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Menopause represents the end of menstruation , usually confirmed when a woman has not had a menstrual period for 12 consecutive months, in the absence of any other obvious cause. Menopause is not a disease, but a natural event - the end of fertility - resulting from the ovaries ' decreased production of the sex hormones estrogen and progesterone .

Several terms are used to describe the menopause experience and they are defined below:

  • Menopause : The end of menstruation, confirmed after 12 consecutive months without a period, or when ovaries are removed or damaged (cf. menopausal problems ).
  • Perimenopause : The six years or so immediately prior to natural menopause (not caused by any medical intervention) when changes begin - plus one year after menopause.
  • Induced menopause : Immediate menopause caused by a medical intervention that removes or damages the ovaries.
  • Premature menopause : Naturally occurring menopause before age 40.
  • Postmenopause : All the years beyond menopause.

In the Western world, a majority of women experience natural menopause between the ages of 45 and 55 - on average at about age 51. Some women reach menopause earlier (in their 40s or even their 30s) and a few, in their 60s.

Menopausal Changes

Changes, sometimes called symptoms even though menopause is not a disease, changes during perimenopause are perfectly normal and natural, but they signal a need for a medical examination. Some of the typical perimenopausal changes include:

  • Hot flashes/flushes . The most common perimenopausal disturbance, experienced by about two-thirds of all women during the perimenopause. A hot flush is a sudden warm feeling in the face and/or upper body, accompanied by blushing, increased pulse rate, and sometimes perspiration. A cold chill often follows. A few women have only the chill without the flash. The hot flush results from a change in the body's circulation. The usual underlying cause is decreasing or fluctuating estrogen levels.
  • Reduced fertility .
  • Changes in menstrual periods .
  • Urinary and genital changes . During perimenopause, some women may begin to notice changes in the vagina or the area around the vagina as well as the urinary tract. These urogenital changes can include: dryness and/or irritation of the vagina; itching and/or irritation of the vulva ; discomfort during sexual activity, urinary "urgency" or the need to urinate more frequently and leaking urine when coughing or sneezing.
  • Changes in sexual function .
  • Psychological changes . Due to the change in female hormones (cf. also depression in women ).

The bodily changes associated with menopause may also pose health risks for certain women. The major problems associated with menopause are Osteoporosis and Cardiovascular disease .

1. Cardiovascular disease . Women tend to think of heart disease as a "man's disease." In reality, while a man's risk of heart disease increases after age 45, women are also at risk - after the age of 55. Women who have heart attacks are twice as likely as men to die from them. Heart disease is the number-one killer of women in North America. In fact, after age 50, more than half of all deaths in women are due to some form of cardiovascular disease. Many more women die from heart disease than from breast cancer.
Estrogen replacement therapy (ERT) may reduce the risk of heart disease by as much as 50%,

2. Osteoporosis is a disease characterized by decreased bone density. When the bones lose density, they become porous and fragile - leading to an increased risk of fracture, particularly in the hip and spine. There are many factors that affect a woman's risk for developing osteoporosis, but one of the most significant is menopause.
Studies have demonstrated that estrogen plays a key role in maintaining bone density. After menopause, when estrogen levels decline, bone loss increases. Osteoporosis is preventable and treatable in most women. Osteoporosis is much easier to prevent than it is to treat. it is essential to get enough calcium, vitamin D, and exercise.

After menopause, several forms of estrogen replacement therapy (ERT) are effective in preventing osteoporosis and - if osteoporosis has been diagnosed - restoring some of the bone loss. Estrogen is approved by the U.S. Federal Drug Administration for both osteoporosis prevention and treatment.
If taken for many years, ERT can reduce the risk of spine, hip, and wrist fractures by 50% to 75%. ERT is especially recommended for women who have experienced premature menopause.

For further, more detailed information on this topic, please refer to the reference source for this page.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. The North American Menopause Society:

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Contact Last modified: Jun 25 2002