Menopause
Menopause, also known as the climacteric, is the time in most women's lives when menstrual periods stop permanently, and they are no longer able to bear children. Menopause typically occurs between 49 and 52 years of age. Medical professionals often define menopause as having occurred when a woman has not had any vaginal bleeding for a year. It may also be defined by a decrease in hormone production by the ovaries. In those who have had surgery to remove their uterus but still have ovaries, menopause may be viewed to have occurred at the time of the surgery or when their hormone levels fell. Following the removal of the uterus, symptoms typically occur earlier, at an average of 45 years of age.
In the years before menopause, a woman's periods typically become irregular, which means that periods may be longer or shorter in duration or be lighter or heavier in the amount of flow. During this time, women often experience hot flashes; these typically last from 30 seconds to ten minutes and may be associated with shivering, sweating, and reddening of the skin. Hot flashes often stop occurring after a year or two. Other symptoms may include vaginal dryness, trouble sleeping, and mood changes. The severity of symptoms varies between women. While menopause is often thought to be linked to an increase in heart disease, this primarily occurs due to increasing age and does not have a direct relationship with menopause. In some women, problems that were present like endometriosis or painful periods will improve after menopause.
Menopause is usually a natural change. It can occur earlier in those who smoke tobacco. Other causes include surgery that removes both ovaries or some types of chemotherapy. At the physiological level, menopause happens because of a decrease in the ovaries' production of the hormones estrogen and progesterone. While typically not needed, a diagnosis of menopause can be confirmed by measuring hormone levels in the blood or urine. Menopause is the opposite of menarche, the time when a girl's periods start.
Specific treatment is not usually needed. Some symptoms, however, may be improved with treatment. With respect to hot flashes, avoiding smoking, caffeine, and alcohol is often recommended. Sleeping in a cool room and using a fan may help. The following medications may help: menopausal hormone therapy (MHT), clonidine, gabapentin, or selective serotonin reuptake inhibitors. Exercise may help with sleeping problems. While MHT was once routinely prescribed, it is now only recommended in those with significant symptoms, as there are concerns about side effects. High-quality evidence for the effectiveness of alternative medicine has not been found. There is tentative evidence for phytoestrogens. Menopause
The menopause transition typically begins between 40 and 50 years of age (average 47.5). The duration of perimenopause may be for up to eight years. Women will often, but not always, start these transitions (perimenopause and menopause) about the same time as their mother did. Menopause
Menopause typically occurs between 49 and 52 years of age. The majority of women have their last period between the ages of 48 and 55. The average age of the last period in the United States is 51 years, in the United Kingdom is 52 years, in Ireland is 50 years and in Australia is 51 years. In India and the Philippines, the median age of natural menopause is considerably earlier, at 44 years. The menopausal transition or perimenopause leading up to menopause usually lasts 7 years (sometimes as long as 14 years). Sex differences in human physiology
Female fertility declines after age 30 and ends with the menopause. Female physical experiences vary depending on external forces such as diet, marriage patterns, culture, and other aspects. In Western nations menstruation begins to affect females at 13 and menopause starts around 51. In non-industrialized countries, on the other hand, most females begin menstruation at a later age. More lactation in the lifetime of non-western females inhibits ovulation and extends the number of fertile years. Pregnancy in the 40s or later has been correlated with increased risk of Down syndrome in the children. Males are capable of fathering children into old age. Paternal age effects in the children include multiple sclerosis, autism, breast cancer and schizophrenia, as well as reduced intelligence. Adriana Iliescu was reported as the world's oldest woman to give birth, at age 66. Her record stood until Maria del Carmen Bousada de Lara gave birth to twin sons at Sant Pau Hospital in Barcelona, Spain on December 29, 2006, at the age of 67. In both cases IVF was used. The oldest known father was former Australian miner Les Colley, who fathered a child at age 93.
Menstrual cycle
The cessation of menstrual cycles at the end of a woman's reproductive period is termed menopause. The average age of menopause in women is 52 years, with anywhere between 45 and 55 being common. Menopause before age 45 is considered "premature" in industrialised countries. Like the age of menarche, the age of menopause is largely a result of cultural and biological factors; however, illnesses, certain surgeries, or medical treatments may cause menopause to occur earlier than it might have otherwise. Menstrual cycle
The menstrual cycle is the regular natural change that occurs in the female reproductive system (specifically the uterus and ovaries) that makes pregnancy possible. The cycle is required for the production of oocytes, and for the preparation of the uterus for pregnancy. Up to 80% of women report having some symptoms during the one to two weeks prior to menstruation. Common symptoms include acne, tender breasts, bloating, feeling tired, irritability and mood changes. These symptoms interfere with normal life and therefore qualify as premenstrual syndrome in 20 to 30% of women. In 3 to 8%, they are severe.
The first period usually begins between twelve and fifteen years of age, a point in time known as menarche. They may occasionally start as early as eight, and this onset may still be normal. The average age of the first period is generally later in the developing world and earlier in developed world. The typical length of time between the first day of one period and the first day of the next is 21 to 45 days in young women and 21 to 35 days in adults (an average of 28 days). Menstruation stops occurring after menopause which usually occurs between 45 and 55 years of age. Bleeding usually lasts around 2 to 7 days.
