What is Menopause?
Menopause is a natural biological process that signals the end of a woman’s reproductive years. Women who’ve reached menopause no longer have periods and are not able to have any children. While some people refer to menopause as the “change”, menopause is not just a single event. Menopause includes the transitory phase where women experience many signs and symptoms well before their periods have stopped permanently.
In decades past, many women did not live beyond menopause. However, in today’s world, most women will live nearly a third of their lives or more after menopause. While there are many physical and emotional changes involved, menopause is not the end of your life. Women today have happy and productive lives after menopause.
Full menopause that occurs after the age of 40 and is not the result of a medical treatment is considered a natural part of aging. Every women is born with a finite number of eggs in their ovaries. As a women reaches the end of her reproductive years, her ovaries being making less and less of the hormones estrogen and progesterone, until finally, the ovaries stop producing eggs and menstruation no longer occurs.
Two factors that influence the timing of this natural change are smoking and genetics. On average, smokers reach menopause 2 years earlier than nonsmokers. In terms of genetics, it has been shown that most women experience menopause at about the same age as their mothers and sisters. There is also some evidence that women who have not given birth to children also reach menopause slightly earlier.
Estrogen and Progesterone are hormones that are responsible for regulating a women’s ovulation and menstruation cycles. As the supply of progesterone diminishes, the chance of pregnancy diminishes until finally, menstruation stops all together and pregnancy is longer possible.
For women who are experiencing natural menopause, the process is gradual and progresses through stages:
- Premenopause is the “normal” period of time in a women’s reproductive life where menstruation, ovulation, and hormone production is normal.
- Perimenopause literally means “around menopause” and is the period of time when women begin to exhibit symptoms of menopause. The stage typically starts in the late thirties and can last up to 15 years. On average, perimenopause lasts about 6 years and ends 1 year after the final menstrual period. Menstruation has not yet completely stopped, but the erratic fluctuation of ovarian hormones causes typical menopause signs and symptoms such as hot flashes, irregular menstrual periods, mood swings, vaginal dryness, and sleep disturbances.
- Menopause is the last stage in a women’s reproductive life. Her ovaries stop producing eggs, and estrogen & progesterone production is permanently decreased to low levels. Women are no longer able to get pregnant naturally at this stage. This stage is confirmed after 12 consecutive months without a period.
- Postmenopause is the period of time in a women’s life after full menopause has occurred. Due to diminished estrogen levels, postmenopausal women are at increased risk of developing diseases as such osteoporosis.
Premature Menopause (Early Menopause)
Full onset menopause before the age of 40 is considered to be premature menopause. Premature menopause can be caused by a number of factors:
- Genetics – Women who have a family history of early menopause are more likely to experience premature menopause themselves. Additionally, chromosome defects such as Turner’s syndrome can cause premature menopause.
- Autoimmune diseases – Diseases such as thyroid disease, rheumatoid arthritis, and lupus often experience premature menopause. While the exact details varies from disease to disease, the basic pattern is that the body mistakenly attacks part of its own reproductive system and causes damage to the ovaries.
- Induced Menopause – Treatment of diseases such as uterine cancer or endometriosis often lead to surgical removal of both ovaries (bilateral oophorectomy), which induces immediately menopause. Additionally, cancer treatments such as chemotherapy and pelvic radiation can cause ovarian damage and trigger premature menopause. The exact probability of premature menopause due to cancer treatment is dependent on the specific type of treatment used, as well as the age of the women. Hysterectomy (removal of the uterus) in general does not induce menopause immediately if the ovaries are left in place, but evidence suggests that menopause tends to occur on average 2 years earlier.
- Premature Ovarian Failure – The ovaries for some unknown reason have prematurely stopped producing eggs and the estrogen and progesterone levels have dropped off. Approximately 1% of women experience premature and the exact cause is often not known.