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Menopause Overview

Overview

Menopause is the natural end to menstruation (monthly periods). Most American women experience this around the age of 50. Some women can experience menopause symptoms as early as 40 years old or as late as 60 years old. If menopause occurs prior to age 40, it is considered 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 (ophorectomy) 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.

Duration of Menopause

Duration of menopausal symptoms varies based on lifestyle, treatments chosen, and medical history. One longitudinal study on 438 women found the average duration between first and last experience of hot flashes was 5.2 years in only women who had never used hormone replacement therapy (HRT)

This study also found that more exercise was associated with shorter hot flash duration.

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
  • Pregnancy is still possible, but many risks associated with pregnancy increase.

Read more about pregnancy and perimenopause here.

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, including
    • osteoporosis
    • cardiovascular disease
    • vaginal dryness

References

Col, Nananda F. MD, MPH, MPP, FACP1 et al. “Duration of vasomotor symptoms in middle-aged women: a longitudinal study,” Menopause 16, no 3 (2009): 453-457. doi: 10.1097/gme.0b013e31818d414e

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