The menstrual cycle is governed by hormonal changes. These changes can be altered by using hormonal birth control to prevent pregnancy. Each cycle can be divided into three phases based on events in the ovary (ovarian cycle) or in the uterus (uterine cycle). The ovarian cycle consists of the follicular phase, ovulation, and luteal phase whereas the uterine cycle is divided into menstruation, proliferative phase, and secretory phase. Menopause
In contrast to the sudden fall in estradiol during menopause, the levels of total and free testosterone, as well as dehydroepiandrosterone sulfate (DHEAS) and androstenedione appear to decline more or less steadily with age. An effect of natural menopause on circulating androgen levels has not been observed. Thus specific tissue effects of natural menopause cannot be attributed to loss of androgenic hormone production. Menstrual disorder
"Amenorrhea" is the absence of a menstrual period in a woman of reproductive age. Physiologic states of amenorrhoea are seen during pregnancy and lactation (breastfeeding). Outside of the reproductive years there is absence of menses during childhood and after menopause. Irritable male syndrome
The term was popularized by author Jed Diamond in 2004 as being related to "andropause", a concept he had earlier popularized. According to Diamond, andropause is a change of life in middle-aged men, which has hormonal, physical, psychological, interpersonal, social, sexual, and spiritual aspects. He says that this change occurs in all men, may occur as early as age 45 to 50 and more dramatically after the age of 70 in some men, and that women's and men's experiences are somewhat similar phenomena. North American Menopause Society
The North American Menopause Society (NAMS), founded in 1989, is a nonprofit, multidisciplinary organization with the mission of promoting the health and quality of life of women during midlife and beyond through an understanding of menopause and healthy aging. Based in Cleveland, Ohio, NAMS has more than 2,000 members from 51 countries, with 88% of its members from North America.Its membership includes experts from many disciplines such as medicine, nursing, sociology, psychology, nutrition, anthropology, epidemiology, pharmacy, and education. Gem Theatre
2005-2006 "Menopause the Musical" Menopause
The male-biased philopatry theory proposes that male-biased philopatry in social species leads to increased relatedness to the group in relation to female age, making inclusive fitness benefits older females receive from helping the group greater than what they would receive from continued reproduction, which eventually lead to the evolution of menopause. In a pattern of male-biased dispersal and local mating, the relatedness of the individuals in the group decreases with female age, leading to a decrease in kin selection with female age. This occurs because a female will stay with her father in her natal group throughout life, initially being closely related to the males and females. Females are born and stay in the group, so relatedness to the females stays about the same. However, throughout time, the older male relatives will die and any sons she gives birth to will disperse, so that local relatedness to males, and therefore the whole group, declines. The situation is reversed in species where males are philopatric and either females disperse, or mating is non-local. Under these conditions, a female’s reproductive life begins away from her father and paternal relatives because she was either born into a new group from non-local mating or because she dispersed. In the case of female-biased dispersal, the female is initially equally unrelated with every individual in the group, and with non-local mating, the female is closely related to the females of the group, but not the males since her paternal relatives are in another group. As she gives birth, her sons will stay with her, increasing her relatedness to males in the group overtime and thus her relatedness with the overall group. The common feature that connects these two otherwise different behaviors is male-biased philopatry, which leads to an increase in kin selection with female age. Sexual dysfunction
The female sexual response system is complex and even today, not fully understood. The most prevalent of female sexual dysfunctions that have been linked to menopause include lack of desire and libido; these are predominantly associated with hormonal physiology. Specifically, it is the decline in serum estrogens that causes these changes in sexual functioning. Androgen depletion may also play a role, but currently this is less clear. The hormonal changes that take place during the menopausal transition have been suggested to affect women's sexual response through several mechanisms, some more conclusive than others. Yanomami
The start of "menstruation" symbolizes the beginning of womanhood. Girls typically start menstruation around the age of 12-15. Girls are often betrothed before menarche and the marriage may only be consummated once the girl starts menstruating, though the taboo is often violated and many girls become sexually active before then. The Yanomami word for menstruation ("roo") translates literally as "squatting" in English, as they use no pads or cloths to absorb the blood. Due to the belief that menstrual blood is poisonous and dangerous, girls are kept hidden away in a small tent-like structure constructed of a screen of leaves. A deep hole is built in the structure over which girls squat, to "rid themselves" of their blood. These structures are regarded as isolation screens. Menopause
The menopausal transition, and postmenopause itself, is a natural change, not usually a disease state or a disorder. The main cause of this transition is the natural depletion and aging of the finite amount of oocytes (ovarian reserve). This process is sometimes accelerated by other conditions and is known to occur earlier after a wide range of gynecologic procedures such as hysterectomy (with and without ovariectomy), endometrial ablation and uterine artery embolisation. The depletion of the ovarian reserve causes an increase in circulating follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels because there are fewer oocytes and follicles responding to these hormones and producing estrogen. Late-onset hypogonadism
The terms "male menopause" and "andropause" are used in the popular media and are misleading, as they imply a sudden change in hormone levels similar to what women experience in menopause. A decrease in libido in men as a result of age is sometimes colloquially referred to as "penopause". Menopause
During early menopause transition, the menstrual cycles remain regular but the interval between cycles begins to lengthen. Hormone levels begin to fluctuate. Ovulation may not occur with each cycle. Menopause
