Menopause is a normal change in a woman’s life. It occurs when she has her last period. Menopause, however, doesn’t simply happen when menstruation ends—symptoms may begin years before your last period and continue for months or years after.
The age at which menopause occurs varies, but the average age when a woman has her last period is 51. For some, however, menopause occurs in the forties or later in the fifties.
As you approach menopause, levels of estrogen and progesterone (female hormones produced in the ovaries) begin to change, or fall. These changing levels begin to cause the symptoms of menopause. This time of transition, which can start several years before your last period, is known as the menopausal transition or perimenopause. Perimenopause continues for a year after your last period. Once you haven’t had a period for one year, the next phase is called postmenopause, which lasts for the rest of your life.
Menopause and its symptoms are the result of changing levels of estrogen and progesterone. As mentioned earlier, menopause is a normal and natural part of life. There are, however, several outside factors that can lead to an early menopause. Smoking, for instance, can lead to an early menopause, as can surgeries to remove the uterus and/or ovaries. A hysterectomy, where the uterus is removed, will end menstruation, but won’t cause immediate symptoms of menopause; this is because the ovaries (which produce estrogen and progesterone) are not removed. If the ovaries are removed (an oophorectomy), which usually coincides with removal of the uterus, symptoms of menopause will also occur as menstruation ends.
Your body may go through many changes at midlife, and it’s not always clear which are caused by menopause and which are part of the aging process. Also, because estrogen is used by many parts of your body—not just your reproductive system—lower levels of estrogen can affect your health in several ways.
Changes commonly occurring at midlife that may be related to menopause include:
Though they’re not symptoms of menopause, there are certain health concerns that can accompany the change as estrogen levels decrease and other changes related to aging occur. Two common concerns for women at midlife include osteoporosis and heart disease.
Osteoporosis. At the time of menopause, women may be at risk of osteoporosis, a condition where bones become weak and break easily. The body continually breaks down old bone and replaces it with new, healthy bone. Because estrogen helps control bone loss, when you lose estrogen during menopause, you body isn’t able to replace as much bone as it loses. Your doctor can test your bone density to determine your risk for osteoporosis as well as discuss ways to prevent or treat it.
Factors that increase risk for osteoporosis include:
Heart disease. A woman’s risk of heart disease increases after menopause. This is likely the result of changing estrogen levels and the aging process. Factors associated with increasing age—like weight-gain and high blood pressure—raise your risk of heart disease. See your doctor regularly to have your blood pressure and cholesterol levels checked and to discuss ways to keep your heart healthy.
There isn’t one clear method to determine when you’re in the menopausal transition or to predict when you may experience the change. You and your doctor may consider menopausal symptoms, a physical examination, medical history, and certain blood tests for clues about your status. Remember, however, that these are only clues—there’s no definitive test for menopause. Blood tests, for example, are unreliable because the hormones that your doctor may measure—such as estrogen and follicle-stimulating hormone—normally rise and fall during your menstrual cycle.