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Menopause is the period of natural cessation of menstruation, between the ages of 45 and 55. It usually occurs about age 51 -- but it can occur when a woman is in her 30s and as late as in her 60s.

This is usually the diagnosis when a woman has not had a menstrual period for 12 consecutive months, and there is no other obvious biologic or physiologic cause. Menopause is a natural event, not a disease, but it is the end of fertility, resulting from the ovaries slowing down the production of estrogen and progesterone.

Surgical menopause is when the ovaries are removed surgically. Induced menopause is the result when the ovaries cease their function due to damage through drugs or x-rays. Premature menopause is considered to be when it occurs either naturally or is induced before age 40.

Menopause is not a point in time but is a process happening over many years. Many different types of changes occur associated with decreasing estrogen levels. These changes begin most often in a woman's 40s and sometimes in her 30s.

Other terms often used to discuss menopause includes Pre-menopause which includes all the reproductive years prior to menopause.

Peri-menopause includes the time of these early symptoms of menopause when the endocrinological, biological, and clinical features of approaching menopause commence and stretch to a few years immediately after menopause. Post-menopause covers the time following menopause.

Usually menstruation does not suddenly stop completely. Most women experience noticeable changes in their period cycle, some shorter in length, others times longer. Some women have extensive bleeding with clots while others where the flow may be lighter or heavier.

Hot flashes or flush are another uncomfortable change often experienced. This is an over warm feeling and increased pulse rate. This can often be triggered by being in a hot room, eating something like hot or spicy foods, hot drinks, alcohol, caffeine, or even stress. While each woman is different, there is usually a consistent pattern for a woman's hot flashes.

The intensity of hot flashes are varied , some easy to ignore, others are embarrassing, still others can be debilitating. They can occur as 'night sweats' where you experience drenching perspiration while sleeping. They interfere with sleep, and women who have them become tired and sometimes irritable because normal healthy sleep patterns are disrupted.

The body's normal reaction to withdrawal of the sex hormones includes mood changes, forgetfulness, difficulty concentrating, dryness of the vagina, discomfort with intercourse, and lowered sex drive. In addition there are aging changes which may or may not be related to menopause which include incontinence (involuntary leaking of urine), heart disease, and osteoporosis (thinning of bones).

There is a need to assess a woman's risk for developing the more serious problems.

Most women have minimal impact on their life due to minor symptoms but some suffer severly. Fortunately the symptoms do not usually last but diminish or disappear over time. Many find they can be reduced with certain lifestyle changes such as exercise and diet modifications. Most or all decrease or disappear with treatment.

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