Menopause is the stage in a woman's life when fertility ends due to changes in hormone balance. To confirm menopause, a woman must have gone one full year without a menstrual period.
During menopause, the production of female hormones, estrogen, and progestin, decreases. The function of the ovaries slows down, and ovulation becomes irregular, leading to irregular menstrual cycles that eventually cease entirely.
However, women do not lose interest in sex during menopause; on the contrary, many feel more comfortable because there is no longer a risk of pregnancy.
The average age of menopause is between 48 and 50, although this can vary depending on factors such as nutrition, body weight, vegetarianism, whether a woman has had her uterus removed, developmental issues in the womb, and living at high altitudes. Additionally, women who smoke tend to enter menopause earlier.
With increasing life expectancy, the time women spend in menopause has also extended. In developed countries, menopause now constitutes about one-third of a woman’s life.
Monthly periods are the result of complex bodily functions preparing for pregnancy. Hormones secreted in coordination by the brain and ovaries lead to egg development.
These hormones also trigger ovulation, or the release of the egg from its follicle. The inner lining of the uterus, thickened in preparation for pregnancy, is shed as a menstrual period if pregnancy does not occur. As a woman ages, her ovaries age too, and around age 40, the ovaries respond less to hormonal signals from the brain and produce less estrogen.
Menstrual periods become irregular, and estrogen levels drop rapidly in this phase before menopause. Menopause begins when egg development and estrogen production in the ovaries stop entirely. If menstrual delays last longer than six months, blood tests measuring estrogen and follicle-stimulating hormone (FSH) levels can confirm the diagnosis.
The term "perimenopause" refers to the transition period from regular menstruation to menopause. In this phase, known as perimenopause, ovulation becomes less frequent due to the decreasing number of eggs in the ovaries.
Women generally reach menopause around the same age as their mothers. Regardless of age, a woman who has had her ovaries surgically removed is considered to be in menopause. Women who have had their uterus removed but retain their ovaries will not have periods, but they are not considered menopausal as long as ovarian function continues.
Entering menopause before age 40 is classified as early menopause.
If your periods have stopped, some simple blood tests can determine whether you are in menopause. Menopause is a gradual process, and if periods have not occurred for 6-12 months, menopause may not yet have started.
During this time, it is generally recommended to continue using birth control to avoid pregnancy. You should consult a doctor if you experience changes in your menstrual pattern, heavy bleeding, prolonged periods, bleeding more frequently than every three weeks, bleeding after intercourse, or spotting between periods.
The most common symptom of menopause is hot flashes, characterized by sudden redness in the head, neck, and chest area, an increase in body temperature, and excessive sweating afterward.
Although these symptoms usually last 1-2 years, about 25% of women experience them for more than five years. The main factor is believed to be a decrease in estrogen levels, although the exact cause is unknown.
The epithelial lining that covers the vagina and urinary tract thins and loses elasticity. Vaginal dryness is also a common symptom. Although it is generally thought that psychological problems increase during menopause, studies do not support this idea.
The notion that depression is more common during menopause is also no longer widely accepted. However, due to hot flashes, a woman's sleep quality—and consequently, her daily quality of life—may be affected.
Typical symptoms include skin redness, breast tenderness, irritability, sleep disturbances, excessive sweating, fatigue, lack of motivation, extreme emotionality, and a depressed mood.
Other symptoms include increased facial wrinkles, paler skin tone, hair thinning and shedding, wrinkling and loosening of the skin, age spots, nail breakage, breast shrinkage, flattening, and softening, increased body hair growth, a tendency towards varicose veins, abdominal fat accumulation and loss of firmness, thinning, wrinkling, and dryness in the vaginal walls, itching, increased susceptibility to infections, pain during sexual intercourse, urinary incontinence, and tingling sensations.
