• Hot flashes
• Mood disturbances
• Sexual problems
• Poor quality sleep, often due to hot flashes

Talk to your health care provider if your menopause symptoms are bad. You and your provider can weigh the risk and benefits of hormone replacement therapy (HRT) to see if this option would be right for you.

If your provider has prescribed HRT for menopause symptoms, take these medicines as directed. Ask your provider what you should do if you miss a dose.

When taking hormones:

• Follow up carefully with your provider.
• Ask about when you need mammograms or a test to check your bone density.
• Do not smoke. Smoking will increase the chance of blood clots in your legs or your lungs.
• Report any new vaginal bleeding or menstrual bleeding that comes more often or is more severe right away.

The following non-hormonal treatments can help you manage hot flashes:

• Dress lightly and in layers. Try to keep your environment cool.
• Practice slow, deep breathing whenever a hot flash starts to come on. Try taking six breaths per minute.
• Try relaxation techniques such as yoga, tai chi, or meditation.

Watching what you eat or drink can improve your symptoms and help you sleep:

• Eat at regular times each day. Eat a healthy diet that is low in fat and includes lots of fruits and vegetables.
• Milk and other dairy products contain tryptophan, which may help induce sleep.
• If you can, avoid coffee, colas with caffeine, and energy drinks completely. If you cannot avoid them, try not to have any after the early part of the afternoon.
• Alcohol may make your symptoms worse and often leads to more disrupted sleep.

Nicotine stimulates the body and will make it harder to fall asleep. This includes both cigarettes and smokeless tobacco. So, if you smoke, consider quitting.

A class of antidepressant medicines called SSRIs has also been shown to help with hot flashes.

Vaginal dryness may be relieved by using a water-soluble vaginal lubricant during intercourse. Do not use petroleum jelly.

• Over the counter vaginal moisturizers are also available and can help to improve vaginal dryness.
• Ask your provider about vaginal estrogen creams.

Once you have not had a period for 1 year, you are no longer able to become pregnant. Before that, use birth control to prevent pregnancy. Do not use mineral oils or other oils if you use condoms, as these may damage latex condoms or diaphragms.

Kegel exercises can help with vaginal muscle tone and help you control urine leakage.

Continuing to have sexual intimacy is possible after menopause. Ask your provider for help with menopausal symptoms that interfere with sexual intimacy.

Reach out to other people. Find someone you trust (such as a friend, family member, or neighbor) who will listen to you and offer support. Often, just talking to someone helps relieve some of the anxiety and stress of menopause.

Get plenty of exercise. It can help you feel healthier and will keep your bones strong.

You need enough calcium and vitamin D to prevent bone thinning (osteoporosis):

• You need about 1,200 mg of calcium per day from food sources or supplements. Eat high calcium foods, such as cheese, leafy green vegetables, low-fat milk and other dairy products, salmon, sardines, and tofu, or take a calcium supplement. You can make a list of calcium contained in your food to find out how much calcium you usually get from your diet. If you fall below 1,200 mg, add a supplement to make up the rest.
• You need 800 to 1,000 IU of vitamin D a day. Diet and sunlight provide some vitamin D, but most menopausal women need to take vitamin D supplements. Current research suggests that even higher doses of vitamin D may be beneficial. Adding vitamin K2 supplements may also be beneficial for your bone strength and blood vessel health. Talk to your provider about what would be best for you.
• Calcium and vitamin D supplements can be taken as separate supplements or combined as one.
• If you have a history of kidney stones, talk with your provider first.

After menopause, a woman's risk for heart disease and stroke goes up. Ask your provider about what you should do to control your blood pressure, cholesterol, and other risk factors for heart disease.

Contact your provider if you find you are unable to manage your symptoms of menopause with home care only.

Also call if you have any unusual menstrual bleeding, or if you have any spotting or bleeding at all 1 year or more after your last period.