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Menopause: At a Glance

By The Manual's Editorial Staff,

Menopause is the permanent end of menstrual periods.

What Causes Menopause?

For menstrual periods to occur, the ovaries must produce enough of the female hormones estrogen and progesterone. During the years before menopause, the ovaries start producing less and less of these hormones. As a result, menstrual periods and ovulation (release of an egg) occur less often. Eventually, menstrual periods and ovulation end permanently, and pregnancy is no longer possible.

How Do You Know When Menopause Occurs?

A woman's last period can be identified only later, after she has had no periods for at least 1 year. Thus, women cannot be sure that they have reached menopause until 1 year after their last period.

Did You Know...

  • The average age for menopause is about 51.

Perimenopause is a distinctive transitional period that occurs during the years before and the 1 year after the last menstrual period. How many years of perimenopause precede the last menstrual period varies greatly—from 6 months to about 10 years.

The wide fluctuations in hormone levels during perimenopause are thought to cause the menopausal symptoms experienced by many women in their 40s.

For a full discussion of menopause, including treatment options, see Menopause.

What Symptoms May Occur?

Common symptoms include

Did You Know...

  • Hot flashes affect 75 to 85% of women.

Other symptoms that may occur around the time of menopause include

  • Mood changes

  • Depression

  • Irritability, anxiety, and nervousness

  • Sleep disturbances (including insomnia)

  • Loss of concentration

  • Headache

  • Fatigue

However, evidence supporting a connection between menopause and these other symptoms is weak. These symptoms are not directly related to the decreases in estrogen levels that occur with menopause. And many other factors (such as aging itself or a disorder) could explain the symptoms.

After menopause, the lining of the vagina becomes thinner, drier, and less elastic (a condition called atrophic vaginitis). As a result, sexual intercourse may be painful. Other genital organs—the clitoris, uterus, and ovaries—decrease in size.

To Treat or Not to Treat?

Some general measures (such as avoiding foods and beverages that trigger hot flashes and wearing layers of clothing) can help.

Hormone therapyhas risks and benefits. Whether to take hormone therapy is a difficult decision that must be made by a woman and her doctor.

Some women take medicinal herbs (such as black cohosh or DHEA) and other supplements to relieve symptoms. However, such remedies are not regulated as drugs are. Also, they do not appear to be effective.

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