What is menopause?
Menopause is a normal condition that all women experience as they age. The term menopause is commonly used to describe any of the changes a woman experiences either just before or after she stops menstruating, marking the end of her reproductive period.
What causes menopause?
A woman is born with a finite number of eggs, which are stored in the ovaries. The ovaries also produce the hormones estrogen and progesterone, which regulate menstruation and ovulation. Menopause occurs when the ovaries are totally depleted of eggs and no amount of stimulation from the regulating hormones can force them to work.
Menopause, when it occurs between the ages of 45 and 55, is considered "natural" and is a normal part of aging. But, some women can experience menopause early, either as a result of a surgical intervention, such as hysterectomy, or damage to the ovaries, such as from chemotherapy. Menopause that occurs before the age of 45, regardless of the cause, is called premature menopause.
How does natural menopause occur?
Natural menopause is the permanent ending of menstruation that is not brought on by any type of medical treatment. For women undergoing natural menopause, the process is gradual and is described in three stages:
- Perimenopause or "menopause transition." Perimenopause begins eight to 10 years before menopause, when the ovaries gradually produce less estrogen. Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last one to two years of perimenopause, the decrease in estrogen accelerates. At this stage, many women experience menopause symptoms (see below).
- Menopause. Menopause is the point when a woman has her last menstrual period. At this stage, the ovaries have stopped releasing eggs and producing most of their estrogen. Menopause is diagnosed when a woman has gone without a period for 12 consecutive months.
- Postmenopause. These are the years after menopause. During this stage, menopausal symptoms, such as hot flashes, ease for most women. However, health risks related to the loss of estrogen increase as the woman ages.
What conditions cause premature menopause?
Premature menopause can be the result of genetics, autoimmune disorders, or medical procedures. Here are some other conditions that may cause early menopause.
- Premature ovarian failure or POI (Premature Ovarian Insufficiency). Normally, the ovaries produce both estrogen and testosterone. Changes in the levels of these two hormones occur when the ovaries, for unknown reasons, prematurely stop producing eggs. When this happens before the age of 40, it is considered to be premature ovarian failure. Unlike premature menopause, premature ovarian failure is not always permanent.
- Induced menopause. "Induced" menopause occurs when the ovaries are surgically removed for medical reasons, such as uterine cancer or endometriosis. Induced menopause can also result from damage to the ovaries caused by radiation or chemotherapy.
What are the symptoms of menopause?
All women going through menopause will experience hot flashes, a sudden feeling of warmth that spreads over the upper body that is often accompanied by blushing and some sweating. The severity of hot flashes varies from mild in most women to severe in others.
Other common symptoms include:
- Irregular or skipped periods
- Insomnia (inability to sleep)
- Mood swings
- Fatigue
- Depression
- Irritability
- Racing heart
- Headaches
- Joint and muscle aches and pains
- Changes in libido (sex drive)
- Vaginal dryness
- Bladder control problems
- night sweats and/or cold flashes
- anxiety, feeling ill at ease
- feelings of dread, apprehension, and doom
- difficulty concentrating, disorientation, and mental confusion
- memory lapses
- itchy, crawly skin, acne and other skin eruptions
- increased tension in muscles
- breast tenderness
- weight gain
- hair loss or thinning
Not all women get all of these symptoms. However, women affected with symptoms should see a physician for evaluation.
How do I know when I am going through menopause?
When you begin to notice the signs of menopause, either you'll suspect the approach of menopause on your own, or your doctor will put two and two together when you report your symptoms. Two very simple tests can accurately determine what's going on and what stage of menopause you're in. Your follicle stimulating hormone (FSH) levels will dramatically rise as your ovaries begin to shut down; these levels are easily checked through a blood test but are not always helpful as levels are not predictive and can fluctuate widely.
In addition, your vaginal walls will thin, and the cells lining the vagina will not contain as much estrogen. Your doctor will simply take a Pap-like smear from your vaginal walls -- simple and painless -- and analyze the smear to check for vaginal "atrophy," the thinning and drying out of your vagina. It helps if you keep track of your periods and chart them as they become irregular. Your menstrual pattern will be an added clue to your doctor about whether you are pre- or perimenopausal.
What long-term health problems are associated with menopause?
The loss of estrogen associated with menopause has been linked to a number of health problems that become more common as women age.
After menopause, women are more likely to suffer from:
- Osteoporosis (brittle-bone disease)
- Heart disease
- Poor bladder and bowel function
- Poor brain function (increased risk of Alzheimer’s disease)
- Poor skin elasticity (increased wrinkling)
- Poor muscle power and tone
- Some deterioration in vision, such as from cataracts (clouding of the lens of the eye) and macular degeneration (scarring of the tiny spot in the center of the retina that is the center of vision)
There are a number of treatments to consider that can reduce the risks associated with menopause.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 1/19/2007...#10096
