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Menopause is the time when a woman's menstrual periods stop and her ovaries stop releasing eggs. A woman is considered menopausal once she has gone a year without having a menstrual period. Therefore, the exact time of a woman's final menstrual period can only be pinpointed by counting backwards after the fact.
Although most women go through menopause around age 50, normal menopause can happen any time between the age of 40 and 60. The last periods are usually more irregular and have less blood flow. However, some women's periods don't change at all.
Along with normal or natural menopause, there is also premature menopause. Premature menopause occurs before the age of 40 and can be caused by a variety of things, such as removal of the ovaries, autoimmune disorders, endocrinological reasons, or cancer therapy. Medical interventions, such as a hysterectomy (when the uterus is removed), may also prevent menstruation. If the ovaries are removed as well, production of the hormones estrogen and progesterone are stopped, causing the symptoms of menopause.
Menopause is a normal part of the aging process. Follicle stimulating hormone (FSH) and luteinizing hormone (LH) are secreted by the pituitary gland as part of the normal menstrual cycle. They stimulate the ovary to produce estrogen and progesterone and to release an egg. As a woman ages, her ovaries don't respond to FSH or LH as strongly as they used to. Over time, less and less estrogen and progesterone are produced and the woman stops releasing eggs.
Premature menopause can be genetic or it can be caused by autoimmune diseases. These diseases produce antibodies that can damage the ovaries. Surgical removal of the ovaries causes artificial menopause, as can chemotherapy or radiation therapy to the pelvis to treat cancer.
Before her periods stop completely, a woman might experience a variety of unpleasant symptoms, including hot flashes, irritability, night sweats, loss of bladder control, urinary infection, vaginal dryness, and pain during intercourse. These symptoms may also continue after menopause.
About 75% of women have hot flashes. During a hot flash, the woman's head and neck will become red and warm, and she may perspire a lot. A hot flash lasts from 30 seconds to 5 minutes and may be followed by a chill. Hot flashes can start up to 2 years before menopause, are at their worst for the 2 years after menopause, and gradually decrease over 6 years. About 60% of women experience hot flashes for less than 7 years and up to 15% experience them for 15 years or more.
Fluctuating hormone levels may cause a woman to feel irritable, tired, and nervous. She might also have trouble sleeping, have headaches, feel dizzy, or have a rapid or irregular heartbeat. Lack of estrogen makes the skin of the vagina thinner, causing vaginal dryness, itching, or burning. It can also cause pain during intercourse. Some women may experience poor bladder control and, occasionally, aching muscles and joints.
Postmenopausal women are more likely to have osteoporosis, which is a thinning of the bones. Women with osteoporosis can break their hips and backbones easily. Older women may not even have to fall in order to break a bone. A woman loses 3% to 5% of her bone mass every year during the first 5 years after menopause. After 5 years, she loses from 1% to 2% of bone mass yearly. Smoking, heavy drinking, lack of exercise, and not getting enough calcium in the diet can increase a woman's risk of bone loss.