Definition of Menopause
Menopause: The time in a woman's life when
menstrual periods permanently stop; it is also called the "change of
life." Menopause is the opposite of the menarche.
Menopause is defined as the time when there has been no menstrual
periods for 12 consecutive months and no other biological or
physiological cause can be identified. It is the end of fertility,
the end of the childbearing years. (A woman may still, however, be
able to become pregnant unless 12 consecutive months have passed
without a period.)
A woman can usually tell if she is approaching menopause because
her menstrual periods starts changing. The medical terms used to
describe this time are "perimenopause" and the "menopause transition."
Natural menopause occurs when the ovaries naturally begin
decreasing their production of the sex hormones estrogen and
progesterone.
Induced menopause occurs if the ovaries are surgically removed (by
bilateral
oophorectomy) or damaged by radiation or drugs. Due to the
abrupt cutoff of ovarian hormones, induced menopause causes the
sudden onset of hot flashes and other menopause-related symptoms such
as a dry vagina and a decline in sex drive. Early
menopause (before age 40), whether natural or induced, carries a
greater risk for heart disease and osteoporosis since there are more
years spent beyond the protective cover of estrogen.
A "simple" hysterectomy (when the uterus but not the ovaries are
removed) before natural menopause should not affect the
production of sex hormones and so not cause menopause
(unless the nerves or blood supply to the ovaries is damaged during
the hysterectomy).
The timing of natural menopause is variable. In the western world
the average age is now 51. Natural menopause can, however, be in a
woman's 30s or 60s. Factors influencing the time of
menopause include heredity (genetics) and cigarette smoking. Smokers
(and
former smokers) reach menopause an average of 2 years before women
who have never smoked.
There is no relation between the time of a woman's first period
and her age at menopause. The age at menopause is not influenced by a
woman's race, height, number of children or use of oral
contraceptives.
The changes of the menopause transition (perimenopause) begin
about 6 years before the natural menopause. This is a time when the
levels of hormones produced by the aging ovaries fluctuate leading to
irregular menstrual patterns (irregularity in the length of the
period, the time between periods, and the level of flow) and hot
flashes (a sudden warm feeling with blushing). Other changes
associated with the perimenopause and menopause include night sweats,
mood swings, vaginal dryness, fluctuations in sexual desire (libido),
forgetfulness, trouble sleeping and fatigue (probably from the loss
of sleep).
Conditions that have not been proved due to the menopause
include headache, dizziness, palpitations of the heart and depression.
Estrogen replacement therapy (ERT) is used to treat menopause. It
reduces or stops the short-term changes of menopause such as hot
flashes, disturbed sleep, and vaginal dryness. ERT can prevent
osteoporosis, a consequence of lowered estrogen levels. To keep bones
strong, ERT should be taken from menopause throughout a woman's life.
Stopping ERT allows bone loss to resume.
ERT reduces the risk of heart disease up to 50%. Vaginal ERT
products help with vaginal dryness, more severe vaginal changes, and
bladder effects but, since very little vaginal estrogen enters the
circulation, it may not help with hot flashes or prevent osteoporosis
and heart disease.
The use of unopposed ERT (ERT alone) is associated with an
increase in the risk of endometrial cancer (cancer of the lining of
the uterus). However, by taking the hormone progestogen along with
estrogen, the risk of endometrial cancer is reduced substantially.
Progestogen protects the uterus by keeping the endometrium from
thickening (an effect caused by estrogen). The combination therapy of
estrogen plus progestogen is called hormone replacement therapy (HRT).
Last Editorial Review: 6/24/2000Common Misspellings: menapause
- gabapentin, Neurontin, Gabarone - Read about the medication gabapentin (Neurontin, Gabarone), a drug used for treating seizure disorders, shingles, fibromyalgia, neuropathy, hot flashes, restless leg syndrome, and hyperydrosis.
- Dilation and Curettage (D&C) - Read about dilation and Curettage (D&C), a procedure performed for a variety of reasons including determining the cause of abnormal uterine (vaginal) bleeding, tissue removal after miscarriage, or abortion.
- Night Sweats - Night sweats have many different causes. A doctors must take a complete medical history and order tests to find the cause of the underlying medical condition that is responsible for night sweats.
Latest Medical News
Back to MedTerms online medical dictionary A-Z List
Menopause RSS