Menopause is the permanent shutting down of the female reproductive system, a considerable length of time before the end of the lifespan. Menopause occurs in a variety of animals, including humans. It is usually a natural process. The word consists of two Greek words meno (month) and pausis (a halt).

In adult human females who still have a uterus, and who are not pregnant or lactating, post menopause is identified by a permanent (at least one year’s) absence of monthly periods or menstruation.

In human females, menopause usually happens more or less in midlife, signaling the end of the fertile phase of a woman’s life. Menopause is perhaps most easily understood as the opposite process to menarche, the start of the monthly periods. However, menopause in women cannot satisfactorily be defined simply as the permanent “stopping of the monthly periods”, because in reality what is happening to the uterus is quite secondary to the process; it is what is happening to the ovaries that is the crucial factor.

For medical reasons, the uterus must sometimes be surgically removed (hysterectomy) in a younger woman; her periods will cease permanently, and the woman will technically be infertile, but as long as at least one of her ovaries is still functioning, the woman will not have reached menopause, because even without the uterus, ovulation and the release of the sequence of reproductive hormones will continue to cycle on until menopause is reached. But in circumstances where a woman’s ovaries are removed (oophorectomy), even if the uterus were to be left intact, the woman will immediately be in “surgical menopause”.

The menopause transition, and post-menopause itself, is a natural life change, not a disease state or a disorder. The transition itself can be challenging for a number of women, but for others it is not difficult.

Age of Women for Menopause

The average age of menopause is 45 and 55 years. In some cased the last period occur which is between the ages of 55 to 60 is called as “late menopause”. There may be an early menopause which is in the age of 40 to 45. Rarely the ovaries stop working at a very early age, anywhere from the age of puberty to age 40, and this is known as premature ovarian failure (POF), also commonly referred to as “premature menopause”. Premature menopause is diagnosed or confirmed by measuring the levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH); the levels of these hormones will be abnormally high if menopause has occurred.

Social and psychological significance

The stoppage of the female reproductive system in a particular age of life leads to the third part of a woman’s life, which is known as the “third age”. The menopause change is a major life change, similar to menarche in the magnitude of its social and psychological significance.

The causes of menopause

The causes of menopause can be considered from complementary proximate (mechanistic) and ultimate (adaptive evolutionary) perspectives.

Proximate perspective

It is a natural or physiological menopause which occurs as a part of a woman’s normal aging process. This is the result of the eventual atresia of almost all oocytes in the ovaries. This causes an increase in circulating follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels as there are a decreased number of oocytes responding to these hormones and producing estrogen. This decrease in the production of estrogen leads to the perimenopausal symptoms of hot flashes, insomnia and mood changes, as well as post-menopausal osteoporosis and vaginal atrophy.

Menopause can be surgically induced by bilateral salpingo-oophorectomy (removal of both ovaries and both fallopian tubes). It is conjunction with hysterectomy. Cessation of menses as a result of removal of the ovaries is called “surgical menopause”. The sudden and complete drop in reproductive hormone levels usually produces extreme hormone-withdrawal symptoms such as hot flashes, etc.

As mentioned above, removal of the uterus, hysterectomy, does not itself cause menopause, although pelvic surgery can often precipitate a somewhat earlier menopause, perhaps because of a compromised blood supply to the ovaries. Removing the ovaries however, causes an immediate and powerful “surgical menopause”, even if the uterus is left intact.

Cigarette smoking caused the decreasing the age at menopause by as much as one year, and women who have undergone hysterectomy with ovary conservation go through menopause 3.7 years earlier than average. However, premature menopause (before the age of 40) is generally idiopathic.

Ultimate perspective

Possible effects of per menopause, the menopause transition time as the body responds to the rapidly changing levels of natural hormones, a number of effects can appear. It is however worth pointing out, that not every woman experiences bothersome levels of these effects, and even in those women who do experience strong effects, the range of effects and the degree to which they appear is very variable from person to person.

• It may be due to low estrogen levels (for example vaginal atrophy and skin drying) remain present even after the menopause transition years are over
• Many of the effects that are caused by the extreme fluctuations in hormone levels (for example hot flashes and mood changes) usually disappear or improve significantly once the perimenopause transition time has been completed.

Menopause Effect

• Lack of energy as the most frequent and distressing effect
• Other effects can include vasomotor symptoms such as hot flashes and palpitations
• Psychological effects such as depression, anxiety, irritability, mood swings, memory problems
• Lack of concentration
• Atrophic effects such as vaginal dryness and urgency of urination
• Sleep disturbances, poor quality sleep, light sleep, insomnia

Treatment

Perimenopause type is a natural stage of life, its not disease or a disorder and it needs no medical treatment. In this case those cases where the physical, mental, and emotional effects of perimenopause are severe, and disrupt the everyday life of the woman, then medical treatment may sometimes be appropriate and helpful.

Hormone therapy is a process to reduce the time or increase the hormones. There are several types of hormone therapies, with various side effects. Hormone replacement therapy or HRT, known in Britain as Hormone Therapy or HT, and the SSRIs appear to provide the most reliable pharmaceutical relief.

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I am Asif Kamboh from Pakistan, having interest to write on different topics.

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