vaihdevuodet

Vaihdevuodet is the climacteric period in women characterized by the decline of ovarian function, leading to the end of reproductive years. The term covers perimenopause, the transitional years before menopause, and menopause itself, defined as 12 consecutive months without a menstrual period. Postmenopause refers to the years after menopause.

Most people experience Vaihdevuodet between ages 45 and 55, with a median around 51, though onset varies by genetics, ethnicity, and health factors.

Causes are hormonal: decreasing levels of ovarian estrogen and progesterone as ovarian follicles decline. This hormonal shift affects multiple organ systems.

Common symptoms include hot flashes and night sweats, sleep disturbance, mood changes, vaginal dryness, urinary symptoms, and reduced libido. Some people gain weight or notice skin changes. Long-term effects include lower bone density and a higher risk of cardiovascular disease after menopause.

Diagnosis is usually clinical, based on menstrual history and symptoms. Blood tests are not routinely required but may be used to rule out other conditions, such as thyroid disorders.

Management focuses on symptom relief and health maintenance. Lifestyle measures such as regular exercise, weight-bearing activity, calcium and vitamin D, smoking cessation, and limited alcohol can help. Hormone therapy using estrogen, with or without progestin, is the most effective treatment for vasomotor symptoms and vaginal atrophy, but is tailored to risk factors and used at the lowest effective dose for the shortest duration. Non-hormonal options, including certain antidepressants (SSRIs/SNRIs), gabapentin, and vaginal moisturizers or local estrogen, can relieve symptoms. Fertility ends with menopause; contraception is no longer necessary after one year without menses.