What is Menopause? How Menopause Occurs?

24 August 2014

The exact definition is the end of menstruation and “the age of menopause” refers to the time a woman has ovulation for the last time.

The Menopause

In women, the end of the period owing to menopause is a sign that the ovaries have lost their function and hormones are not produced any longer. Contrary to common belief, it is the end of functioning of the ovaries not the uterus. Hormone and egg (oocyte) production cannot be done in the ovaries. Due to insufficient estrogen and progesterone hormone production, ovulation (menstruation) does not take place.

What is the average age for menopause?

While 50 is the generally accepted average for it, ages 45-50 are accepted as normal.
Although there are many causes that determine the start of menopause, the most important causes are genetic factors. Additionally, excessive smoking might also lead to early menopause.

What are Premenopause and Postmenopause?

The time period right before the end of menstruation is called “premenopause” and the period afterwards is called “postmenopause”.

What is climacterium (perimenopause)?

Climacterium”” refers to a period which covers both premenopause and postmenopause periods, and this is when menopausal complaints are most and intense. Climacterium usually starts at the age of 45 and continues till 55; sometimes it might continue until 65. The word “perimenopause” can be used as synonyms with climacterium.

Premenopause (The time period before menopause)

After the age of 40, usually women experience irregularities regarding menstruation. Actually, even if menstruation continues, fever and sweating may accompany it. Late menstruation or sometimes the opposite early and frequent menstruation might be experienced. The main reason for these is the decrease of estrogen hormone secreted from the ovaries.

Fever and late menstruation also show that estrogen levels are lower than necessary for the body. Thus, conditions such as “osteoporosis” (weakening and loss of bone tissue) which is observed after menopause actually start before it.

What are the symptoms of menopause? How is it determined?

Prior to it, one important condition that might be experienced is pregnancy which has been noticed late. Late menstruation doesn’t always mean menopause. That’s why; until menopause is definite, effective birth control methods should be used.

By principle, every menstruating woman has the potential to become pregnant. Although the chances become lower due to advanced age, theoretically they never reach zero.

For every woman who is over 40 and experiences latent menstruation, a pregnancy test should be done. If there is no pregnancy, some hormone tests, measuring ovarian functions, should be done to determine if there is a transition to it. If, in such a case, a woman doesn’t have any menstruation for 6 months, this might be considered as it.

That is, in order to observe menopause for certain, a 6-month latent menstruation period is needed.

What are laboratory tests to diagnose menopause?

In order to identify menstruation in the laboratory FSH, LH and Estrogen hormone (E2) levels in blood are evaluated. Rise in FSH and LH levels and decrease in estrogen show that the ovaries have been exhausted, which is diagnosed as menopause. In recent years, it has been observed that the ovaries not only produce estrogen and progesterone hormones but also many other materials and thus, research shows their importance for the female physiology. Properly functioning ovaries are one of the most important organs for a woman.

What is surgical menopause?

Surgical menopause is the type of menopause which develops after the ovaries have been removed (for some reason) by a gynaecologist.

In surgery, the removal of ovaries usually coincides with the surgical operation of removal of uterus (hysterectomy).

Mostly, when women receive hysterectomy surgery due to myoma (tumour in the uterus) after the age of 45 the ovaries are also removed with the uterus. The reason for removing the ovaries is to avoid possible future ovarian cancer risks.

However, when the operation is done under the age of 45, usually, the ovaries are left because although with the uterus removed and menstruation ended, the ovaries will still continue to function, thus it will not take place. That is, fever and sweating symptoms of it won’t be experienced.

The condition when ovaries are removed and menstruation ends is called “surgical menopause”.

In what ways does surgical menopause differ from regular menopause?

Complaints and problems regarding the ending of menstruation due to surgical menopause are more severe compared to regular (natural) menopause. This is because in regular menopause the ovaries become exhausted slowly and the adapts to this situation whereas in surgical menopause this process is very fast.

Patients who experience menopause after hysterectomy (removal of the uterus) should start their menopause treatment by seeing their doctor 15-20 days after the operation.

What is early menopause?

If menstruation ends before the age of 40, it is defined as “early menopause”. Early menopause is also referred to as “premature menopause” in literature.

What is “Premature Ovarian Failure” (POF)?
When menopause is encountered before the age of 30, it is called “premature ovarian failure”. The exhaustion of the ovaries at such an early age brings forth many other psychological and physiological issues for women. Premature ovarian failure (POF) is a condition which requires the investigation of the reasons and that proper treatment be started.
What are the causes of “Premature Ovarian Failure”?
Although many causes are stated to start early menopause and premature ovarian failure, there is no definite view as to what determines the beginning of it. Some suggested causes of premature ovarian failure (POF) include genetic traits, some auto immunity diseases (Cushing’s syndrome, thyroid diseases, SLE etc.), smoking, stress, cancer treatment, diabetes and genetic (chromosome) conditions. The only certainty is that menopause before the age of 40 definitely requires treatment.
If early/premature menopause is not treated, the woman’s body will experience the damaging effects of menopause at a very early age and it is related conditions (osteoporosis and heart diseases) may manifest themselves at this early age and more severely.



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