What is Menopause?

The word “menopause” comes from the Latin words mensis (month) and pausa (end) and refers to the end of the monthly menstrual period.  Menopause is the shutting down of your baby-making capability.  It’s part of a process called the climacteric, which involves the fluctuation and gradual decline of the production of female hormones, starting when you’re in your late 20’s or early 30’s.  The process continues over a period of 35 years or longer, until your hormones finally settle down to low but steady levels in your late 50’s or early 60’s.

The menopause hormonal decline is so subtle that at first you probably won’t notice anything. As menopause continues somewhere along the way, usually between the ages of 35 and 45, your hormone levels and your menstrual cycles will start to fluctuate. Periods will become irregular and will sometimes be lighter or heavier than usual.  Sleep may be elusive you and weight gain may occur.  Fatigue, low sexual drive, and water retention may also occur.  It feels like a bad case of premenstrual syndrome (PMS), but it’s actually perimenopause, a period of wildly fluctuating hormone levels that begins about 2 years before your final menstrual period and continues for approximately two more years. The cause of these miserable symptoms: chemical imbalances due to declining estrogen and progesterone. 

Perimenopause overlaps with menopause, the point in time when the ovaries stop releasing eggs and menstruation ends for good. So, technically, you can be perimenopausal  and post-menopausal at the same time.  Premenopause is the period when you’re on the verge of menopause but you haven’t experienced any typical menopausal symptoms, like hot flashes or vaginal dryness. Your periods may be starting to become irregular, but that’s about it.

Contrary to what most people think, menopause is not a process but a single event.

It officially occurs the day after your final period ends, but you won’t know for sure that it’s happened until another 12 months have passed.  At that point, you can backtrack a year to the end of your last period and you’ll know when this important event took place.  The average North American woman enters menopause at about age 50, but menopause may occur as early as age 40 or as late as age 55.

In general, about 85% of women will have entered menopause by age 52.  While race, socioeconomic status, marital status, and geographical location don’t seem to influence the age that it begins, menopause can be brought on prematurely by genetic predisposition, smoking, and autoimmune disorders that damage the ovaries.  Surgery to remove the ovaries or cut back on their blood supply, radiation to the pelvis, or chemotherapy can induce artificial menopause, and this will cause the same symptoms as natural menopause.  A hysterectomy (surgical removal of the uterus) will cause menstrual periods to stop, but it won’t induce menopause because the ovaries will continue to function.

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