By Dr Ananya Mandal, MD
Menopause is a phase of life in women that signifies the end of their reproductive period. It signifies the end of menstruation. This means that the ovaries of the women stop producing an egg every four weeks and there is no monthly period. Beyond menopause a women will no longer be able to have children.
Menopause can only be defined with certainty after twelve months' spontaneous (no other pathology involved) amenorrhoea or lack of periods.
Age of menopause
On average, most women reach menopause in their late 40’s to early 50’s. In the UK, the average age for a woman to reach the menopause is 52. Many women can also experience the menopause in their 30s or 40s.
For those who experience menopause before 40 or 45, the condition is termed premature menopause. Premature menopause can occur due to several pathologies including primary ovarian failure, surgery of ovaries and uterus, radiation and chemotherapy induced loss of periods etc.
Causes of menopause
Every month the ovaries alternatively produce an egg (ovulation) and hormones that make the womb or uterus conducive to bearing a child. The ovaries have a finite number of ovarian follicles that contain the ova.
As menopause is reached, the female hormone estrogen and progesterone levels decrease. This causes the ovaries to stop producing an egg each month. This fall in estrogen leads to both physical and emotional symptoms of menopause. The fall in estrogen and progesterone leads to increase in luteinising hormone (LH) and follicle stimulating hormone (FSH). This causes menstruation to become erratic and eventually the periods cease.
The period before final menopause is reached is called menopausal transition stage, or perimenopause.
Symptoms of menopause
Menstruation or periods may stop abruptly in some women and in most it gradually becomes less frequent, with longer intervals in between each one before they stop completely.
Other symptoms include hot flushes, mood swings, irritability, night sweats and vaginal dryness.
Treatment and when it is necessary
Menopause is a normal physiological process and usually may not require treatment. Women experiencing menopause may need to visit their physician if their symptoms are troubling them or are excessive. To check for actual menopause a blood test to measure the level of follicle-stimulating hormone (FSH) may sometimes be recommended.
For treatment Hormone replacement therapy (HRT) is one of the main modalities. It helps to relieve menopausal symptoms by replacing the female hormones. HRT is available in many forms including tablet, creams or gel, a skin patch or an implant. HRT cannot be continued lifelong.
Apart from HRT most women benefit from alternative therapies like change in their diet, lifestyle, exercising regularly, reducing stress etc.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)