Definition:
Menopause is the transition period in a woman's life when her ovaries stop producing eggs, her body produces less estrogen and progesterone, and menstruation becomes less frequent, eventually stopping altogether.
Alternative Names:
Perimenopause; Postmenopause
Causes, incidence, and risk factors:
Menopause is a natural event that normally occurs between the ages of 45 and 55. Once menopause is complete (called postmenopause) and you have not had a period for 1 year, you are no longer at risk of becoming pregnant. The symptoms of menopause are caused by changes in estrogen and progesterone levels. The ovaries make less of these hormones over time. The specific symptoms and how significant (mild, moderate, or severe) they are varies from woman to woman. A gradual decrease of estrogen generally allows your body to slowly adjust to the hormonal changes. Hot flashes and sweats are at their worst for the first 1 - 2 years. Menopause may last 5 or more years. Estrogen levels may drop suddenly after some medical treatments, as is seen when the ovaries are removed surgically (called surgical menopause). Chemotherapy and anti-estrogen treatment for breast cancer are other examples. Symptoms can be more severe and start more suddenly in these circumstances. As a result of the fall in hormone levels, changes occur in the entire female reproductive system. The vaginal walls become less elastic and thinner. The vagina becomes shorter. Lubricating secretions from the vagina become watery. The outside genital tissue thins. This is called atrophy of the labia.
References:
Estrogen and progestogen use in postmenopausal women: July 2008 position statement of The North American Menopause Society. Menopause. July/August 2008;15(4)584-602. Mosca L, Banka CL, Benjamin EJ, Berra K, Bushnell C, Dolor RJ, et al. Evidence-based guidelines for cardiovascular disease prevention in women: 2007 update. Circulation. 2007 Mar 20;115(11):1481-501. Nelson HD. Menopause. Lancet. 2008 Mar 1;371(9614):760-70. North American Menopause Society. Estrogen and progestogen use in peri- and postmenopausal women: March 2007 position statement of The North American Menopause Society. Menopause. 2007;14:168-182. National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis. Feb. 2008. Accessed July 23, 2008. Rossouw JE, Prentice RL, Manson JE, Wu L, Barad D, Barnabei VM, et al. Postmenopausal hormone therapy and risk of cardiovascular disease by age and years since menopause. JAMA. 2007 Apr 4;297(13):1465-77. U.S. Preventive Services Task Force. Hormone therapy for the prevention of chronic conditions in postmenopausal women: recommendations from the U.S. Preventive Services Task Force. Ann Intern Med. 2005;142:855-860
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