In younger women, during a normal menstrual cycle the ovaries produce estradiol, testosterone and progesterone in a cyclical pattern under the control of FSH and luteinizing hormone (LH), which are both produced by the pituitary gland. During perimenopause (approaching menopause), estradiol levels and patterns of production remain relatively unchanged or may increase compared to young women, but the cycles become frequently shorter or irregular. The often observed increase in estrogen is presumed to be in response to elevated FSH levels that, in turn, is hypothesized to be caused by decreased feedback by inhibin. Similarly, decreased inhibin feedback after hysterectomy is hypothesized to contribute to increased ovarian stimulation and earlier menopause. Hormone replacement therapy
It is commonly perceived that once women near the end of their reproductive years and enter menopause that this equates to the end of her sexual life. However, especially since women today are living one third or more of their lives in a postmenopausal state, maintaining, if not improving, their quality of life, of which their sexuality can be a key determinant, is of importance. A recent study of sexual activities among women aged 40–69 revealed that 75% of women are sexually active at this age; this indicates that the sexual health and satisfaction of menopausal women are an aspect of sexual health and quality of life that is worthy of attention by health care professionals. Menopause
Premenopause is a term used to mean the years leading up to the last period, when the levels of reproductive hormones are becoming more variable and lower, and the effects of hormone withdrawal are present. Premenopause starts some time before the monthly cycles become noticeably irregular in timing. Menopause
Symptoms that may appear during menopause and continue through postmenopause include: Women's Health Initiative
The WHI trial was limited by low adherence, high attrition, inadequate power to detect risks for some outcomes, and evaluation of few regimens. Subsequent to publication of the WHI, controversy arose regarding the applicability of its findings to women just entering menopause. To be properly double blinded, the study required that women not be perimenopausal or have symptoms of menopause. As the average age of menopause is 51, this resulted in an older study population, with an average age of 63. Only 3.5% of the women were 50–54 years of age, the time when women usually decide whether to initiate hormonal therapy. Further analysis of WHI data, however, demonstrated that there is no gained preventive benefit in starting hormone therapy soon after menopause. Menopause
The date of the final menstrual period is usually taken as the point when menopause has occurred. During the menopausal transition and after menopause, women can experience a wide range of symptoms. International Menopause Society
The Society's official journal, "Climacteric", the Journal of Adult Women's Health and Medicine, was founded in 1998 and is listed in Index Medicus/MEDLINE. The editors-in-Chief are Anna Fenton (New Zealand), and Nick Panay (United Kingdom). It publishes international, original, peer-reviewed research on all aspects of aging in men and women, especially during the menopause and climacteric. The content of the journal covers the whole range of subject areas relevant to climacteric studies and adult women’s health and medicine, including underlying endocrinological changes, treatment of the symptoms of the menopause and other age-related changes, hormone replacement therapies, alternative therapies, effective life-style modifications, non-hormonal midlife changes, and the counselling and education of perimenopausal and postmenopausal patients. Menstruation
For many women, primary dysmenorrhea gradually subsides in late second generation. Pregnancy has also been demonstrated to lessen the severity of dysmenorrhea, when menstruation resumes. However, dysmenorrhea can continue until menopause. 5–15% of women with dysmenorrhea experience symptoms severe enough to interfere with daily activities. Menopause
The reason for this delay in declaring postmenopause is because periods are usually erratic at this time of life. Therefore, a reasonably long stretch of time is necessary to be sure that the cycling has ceased. At this point a woman is considered infertile; however, the possibility of becoming pregnant has usually been very low (but not quite zero) for a number of years before this point is reached. Hot flash
The hot-flash event may be repeated a few times each week or every few minutes throughout the day. Hot flashes may begin to appear several years before menopause starts and last for years afterwards. Some women undergoing menopause never have hot flashes. Others have mild or infrequent flashes. The worst sufferers experience dozens of hot flashes each day. In addition, hot flashes are often more frequent and more intense during hot weather or in an overheated room, the surrounding heat apparently making the hot flashes themselves both more likely to occur, and more severe. Sexual motivation and hormones
Following natural or surgically induced menopause, many women experience declines in sexual motivation. Menopause is associated with a rapid decline of estrogen, as well as a steady rate of decline of androgens. The decline of estrogen and androgen levels is believed to account for the lowered levels of sexual reproduction desire and motivation in postmenopausal women, although the direct relationship is not well understood. Hyperandrogenism
One such cause is the end of ovulation and the beginning of menopause. When the body transitions from ovulation to menopause, it stops releasing estrogen at faster rate than it stops releasing androgens. In some cases, estrogen levels can drop enough that there are substantially higher androgen levels leading to hyperandrogenism. A decrease in sex hormone levels while the free androgen index increases helps to aid this process, as well. Female promiscuity
It is common for sex drive to diminish dramatically after menopause. A number of studies, including Alfred Kinsey's, have concluded that the average age group in which women are the most active sexually is their mid-thirties, one study liberally estimating 27-45 as the limits of the age group (the average man peaks earlier). Women in this age group typically report having sexual fantasies greater in number and intensity, engaging in sexual activity more frequently, and being more interested in casual sex. Menopause The Musical
