Menopause

The word Menopause literally means the physiological cessation of menstrual cycles, from the Greek roots 'meno-' (month) and 'pausis' (a pause, a cessation). However, in reality menopause is not simply a matter of the permanent stopping of periods, it is a phenomenon which involves the shutting down of the whole of a woman's reproductive functioning. The root cause of menopause is not what is happening to the uterus, the whole process of menopause is triggered by the faltering and shutting down of the ovaries. This process usually normally occurs more or less in midlife.

The normal age range for last period ever is between age 45 to 55, with the peak being at about age 51. An "early menopause" is defined as last period ever at an age between 40 to 45. Age 55 to 60 for last period ever is described as a "late menopause". Last period ever prior to age 40 is considered a "premature menopause", and this is not viewed as being due to normal causes.

In common everyday parlance however, the word "menopause" is most often used to refer to the menopause transition years, also known as the change of life or the climacteric. This time of life is also sometimes known as perimenopause, (literally meaning around menopause).

Perimenopause refers to the years both before and after the last period ever, when many women find that they undergo symptoms of hormonal change and fluctuation, such as hot flashes, mood changes, insomnia, etc.

A woman who still has her uterus can only be declared to be in post-menopause once she has gone 12 full months with no flow at all, not even any spotting. At that point she is one year into post-menopause. The reason for this delay in declaring a woman post-menopausal is because periods become very erratic at this time of life, and therefore a reasonably long stretch of time is necessary to be sure that the cycling has actually ceased.

In women who have no uterus and therefore have no periods, post-menopause can be determined by a blood test which can reveal the very high levels of FSH or Follicle Stimulating Hormone typical of post-menopausal women.

The ovaries are the essential organs; they are endocrine glands and produce hormones. Because of this, removal of the uterus, hysterectomy, does not itself cause menopause, although pelvic surgery can sometimes 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.

Menopause does also exist in some of the other few mammal species that experience menstrual cycles, such as rhesus monkeys and some cetaceans.