According to the onset and time relationship there are several definitions which describe various categories related to the menopause:

• Natural menopause: the permanent cessation of menstruation, which can only be determined retrospectively after no menstrual periods have occurred for 12 consecutive months. The range for the age of natural menopause is approximately from age 48 to 55.

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  Induced menopause: the cessation of menstruation due to removal of both ovaries (with or without removal of the uterus), or the inhibition of normal ovarian function by medication given by the doctor.
• Premature menopause: spontaneous menopause occurring before age 40. Also known as premature ovarian failure (POF). Possible reasons include:
  • Genetic factors which means an abnormality in her genes carrying the programmes of her inheritance.
  • Autoimmune disorders. These are diseases whereby antibodies are developed against the body’s own tissues or cells (for example Myasthenia gravis which is a chronic autoimmune neuromuscular disease)
• Early menopause: cessation of menstruation after the age of 40 but before the age of 48 years. The following are risk factors for early menopause:
  • Cigarette smoking
  • Living in places of high altitude
  • History of having a mother with early menopause
  • Late menarche (having started late with the first menstruation)

In cases of induced, premature or early menopause, there is a greater risk of health problems such as heart disease and osteoporosis, since a longer time is spent without the protective effects of oestrogens.

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