Conditions InDepth: Menopause

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Menopause is the natural end to menstruation (monthly periods). Most American women experience this around the age of 50. However, some women can experience menopause as early as 40 years old or as late as 60 years old. If menopause occurs prior to age 40, this is thought to be abnormal and is called premature menopause.

Menopause is the result of the depletion of egg cells from the ovaries and the reduction of female hormones. Menopause is considered complete when you have been without your period for a full year. Rather than a single point in time, menopause is a process or transitional period when women move away from the phase of life where reproduction is possible.

Menopause is a normal part of life. It marks the end of a long, slow process that begins in the mid-30’s, when ovaries begin to produce less estrogen and progesterone. These female hormones are both important for normal menstrual cycles and successful pregnancy. Surgery to remove the ovaries ( oophorectomy ) and/or uterus ( hysterectomy ) in premenopausal women causes menopause to begin prematurely (surgical menopause).

In addition to its role in reproduction, estrogen is an important hormone for maintaining bone health, and it may also play important roles in heart health, skin elasticity, and brain function.

Stages of Menopause

Perimenopause:

  • May begin 3-5 years before your last menstrual period
  • Lasts about one to two years after your last menstrual period
  • Signs and symptoms may appear during this phase

Menopause:

  • Complete cessation of menstrual periods
  • You have had no menstrual periods for one year or undergo surgical menopause or have a blood test confirmation of menopause (FSH elevated).
  • Childbearing is no longer naturally possible

Postmenopause:

  • Begins one to two years after your last menstrual period
  • You no longer menstruate.
  • Risk of certain health problems increases (such as osteoporosis, cardiovascular disease, and vaginal dryness)

References:

  • American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/ . Accessed February 14, 2006.
  • National Institute on Aging website. Available at: http://www.nia.nih.gov/ . Accessed February 14, 2006.
  • National Women's Health Information Center website. Available at: http://www.4woman.gov/ . Accessed February 14, 2006.

Last reviewed November 2008 by Jeff Andrews, MD, FRCSC, FACOG

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