The word “menopause” derives from the Greek language and it literally means “cessation of monthly cycles (meno meaning month and pausis meaning a halt). Menopause is, therefore, the time in a woman’s life when her menstrual cycles terminate, it usually occurs sometime between mid-40s and mid-50s and it indicates the end of the woman’s fertility. I should perhaps also note that although menopause was originally a term intended to describe that particular phase in a woman’s life, it is now also applied to several other species whose female reproductive cycles are not necessarily of the same length or duration as that of women.
Causes of Menopause
Although the uterus is somewhat affected during menopause, it is the ovaries which are the crucial factors in determining whether the woman is in menopausal or not. To demonstrate this more clearly, let us look at several scenarios:
- A young woman who has had her uterus surgically removed (hysterectomy) for one medical reason or another but still retains one or both of her ovaries will, of course, stop menstruating and will be infertile but her ovaries will continue the process of ovulation and to release the reproductive hormones as they had done before the surgery. This woman would not have yet reached menopause.
- 2However, if the same young woman has had her ovaries surgically removed (oophorectomy) but retained her uterus, she will immediately be in surgically induced menopause.
Therefore, it is accurate to define menopause as the decline in the production of hormones by the ovaries, whether it is part of a natural aging process or due to surgery. The ovaries are part of the female body’s endocrine system of hormone production and more specifically, the production of reproductive hormones: progesterone; estradiol, estriol and estrone which are the three estrogen hormones; and testosterone. In menopause the production of progesterone stops as does the production of estradiol and estriol. However, estrone and testosterone continue to be produced but at somewhat reduced levels.
The Process Leading Up to Menopause and Post-Menopause
The process which leads up to menopause and then to post-menopause is called premenopause and it may last several years. A woman who has not undergone a hysterectomy or an oophorectomy is considered in premenopause when the functions of her ovaries start displaying changes as ovulation becomes more erratic and her menstrual cycles appear irregularly. With the passing of time the changes become more distinct, her menstrual cycles may begin to skip one or more months at a time and her flow may either become quite a bit heavier or much lighter.
The changes in hormonal levels often lead to many additional symptoms such as:
- Hot flashes and night sweats
- Increased risk of atherosclerosis
- Migraine headaches
- Atrophy of the vagina which results in dryness, itching, bleeding
- Urinary instability (frequency, urgency, incontinence and infections)
- Increased risk of osteoporosis
- Joint, muscle and back pain
- Atrophy of the breasts
- Mood swings, irritability, memory loss, depression and sleep disturbances
- Reduced libido and painful intercourse
Although menopause and post-menopause, which is indicated after 12 continual months of non-interrupted menopause, can prove to be challenging to some women, it is not a diseased condition or an abnormal disorder but rather a natural life change.