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About Menopause

About Menopause

Menopause is the permanent end of having a period (menstruation).1

Menopause is reached when it has been a year (12 months) since the last menstrual period.1,2

Transition to menopause usually takes about 7 years but can last up to 14 years.2

Changes typically begin between 45 and 55 years of age.1,2

The average age for menopause in the US is 52 years.1

Induced menopause, when the ovaries are removed or damaged, can happen earlier.3

Symptoms of menopause are caused by changes in hormone levels.1

Symptoms include hot flashes and vaginal changes.1,4

These symptoms can be treated. Ask your healthcare provider.

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Click a topic below to learn more.

Menopause is a part of life. It is a result of natural changes to the ovaries. The ovaries are part of the reproductive system. The ovaries release eggs each month as part of the menstrual cycle.3

The ovaries also produce hormones, including estrogen. These are called ovarian hormones. Over time, ovary function slows down. The body’s ovarian hormone levels decline.2,3

Changes in hormone levels lead to symptoms such as hot flashes, irregular periods, and vaginal irritation. Symptoms typically begin when a woman is in her mid-40s to mid-50s. The transition to menopause may take several years.1,2

To learn more, talk with your healthcare provider.

Induced menopause can happen as a result of3

  • removal of the ovaries by surgery
  • damage to the ovaries by radiation or chemotherapy

The ovaries produce hormones, including estrogen. Removing or damaging the ovaries causes a sudden drop in the body’s hormone levels. This can cause symptoms of menopause.2,3

Natural menopause happens gradually, but induced menopause can cause symptoms right away.2

A hysterectomy is removal of the womb (uterus) by surgery.3

  • Does end periods (menstruation) and the ability to become pregnant.
  • Does not cause menopause unless both ovaries are also removed.

To learn more, talk with your healthcare provider.

As many as 4 in 5 women have hot flashes during the transition to menopause.5

Hot flashes are a feeling of heat in the upper body and face.1,5-7

  • Heat may be sudden and severe
  • May cause sweating and red, blotchy skin
  • Can last from 30 seconds to 10 minutes
  • Sometimes followed by chills and shivering

Night sweats, or hot flashes at night, can cause sleep problems.5

Hot flashes are caused by the drop in estrogen levels during menopause.7

They are most common in the years just before and after having the last period. They can start much earlier, though, and may continue for years later.5

To learn more, talk with your healthcare provider.

Changes in and around the vagina are common after menopause. About half of all women have symptoms of vaginal changes after menopause. Like hot flashes, they are caused by the drop in estrogen levels.7,8

Menopausal changes in and around the vagina may include4,8

  • Dryness
  • Itching
  • Irritation
  • Pain or bleeding with sex

Vaginal changes after menopause usually do not improve on their own. Symptoms can have an impact on emotions, relationships, and self-image.8,9

However, few women (7 out of 100) with vaginal symptoms of menopause said that their healthcare provider started a conversation about these symptoms.9

8 in 10 women with vaginal discomfort said it negatively affected their lives.9*

*Among US women in a survey about vaginal discomfort after menopause.9

Don't hold back. If you are experiencing vaginal symptoms of menopause, talk with your healthcare provider. Treatment can help.

Menopause is a natural part of life, but its symptoms can be disruptive.9,10 If you find that moderate to severe symptoms of menopause are holding you back, talk with your doctor. There are many treatment options.

Common symptoms, such as hot flashes and vaginal dryness, can be managed effectively with estrogen therapy. EstroGel 0.06% (estradiol gel) is an estrogen therapy gel approved by the FDA to be used after menopause to11

  • Reduce moderate to severe hot flashes
  • Treat moderate to severe menopausal changes in and around the vagina
  • If you use EstroGel only to treat menopausal changes in and around your vagina, talk with your healthcare provider about whether a topical vaginal product would be better for you.11

Symptoms of menopause can be managed. To learn more, talk with your healthcare provider.