Written by Jeanie Linders, Menopause The Musical debuted March 28, 2001 in Orlando, Florida. The original cast members were Shelly Browne as the Power (later Professional) Woman, Patti McGuire as the Iowa Housewife, Pammie O'Bannon as the Earth Mother and Wesley Williams as the Soap Star. The musical follows four women shopping for lingerie at a Bloomingdale's sale sing 25 songs about chocolate cravings, hot flashes, loss of memory, nocturnal sweats, and sexual predicaments. The lyrics parody popular music from the baby boomer era, and includes the numbers "Stayin' Awake" and "Puff, My God I'm Draggin'." International Menopause Society
The International Menopause Society (IMS) is a UK based charity. The Association was created in 1978 in Jerusalem during the second Menopause Congress and currently has members in 62 countries. In addition to organizing congresses, symposia, and workshops, the IMS owns its own journal: Climacteric, the Journal of Adult Women's Health and Medicine, published by Informa Healthcare. The IMS has three sub-organs: CAMS, the Council of Affiliated Menopause Societies, the WSSM, the World School for the Study of the Menopause and the CPP, the Council of Past Presidents. Age and female fertility
The average age of a young woman's first period (menarche) is 12 to 13 (12.5 years in the United States, 12.72 in Canada, 12.9 in the UK) but, in postmenarchal girls, about 80% of the cycles are anovulatory in the first year after menarche, 50% in the third and 10% in the sixth year. A woman's fertility peaks in her early and mid-20s after which it starts to decline. However, the exact estimates of the chances of a woman to conceive after a certain age are not clear, and are subject to debate. Women's health
Women's menstrual cycles, the approximately monthly cycle of changes in the reproductive system, can pose significant challenges for women in their reproductive years (the early teens to about 50 years of age). These include the physiological changes that can effect physical and mental health, symptoms of ovulation and the regular shedding of the inner lining of the uterus (endometrium) accompanied by vaginal bleeding (menses or menstruation). The onset of menstruation (menarche) may be alarming to unprepared girls and mistaken for illness. Menstruation can place undue burdens on women in terms of their ability to participate in activities, and access to menstrual aids such as tampons and "sanitary pads". This is particularly acute amongst poorer socioeconomic groups where they may represent a financial burden and in developing countries where menstruation can be an impediment to a girl's education. Folliculogenesis
The supply of follicles decreases slightly before birth, and to 180,000 by puberty for the average case (populations at puberty range from 25,000 to 1.5 million). By virtue of the "inefficient" nature of folliculogenesis (discussed later), only 400 of these follicles will ever reach the preovulatory stage. At menopause, only 1,000 follicles remain. It seems likely that early menopause occurs for women with low populations at birth, and late menopause occurs for women with high populations at birth, but there is as yet no clinical evidence for this. Age and female fertility
A woman's fertility peaks in the early and mid-20s, after which it starts to decline slowly. While many sources suggest a more dramatic drop at around 35, this is unclear since studies are still cited from the nineteenth century and earlier. One 2004 study of European women found fertility of the 27–34 and the 35–39 groups had only a four-percent difference. At age 45, a woman starting to try to conceive will have no live birth in 50–80 percent of cases. Menopause, or the cessation of menstrual periods, generally occurs in the 40s and 50s and marks the cessation of fertility, although age-related infertility can occur before then. The relationship between age and female fertility is sometimes referred to as a woman's "biological clock." Henopause
Henopause, a wordplay combination of "hen" and "menopause", is sometimes used to refer to the point at which hens stop laying eggs. Although daily egg production starts to tail off after 1 year old, it may continue until 5–7 years old. Older hens gradually produce fewer eggs, and the eggs are usually larger. Since the average lifespan of a pet layer hen is 8–15 years, henopause has received attention as a potential problem for backyard or urban chicken farmers who are eventually faced with the decision to either slaughter older layers or keep them as non-producing pets. In the UK, the British Hen Welfare Trust charity rescues commercial hens who would otherwise be sent to slaughter when they become no longer commercially viable. In commercial farming, a layer hen is considered no longer commercially viable at around thirteen months and is called a "spent hen". Menopause
Women who have undergone hysterectomy with ovary conservation go through menopause on average 3.7 years earlier than the expected age. Other factors that can promote an earlier onset of menopause (usually 1 to 3 years early) are smoking cigarettes or being extremely thin. Menopause
In Japanese culture, reporting of vasomotor symptoms has been on the increase, with research conducted by Melissa Melby in 2005 finding that of 140 Japanese participants, hot flashes were prevalent in 22.1%. This was almost double that of 20 years prior. Whilst the exact cause for this is unknown, possible contributing factors include significant dietary changes, increased medicalisation of middle-aged women and increased media attention on the subject. However, reporting of vasomotor symptoms is still significantly lower than North America. Menopause
Psychological symptoms include anxiety,
poor memory,
inability to concentrate,
depressive mood,
irritability,
mood swings, less interest in sexual activity. Menopause
Premature ovarian failure (POF) is the cessation of the ovarian function before the age of 40 years. It is diagnosed or confirmed by high blood levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) on at least three occasions at least four weeks apart. Hysterectomy
The average onset age of menopause after hysterectomy with ovarian conservation is 3.7 years earlier than average. This has been suggested to be due to the disruption of blood supply to the ovaries after a hysterectomy or due to missing endocrine feedback of the uterus. The function of the remaining ovaries is significantly affected in about 40% of women, some of them even require hormone replacement treatment. Surprisingly, a similar and only slightly weaker effect has been observed for endometrial ablation which is often considered as an alternative to hysterectomy. Postmenopausal confusion
