Menopause

Updated 20 July 2014

What is menopause?

Menopause is defined as the time when periods stop permanently. This follows the loss of activity in the ovaries and the permanent cessation of ovulation.

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Menopause is defined as the time when periods stop permanently. This follows the loss of activity in the ovaries and the permanent cessation of ovulation.

The age at which you will reach menopause is likely to be similar to that at which your mother and grandmother did, since age of menopause is largely genetically determined. The average age at which menopause occurs is 51.3 years and this had not changed over many centuries. The range for the age of menopause is from the age of 48 to 55.

However, what has changed is life expectancy, particularly in the Western world. So, if a woman reaches the age of 54, she can expect to live for another 30 years. This means that the years after menopause may account for as much as 40% of a woman’s life.

In the last ten years before menopause there is an increased variability in the concentration of the normal hormones involved in menstruation and ovulation. This occurs even though periods can seem perfectly normal.

Some women have abrupt changes in these hormones, while others have a gradual change.

The terminology of menopause

  • Natural menopause – the permanent cessation of periods (menstruation). This definition is used after 12 months without periods.
  • Perimenopause – this is the period just before the final menstrual period, extending through the first year after this. The perimenopause starts as the reproductive hormones start to change. Another way of looking at this time is to say that it starts when the first features of approaching menopause are noticed, to at least one year after the final menstrual period.
  • Premenopause – the entire reproductive period before the final menstrual period.
  • Induced menopause – the cessation of periods due to the surgical removal of both ovaries, with or without removal of the womb. The function of the ovaries can also be stopped with medication or radiation, which will also result in induced menopause.
  • Premature menopause – natural menopause occurring before the age of 40. This is also called premature ovarian failure.
  • Postmenopause – this dates from the time of the final menstrual period and includes both natural and induced menopause.
  • Menopausal transition – the portion of the menopause which ends with the final menstrual period.

Climacteric can be a confusing word since in practice it is often used interchangeably with menopause. Strictly speaking, it refers to the period of time when a woman passes through a transition from the reproductive years to the postmenopausal years. It is marked by declining function of the ovaries.

More on the perimenopause

The perimenopause is an important time for many women. This is when you first start to notice changes in your body. Often the first sign of the approaching menopause is loss of the regular cycle of your periods. You may also start to have symptoms such as hot flushes and night sweats.

Once you reach your forties, ovulation becomes erratic. Before ovulation stops altogether, the menstrual cycle often lengthens. This can start anything from two to eight years before menopause. This is the reason that older women often find it more difficult to fall pregnant.

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