Your Guide to Menopause

Menopause is the end of a woman's menstrual cycle and fertility and is a normal condition that all women experience as they age. It occurs when the ovaries no longer produce estrogen and progesterone, two necessary hormones for a woman's reproductive cycle to function.

Though it naturally occurs with age, menopause may also come on suddenly as a result of a surgical procedure, treatment of a disease, or illness. In these cases it is referred to as induced menopause.

When Do Women Usually Enter Menopause?

When menopause occurs naturally, it tends to take place anywhere between the ages of 40 and 58, with an average age of 51. But for some women it can occur as early as the late 30s, or as late as your 60s. When menopause occurs before 35, it is considered premature menopause, but just as menarche is genetically predetermined, so is menopause.

What Are the Symptoms of Menopause?

For many women who enter menopause, their menstrual cycle becomes irregular and then stops, and they don't have any other symptoms. But, for others, the decreasing levels of estrogen associated with menopause may cause more distressing symptoms that include:

• Mood swings
• Decreased sex drive
• Hot flashes
• Sweating
• Racing heart (palpitations)
• Headaches
• Vaginal dryness and soreness
• Trouble sleeping
• Bone thinning (osteoporosis)

These symptoms can last from a few months to up to 10 years.

What Are the Stages of Menopause?

Menopause is a gradual process. The events preceding and following menopause amount to a huge change for women both physically and socially. Physically, this process has four stages:

• Premenopause. Some experts feel that this term should include the entire reproductive period up to the final menstrual cycle whereas others consider it to refer to women on the cusp of menopause. Their periods have just started to get irregular, but they do not yet experience any classic menopausal symptoms such as hot flashes or vaginal dryness. A woman in premenopause is usually in her mid-to-late 40s. If your doctor tells you that you're premenopausal, you might want to ask him or her how he or she is using this term.
• Perimenopause. This term refers to women who are in the thick of menopause. Their cycles may be erratic, and they may begin to experience hot flashes and vaginal dryness. On average, women are about 47 when they hit the perimenopause stage.
• Menopause. This refers to your final menstrual period. You will not be able to pinpoint your final period until you've been completely free from periods for one year. Then, you count back to the last period you charted, and that date is the date of your menopause. Note: After more than one year of no menstrual periods due to menopause, any vaginal bleeding is now considered abnormal.
• Postmenopausal. This term refers to the last third of most women's lives, ranging from women who have been free of menstrual periods for at least one year to women celebrating their 100th birthday and beyond. In other words, once you're past menopause, you'll be referred to as postmenopausal for the rest of your life.