Research on menopause as a whole declined with the end of the Women's Health Initiative (WHI) studies, but research on the treatment of symptoms associated with menopause—especially the treatment of cognitive decline—continues. New research refutes the WHI findings that estrogen therapy (ET) is not a useful treatment for menopausal symptoms. This is especially shown in Alzheimer's research as the Women's Health Initiative Memory Study refuted the argument that a decline in oestrogens and progestogens seen during menopause increases vulnerability to neurodegenerative diseases. Mice are the main subject for research involving the effects of estrogen on brain health, cognition, and neurodegenerative disorders, and research in this area continues. Menopause
Human primary oocytes are present at an intermediate stage of meiosis, termed prophase I (see Oogenesis). Expression of four key DNA repair genes that are necessary for homologous recombinational repair during meiosis (BRCA1, MRE11, Rad51, and ATM) decline with age in oocytes. This age-related decline in ability to repair DNA double-strand damages can account for the accumulation of these damages, that then likely contributes to the depletion of the ovarian reserve. Postmenopausal confusion
During menopause, the amygdala, which controls emotion, and the prefrontal cortex, which regulates judgment, become more regular. Estrogens, a group of hormones including estradiol and estrone, are secreted by the ovaries and the secretion is regulated by leutenizing hormone (LH) and follicle stimulating hormone (FSH), both of which are produced by the pituitary gland. In women, estrogen levels fluctuate during the menstrual cycle but reach a steady decline and then remain at low levels postmenopause. Menotropin
Menotropin (also called human menopausal gonadotropin or hMG) is a hormonally active medication for the treatment of fertility disturbances. Frequently the plural is used as the medication is a mixture of gonadotropins. Menotropins are extracted from the urine of postmenopausal women. Late-onset hypogonadism
Popular interest in the concept of "andropause" was fueled by the 1998 book "Male Menopause", written by Jed Diamond, a lay person. According to Diamond's view, andropause is a change of life in middle-aged men, which has hormonal, physical, psychological, interpersonal, social, sexual, and spiritual aspects. Diamond claims that this change occurs in all men, may occur as early as age 45 to 50 and more dramatically after the age of 70 in some men, and that women's and men's experiences are somewhat similar phenomena. The language of "andropause" and its supposed parallels with menopause have been rejected by the medical community. Menopause
In rare cases, a woman's ovaries stop working at a very early age, ranging anywhere from the age of puberty to age 40. This is known as premature ovarian failure and affects 1 to 2% of women by age 40. Menopause
It also appears effective for preventing bone loss and osteoporotic fracture, but it is generally recommended only for women at significant risk for whom other therapies are unsuitable. Libido
Although some specialists disagree with this theory, menopause is still considered by the majority a factor that can cause decreased sex desire in women. The levels of estrogen decrease at menopause and this usually causes a lower interest in sex and vaginal dryness which makes intercourse painful. However, the levels of testosterone increase at menopause and this may be why some women may experience a contrary effect of an increased libido. Greene Menopause Index
The Greene Menopause Index, also known as the Greene Climateric Scale, is a questionnaire a tool used by researchers to study the symptoms of menopause. It is a standard list of 21 questions which women use to rate how much they are bothered by menopause symptoms such as hot flashes, night sweats, rapid heartbeat, and difficulty sleeping. Menopause
Rates of premature menopause have been found to be significantly higher in fraternal and identical twins; approximately 5% of twins reach menopause before the age of 40. The reasons for this are not completely understood. Transplants of ovarian tissue between identical twins have been successful in restoring fertility. Menopause
Some believe a problem concerning the grandmother hypothesis is that it requires a history of female philopatry, while in the present day the majority of hunter-gatherer societies are patrilocal. However, there is disagreement split along ideological lines about whether patrilineality would have existed before modern times. Some believe variations on the mother, or grandmother effect fail to explain longevity with continued spermatogenesis in males (oldest verified paternity is 94 years, 35 years beyond the oldest documented birth attributed to females). Notably, the survival time past menopause is roughly the same as the maturation time for a human child. That a mother's presence could aid in the survival of a developing child, while an unidentified father's absence might not have affected survival, could explain the paternal fertility near the end of the father's lifespan. A man with no certainty of which children are his may merely attempt to father additional children, with support of existing children present but small. Note the existence of partible paternity supporting this. Some argue that the mother and grandmother hypotheses fail to explain the detrimental effects of losing ovarian follicular activity, such as osteoporosis, osteoarthritis, Alzheimer's disease and coronary artery disease. Amenorrhea
The social effects of amenorrhoea on a person vary significantly. Amenorrhoea is often associated with anorexia nervosa and other eating disorders, which have their own effects. If secondary amenorrhoea is triggered early in life, for example through excessive exercise or weight loss, menarche may not return later in life. A woman in this situation may be unable to become pregnant, even with the help of drugs. Long-term amenorrhoea leads to an estrogen deficiency which can bring about menopause at an early age. The hormone estrogen plays a significant role in regulating calcium loss after ages 25–30. When her ovaries no longer produce estrogen because of amenorrhoea, a woman is more likely to suffer rapid calcium loss, which in turn can lead to osteoporosis. Increased testosterone levels cause by amenorrhoea may lead to body hair growth and decreased breast size. Increased levels of androgens, especially testosterone, can also lead to ovarian cysts. Some research among amenorrhoeic runners indicates that the loss of menses may be accompanied by a loss of self-esteem. Menopause
A woman's reproductive hormone levels continue to drop and fluctuate for some time into post-menopause, so hormone withdrawal effects such as hot flashes may take several years to disappear. Meg Mathews