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References: 1. The Office on Women’s Health. Top Questions About Menopause. Washington, DC; US Department of Health and Human Services; August 2017. 2. National Institute on Aging. What is menopause? https://www.nia.nih.gov/health/what-menopause. Reviewed June 27, 2017. Accessed January 8, 2020. 3. The North American Menopause Society. Menopause glossary. www.menopause.org/for-women/menopause-glossary. Accessed January 22, 2020. 4. Food and Drug Administration. Estrogen and estrogen/progestin drug products to treat vasomotor symptoms and vulvar and vaginal atrophy symptoms—recommendations for clinical evaluation. Draft guidance. Washington, DC; US Department of Health and Human Services; January 2003. 5. Thurston RC, Joffe H. Vasomotor symptoms and menopause: findings from the Study of Women’s Health Across the Nation. Obstet Gynecol Clin North Am. 2011;38(3):489-501. 6. NIH State-of-the-Science Panel. National Institutes of Health state-of-the-science conference statement: management of menopause related symptoms. Ann Intern Med. 2005;142(12):1003-1013. 7. The American Congress of Obstetricians and Gynecologists. 2011 Women’s Health Stats & Facts. Washington, DC; 2011. 8. Nappi RE, Palacios S, Bruyniks N, Particco M, Panay N; EVES Study investigators. The burden of vulvovaginal atrophy on women’s daily living: implications on quality of life from a face-to-face real-life survey. Menopause. 2019;26(5):485-491. 9. The North American Menopause Society. Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society. Menopause. 2013;20(9):888-902. 10. Avis NE, Crawford SL, Greendale G, et al; for the Study of Women’s Health Across the Nation (SWAN). Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015;175(4):531-539. 11. EstroGel [package insert]. Morristown, NJ: ASCEND Therapeutics; 2023.

Indication & Important Risk Information

Please see Patient Information and Boxed Warning for more details at www.estrogel.com.

EstroGel® 0.06% is approved by the FDA for use after menopause to reduce moderate to severe hot flashes and to treat moderate to severe menopausal changes in and around the vagina. If you use EstroGel only to treat your menopausal changes in and around your vagina, talk with your healthcare provider about whether a topical vaginal product would be better for you.

WHAT IS THE MOST IMPORTANT RISK INFORMATION I SHOULD KNOW ABOUT EstroGel® (AN ESTROGEN HORMONE)?

  • Using estrogen-alone may increase your chance of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are using EstroGel. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb). Your healthcare provider should check any unusual vaginal bleeding to find out the cause.
  • Do not use estrogen-alone to prevent heart disease, heart attacks, strokes or dementia (decline in brain function).
  • Using estrogen-alone may increase your chances of getting strokes and blood clots.
  • Using estrogen-alone may increase your chance of getting dementia, based on a study of women 65 years of age and older.
  • Do not use estrogens with progestogens to prevent heart disease, heart attack, strokes or dementia.
  • Using estrogens with progestogens may increase your chances of getting heart attacks, strokes, breast cancer, or blood clots.
  • Using estrogens with progestogens may increase your chance of getting dementia, based on a study of women 65 years of age and older.
  • Only one estrogen-alone product and dose have been shown to increase your chances of getting strokes, blood clots, and dementia. Only one estrogen with progestogen product and dose have been shown to increase your chances of getting heart attacks, strokes, breast cancer, blood clots, and dementia. Because other products and doses have not been studied in the same way, it is not known how the use of EstroGel will affect your chances of these conditions. You and your healthcare provider should talk regularly about whether you still need treatment with EstroGel.

Do not start using EstroGel if you have unusual vaginal bleeding, have been diagnosed with a bleeding disorder, currently have or have had certain cancers, had a stroke or heart attack, currently have or have had blood clots, currently have or have had liver problems, or are allergic to EstroGel or any of its ingredients.

Before using EstroGel, tell your healthcare provider about all of your medical conditions, including if you have any unusual vaginal bleeding, have any other medical conditions that may become worse while you are using EstroGel, are going to have surgery or will be on bed rest, are pregnant or think you may be pregnant, are breastfeeding, and about all the medicines you take.

In general, the addition of a progestogen is recommended for women with a uterus to reduce the chance of getting cancer of the uterus (womb). See your healthcare provider right away if you get vaginal bleeding while using EstroGel

Serious but less common side effects include heart attack, stroke, blood clots, breast cancer, cancer of the lining of the uterus (womb), cancer of the ovary, dementia, high or low blood calcium, gallbladder disease, visual abnormalities, high blood pressure, high levels of fat (triglycerides) in your blood, liver problems, changes in your thyroid hormone levels, fluid retention, cancer changes of endometriosis, enlargement of benign tumors of the uterus (“fibroids”), worsening of swelling of face and tongue (angioedema) in women with a history of angioedema, and changes in laboratory test results such as bleeding time and high blood sugar.

