Menopause in women however cannot be defined simply as the permanent "stopping of the monthly periods", because in reality what is happening to the uterus is quite secondary to the process. For medical reasons, the uterus is sometimes surgically removed (hysterectomy) in a younger woman, and after this her periods will cease permanently, and the woman will technically be infertile, but as long as at least one of her ovaries is still functioning, the woman will not have entered menopause. This is because even without the uterus, ovulation, and the release of the sequence of reproductive hormones that are an essential part of the reproductive cycles, will continue until the time of menopause is reached.

Hormonal changes cause the physical symptoms of menopause, but mistaken beliefs about the menopausal transition are partly to blame for the emotional ones. First, menopause doesn't mean the end is near — you've still got as much as half your life to go. Second, menopause will not snuff out your femininity and sexuality. In fact, you may be one of the many women who find it liberating to stop worrying about pregnancy and periods.

Causes

Menopause begins naturally when your ovaries start making less estrogen and progesterone, the hormones that regulate menstruation. The process gets under way in your late 30s. By that time, fewer potential eggs are ripening in your ovaries each month, and ovulation is less predictable. Also, the post-ovulation surge in progesterone — the hormone that prepares your body for pregnancy — becomes less dramatic. Your fertility declines, perhaps partially due to these hormonal effects.

Menopause occurs at a different time in every woman. You are likely to go through menopause around the same time that your grandmother, mother, or sister did, give or take a few years. Most women stop menstruating completely between the ages of 50 and 51, however the whole menopausal process can last a number of years. Most North American women begin menopause sometime between the ages of 45 and 55 however, menopause can occur as early as 35 or as late as 60.

Symptoms

Most women experience absent, short, irregular periods at some point in their lives. A wide range of conditions can cause these symptoms, while the most common cause is hormone imbalance. Your periods may come more frequently, every 24 days instead of every 28, or they may come later than they used to. You may have a light period that lasts only a few days, then the next month have very heavy bleeding. Your period may last a shorter amount of time, or go on and on for what feels like an eternity. You may skip a month, then go back to normal for several months, then skip two periods in a row.

Treatment

Menopause is a natural process. Treatment with hormones may be helpful if you experience debilitating symptoms such as hot flashes, night sweats, or vaginal dryness. Discuss the decision to take hormones thoroughly with your doctor, weighing your risks against any possible benefits. Pay careful attention to the many options currently available to you that do not involve taking hormones. If you have a uterus and decide to take estrogen, you must also take progesterone to prevent endometrial cancer (cancer of the lining of the uterus). If you do not have a uterus, progesterone is not necessary.

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