Meg Mathews (born March 14, 1966) is an activist and entrepreneur. She rose to fame in the Britpop scene while working in music management. In 2018, she launched "MegsMenopause", a platform dedicated to breaking the stigma around the menopause. Hormone replacement therapy
Current research that has examined the impact of menopause on women’s self-reported sexual satisfaction indicates that 50.3% of women experience some sexual disturbance in one of five domains, and 33.7% experience disturbances in two of the domains. Of these were desire, orgasm, lubrication, and arousal disturbances. With regards to arousal, they found a significant negative association between age and arousal, in that as women aged they were more likely to report lower arousal scores. In the desire and orgasm domains, 38% of women reported a disturbances in their desire, and 17% reported a disturbance in their orgasm capabilities; of the 17%, 14% were premenopausal, 15.2% were postmenopausal and taking a form of HRT, and 22% were postmenopausal not on a form of HRT. Eight percent of women reported disturbances lubricating during sexual activity; 14.3% in the premenopausal group, 30% in the postmenopausal group not using a HRT, and 11.7% among those postmenopausal women using HRT. Lastly, 21% of women reported pain as a disturbance in their sexual satisfaction — the premenopausal group at 14.3%, the postmenopausal women using HRT at 13.3% and the group with the highest rates, similarly to the other results, was the postmenopausal women not taking HRT at 34%. This study concluded that there was a significant decline in sexual function related to menopause in the pain and lubrication domains. Germaine Greer
Natalie Angier, writing in "The New York Times", called "The Change: Women, Ageing, and the Menopause" (1991) a "brilliant, gutsy, exhilarating, exasperating fury of a book ... tantalizingly close to being a potential feminist classic on a par with "The Female Eunuch"." In it, Greer writes of the myths about menopause—or as she prefers to call it the "climacteric", or critical period. "Frightening females is fun," she wrote in "The Age" in 2002. "Women were frightened into using hormone replacement therapy by dire predictions of crumbling bones, heart disease, loss of libido, depression, despair, disease and death if they let nature take its course." She argues that scaring women is "big business and hugely profitable". The book, including the medical information, was updated and reissued in 2018. Menarche
Menstruation is a cultural as well as scientific phenomenon as many societies have specific rituals and cultural norms associated with it. These rituals typically begin at menarche and some are enacted during each menstruation cycle. The rituals are important in determining a status change for girls. Upon menarche and completion of the ritual, they have become a woman as defined by their culture. Menopause
The grandmother hypothesis suggests that menopause was selected for humans because it promotes the survival of grandchildren. According to this hypothesis, post-reproductive women feed and care for children, adult nursing daughters, and grandchildren whose mothers have weaned them. Human babies require large and steady supplies of glucose to feed the growing brain. In infants in the first year of life, the brain consumes 60% of all calories, so both babies and their mothers require a dependable food supply. Some evidence suggests that hunters contribute less than half the total food budget of most hunter-gatherer societies, and often much less than half, so that foraging grandmothers can contribute substantially to the survival of grandchildren at times when mothers and fathers are unable to gather enough food for all of their children. In general, selection operates most powerfully during times of famine or other privation. So although grandmothers might not be necessary during good times, many grandchildren cannot survive without them during times of famine. Arguably, however, there is no firm consensus on the supposed evolutionary advantages (or simply neutrality) of menopause to the survival of the species in the evolutionary past. Menstruation
The first menstrual period occurs after the onset of pubertal growth, and is called menarche. The average age of menarche is 12 to 15. However, it may start as early as eight. The average age of the first period is generally later in the developing world, and earlier in the developed world. The average age of menarche has changed little in the United States since the 1950s. Menstruation
Menstruation is the most visible phase of the menstrual cycle and its beginning is used as the marker between cycles. The first day of menstrual bleeding is the date used for the last menstrual period (LMP). The typical length of time between the first day of one period and the first day of the next is 21 to 45 days in young women, and 21 to 31 days in adults (an average of 28 days). Menopause
The term "postmenopausal" describes women who have not experienced any menstrual flow for a minimum of 12 months, assuming that they have a uterus and are not pregnant or lactating. In women without a uterus, menopause or postmenopause can be identified by a blood test showing a very high FSH level. Thus postmenopause is the time in a woman's life that takes place after her last period or, more accurately, after the point when her ovaries become inactive. North American Menopause Society
NAMS also releases consumer educational materials such as the print resource "The Menopause Guidebook" and the e-mail newsletter "Menopause Flashes". Other educational resources related to menopause can be found at the NAMS website menopause.org. Menopause
Undiagnosed and untreated coeliac disease is a risk factor for early menopause. Coeliac disease can present with several non-gastrointestinal symptoms, in the absence of gastrointestinal symptoms, and most cases escape timely recognition and go undiagnosed, leading to a risk of long-term complications. A strict gluten-free diet reduces the risk. Women with early diagnosis and treatment of coeliac disease present a normal duration of fertile life span. Premature ovarian failure
The age of onset can be as early as 11 years, or can even exist from birth, but varies widely. If a girl never begins menstruation, it is called primary ovarian failure. The age of 40 was chosen as the cut-off point for a diagnosis of POF. This age was chosen somewhat arbitrarily, as all women's ovaries decline in function over time. However an age needed to be chosen to distinguish usual menopause from the abnormal state of premature menopause. Premature ovarian failure has components to it that distinguish it from normal menopause. Advanced maternal age