Call your healthcare provider right away if you get any of the following symptoms: new breast lumps; unusual vaginal bleeding; changes in vision or speech; sudden new severe headaches; severe pains in your chest or legs with or without shortness of breath, weakness and fatigue; swelling of face, lips, and tongue with or without red itchy bumps.

Common side effects of EstroGel include headache, breast tenderness or pain, stomach or abdominal cramps, bloating, nausea and vomiting, hair loss, fluid retention, and vaginal yeast infection.

If you would like more information, talk with your healthcare provider. You may report side effects to ASCEND Therapeutics® US, LLC at 1-877-204-1013.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit , or call 1-800-FDA-1088.

Please see full Patient Information, including Boxed Warnings.

Indication & Important Risk Information

Please see Patient Information and Boxed Warning for more details at www.estrogel.com.

EstroGel® 0.06% is approved by the FDA for use after menopause to reduce moderate to severe hot flashes and to treat moderate to severe menopausal changes in and around the vagina. If you use EstroGel only to treat your menopausal changes in and around your vagina, talk with your healthcare provider about whether a topical vaginal product would be better for you.

WHAT IS THE MOST IMPORTANT RISK INFORMATION I SHOULD KNOW ABOUT EstroGel® (AN ESTROGEN HORMONE)?

  • Using estrogen-alone may increase your chance of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are using EstroGel. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb). Your healthcare provider should check any unusual vaginal bleeding to find out the cause.
  • Do not use estrogen-alone to prevent heart disease, heart attacks, strokes or dementia (decline in brain function).
  • Using estrogen-alone may increase your chances of getting strokes and blood clots.
  • Using estrogen-alone may increase your chance of getting dementia, based on a study of women 65 years of age and older.
  • Do not use estrogens with progestogens to prevent heart disease, heart attack, strokes or dementia.
  • Using estrogens with progestogens may increase your chances of getting heart attacks, strokes, breast cancer, or blood clots.
  • Using estrogens with progestogens may increase your chance of getting dementia, based on a study of women 65 years of age and older.
  • Only one estrogen-alone product and dose have been shown to increase your chances of getting strokes, blood clots, and dementia. Only one estrogen with progestogen product and dose have been shown to increase your chances of getting heart attacks, strokes, breast cancer, blood clots, and dementia. Because other products and doses have not been studied in the same way, it is not known how the use of EstroGel will affect your chances of these conditions. You and your healthcare provider should talk regularly about whether you still need treatment with EstroGel.

Do not start using EstroGel if you have unusual vaginal bleeding, have been diagnosed with a bleeding disorder, currently have or have had certain cancers, had a stroke or heart attack, currently have or have had blood clots, currently have or have had liver problems, or are allergic to EstroGel or any of its ingredients.

Before using EstroGel, tell your healthcare provider about all of your medical conditions, including if you have any unusual vaginal bleeding, have any other medical conditions that may become worse while you are using EstroGel, are going to have surgery or will be on bed rest, are pregnant or think you may be pregnant, are breastfeeding, and about all the medicines you take.

In general, the addition of a progestogen is recommended for women with a uterus to reduce the chance of getting cancer of the uterus (womb). See your healthcare provider right away if you get vaginal bleeding while using EstroGel

Serious but less common side effects include heart attack, stroke, blood clots, breast cancer, cancer of the lining of the uterus (womb), cancer of the ovary, dementia, high or low blood calcium, gallbladder disease, visual abnormalities, high blood pressure, high levels of fat (triglycerides) in your blood, liver problems, changes in your thyroid hormone levels, fluid retention, cancer changes of endometriosis, enlargement of benign tumors of the uterus (“fibroids”), worsening of swelling of face and tongue (angioedema) in women with a history of angioedema, and changes in laboratory test results such as bleeding time and high blood sugar.

Call your healthcare provider right away if you get any of the following symptoms: new breast lumps; unusual vaginal bleeding; changes in vision or speech; sudden new severe headaches; severe pains in your chest or legs with or without shortness of breath, weakness and fatigue; swelling of face, lips, and tongue with or without red itchy bumps.

Common side effects of EstroGel include headache, breast tenderness or pain, stomach or abdominal cramps, bloating, nausea and vomiting, hair loss, fluid retention, and vaginal yeast infection.

If you would like more information, talk with your healthcare provider. You may report side effects to ASCEND Therapeutics® US, LLC at 1-877-204-1013.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit , or call 1-800-FDA-1088.

Please see full Patient Information, including Boxed Warnings.