Women with an inherited mutation in the DNA repair gene "BRCA1" undergo menopause prematurely, suggesting that naturally occurring DNA damages in oocytes are repaired less efficiently in these women, and this inefficiency leads to early reproductive failure. Genomic data from about 70,000 women were analyzed to identify protein-coding variation associated with age at natural menopause. Pathway analyses identified a major association with DNA damage response genes, particularly those expressed during meiosis and including a common coding variant in the "BRCA1" gene. List of The Catherine Tate Show characters
In series three Elaine gives up on finding love on-line. Instead she attempts to have a baby with the aid of a sperm donor, but unfortunately her missed periods turned out to be the start of the menopause (a very early menopause, as her age is quoted in the first series as being 34). Oophorectomy
Removal of ovaries causes hormonal changes and symptoms similar to, but generally more severe than, menopause. Women who have had an oophorectomy are usually encouraged to take hormone replacement drugs to prevent other conditions often associated with menopause. Women younger than 45 who have had their ovaries removed face a mortality risk 170% higher than women who have retained their ovaries. Retaining the ovaries when a hysterectomy is performed is associated with better long-term survival. Hormone therapy for women with oophorectomies performed before age 45 improves the long-term outcome and all-cause mortality rates. Menopause
During perimenopause, estrogen levels average about 20–30% higher than during premenopause, often with wide fluctuations. These fluctuations cause many of the physical changes during perimenopause as well as menopause, especially during the last 1–2 years of perimenopause (before menopause). Some of these changes are hot flashes, night sweats, difficulty sleeping, mood swings, vaginal dryness or atrophy, incontinence, osteoporosis, and heart disease. During this period, fertility diminishes but is not considered to reach zero until the official date of menopause. The official date is determined retroactively, once 12 months have passed after the last appearance of menstrual blood. International Menopause Society
"Menopause Live" is a weekly service offered via email by the International Menopause Society. It offers recently published commentaries on scientific papers that may be of interest to members of the IMS. Menopause
Gabapentin or clonidine may help but does not work as well as hormone therapy. Clonidine may be associated with constipation and sleeping problems. Menopause
Adding testosterone to hormone therapy has a positive effect on sexual function in postmenopausal women, although it may be accompanied by hair growth, acne and a reduction in high-density lipoprotein (HDL) cholesterol. These side effects diverge depending on the doses and methods of using testosterone. Adolescence
The major landmark of puberty for males is spermarche, the first ejaculation, which occurs, on average, at age 13. For females, it is menarche, the onset of menstruation, which occurs, on average, between ages 12 and 13. The age of menarche is influenced by heredity, but a girl's diet and lifestyle contribute as well. Regardless of genes, a girl must have a certain proportion of body fat to attain menarche. Consequently, girls who have a high-fat diet and who are not physically active begin menstruating earlier, on average, than girls whose diet contains less fat and whose activities involve fat reducing exercise (e.g. ballet and gymnastics). Girls who experience malnutrition or are in societies in which children are expected to perform physical labor also begin menstruating at later ages. Life history theory
There is criticism of the claim that menopause and somewhat earlier age-related declines in female fertility could coevolve with a long term dependency on monogamous male providers who preferred fertile females. This criticism argues that the longer the time the child needed parental investment relative to the lifespans of the species, the higher the percentage of children born would still need parental care when the female was no longer fertile or dramatically reduced in her fertility. These critics argue that unless male preference for fertile females and ability to switch to a new female was annulled, any need for a male provider would have selected against menopause to use her fertility to keep the provider male attracted to her, and that the theory of monogamous fathers providing for their families therefore cannot explain why menopause evolved in humans. Menopause
Diverging from these conclusions, one study appeared to show that many American women "experience this time as one of liberation and self-actualization". Menopause
In the context of the menopause, hormone replacement therapy (HRT) is the use of estrogen in women without a uterus and estrogen plus progestin in women who have an intact uterus. Menopause
Perimenopause is a natural stage of life. It is not a disease or a disorder. Therefore, it does not automatically require any kind of medical treatment. However, in those cases where the physical, mental, and emotional effects of perimenopause are strong enough that they significantly disrupt the life of the woman experiencing them, palliative medical therapy may sometimes be appropriate. Menopause
An early menopause can be related to cigarette smoking, higher body mass index, racial and ethnic factors, illnesses, and the surgical removal of the ovaries, with or without the removal of the uterus. Hormone replacement therapy
A major complaint among postmenopausal women is decreased libido, and many may seek medical consultation for this. Several hormonal changes take place during the menopausal period, including a decrease in estrogen levels and an increase in follicle-stimulating hormone. For most women, the majority of change occurs during the late perimenopausal and postmenopausal stages. Decrease in other hormones such as the sex hormone-binding globulim (SHBG) and inhibin (A and B) also take place in the postmenopausal period. Testosterone, a hormone more commonly associated with males, is also present in women. It peaks at age 30, but declines with age, so there is little variation across the lifetime and during the menopausal transition. However, in surgically induced menopause, instead of the levels of estrogens and testosterone slowly declining over time, they decline very sharply, resulting in more severe symptoms. Hormone replacement therapy
The maintenance and improvement of quality of life during the menopausal period is at the core of estrogen and progestogen-based HRT. Both HRT and estrogen replacement therapy (ERT) have been shown to enhance sexual desire in a significant percent of women; however, as with all pharmacological treatments, not all women have been responsive, especially those with preexisting sexual difficulties. ERT restores vaginal cells, pH levels, and blood flow to the vagina, all of which deterioration are associated with the onset of menopause. Dyspareunia (due to vaginal dryness) appears to be the most responsive component of menopausal women’s sexuality to ERT. It also has been shown to have positive effects on the urinary tract and atrophy and may initially improve libido or sexual sensitivity. Other improvements in areas such as sexual desire, arousal, fantasies, and frequency of coitus and orgasm have also been noted. However, the effectiveness of ERT has been shown to decline in some women after long-term use. A number of studies have found that the combined effects of estrogen/androgen replacement therapy can increase a woman’s motivational aspects of sexual behaviour over and above what can be achieved with estrogen therapy alone. Findings on a relatively new form of HRT called tibolone — a synthetic steroid with estrogenic, androgenic, and progestogenic properties — suggest that it has the ability to improve mood, libido, and somatic symptoms of surgically menopausal women to a greater degree than ERT. In various placebo-controlled studies, improvements in vasomotor symptoms, emotional reactions, sleep disturbances, somatic symptoms, and sexual desire have been observed. However, while this is and has been available in Europe for almost two decades, this has not been approved for use in North America at this point. Menopause
The stages of the menopause transition have been classified according to a woman's reported bleeding pattern, supported by changes in the pituitary follicle-stimulating hormone (FSH) levels. European Menopause and Andropause Society
The official journal of the European Menopause and Andropause Society, Maturitas, is published on a monthly basis by Elsevier Science It covers a variety of disciplines, including management of chronic diseases, epidemiology, therapeutic techniques, and alternative medicine. The journal impact factor is 2.942. Margaret Rees serves as Editor-in-Chief. Menopause
It seems that Japanese women experience menopause effects, or "konenki", in a different way from American women. Japanese women report lower rates of hot flashes and night sweats; this can be attributed to a variety of factors, both biological and social. Historically, konenki was associated with wealthy middle-class housewives in Japan, i.e., it was a "luxury disease" that women from traditional, inter-generational rural households did not report. Menopause in Japan was viewed as a symptom of the inevitable process of aging, rather than a "revolutionary transition", or a "deficiency disease" in need of management. Menopause
Long-term effects of menopause may include osteoporosis, vaginal atrophy as well as changed metabolic profile resulting in cardiac risks. Sexual dysfunction
Whether or not aging directly affects women's sexual functioning during menopause is another area of controversy. However, many studies, including Hayes and Dennerstein's critical review, have demonstrated that aging has a powerful impact on sexual function and dysfunction in women, specifically in the areas of desire, sexual interest, and frequency of orgasm. In addition, Dennerstien and colleagues found that the primary predictor of sexual response throughout menopause is prior sexual functioning. This means that it is important to understand how the physiological changes in men and women can affect their sexual desire. Despite the seemingly negative impact that menopause can have on sexuality and sexual functioning, sexual confidence and well-being can improve with age and menopausal status. Furthermore, the impact that a relationship status can have on quality of life is often underestimated. European Menopause and Andropause Society
EMAS participates in a variety of medical congresses related to menopause, gynecology, and obstetrics each year. The society hosts its own European Congress every three years in a different European location each time. North American Menopause Society
Video Menopause
While it is fairly common for extant hunter-gatherers to live past age 50 provided that they survive childhood, fossil evidence shows that mortality in adults have decreased over the last 30000 to 50000 years (possibly due to innovations relating to defense from large carnivores and/or decrease in the ratio of large carnivores to humans) and that it was extremely unusual for early Homo sapiens to live to age 50. This discovery have led some biologists to argue that there was no selection for or against menopause at the time at which the ancestor of all modern humans lived in Africa and had not split into different ethnicities, suggesting that menopause is instead a random evolutionary effect of a selection shadow regarding ageing in early Homo sapiens. It is also argued that since the population fraction of post-menopausal women in early Homo sapiens was so low, menopause had no evolutionary effect on mate selection or social behaviors related to mate selection. Grandmother hypothesis
However, cross-cultural studies of menopause have found that menopausal symptoms are quite variable among different populations, and that some populations of females do not recognize, and may not even experience, these "symptoms". This high level of variability in menopausal symptoms across populations brings into question the plausibility of menopause as a sort of "culling agent" to eliminate non-reproductive females from competition with younger, fertile members of the species. This also faces the task of explaining the paradox between the typical age for menopause onset and the life expectancy of female humans. Pregnancy over age 50
Pregnancy over age 50 has, over recent years, become possible for more women, and more easily achieved for many, due to recent advances in assisted reproductive technology, in particular egg donation. Typically, a woman's fecundity ends with menopause, which by definition is 12 consecutive months without having had any menstrual flow at all. During perimenopause, the menstrual cycle and the periods become irregular and eventually stop altogether, but even when periods are still regular, the egg quality of women in their forties is lower than in younger women, making the likelihood of conceiving a healthy baby also reduced, particularly after age 42. It is important to note, that the female biological clock can vary greatly from woman to woman. A woman's individual level of fertility can be tested through a variety of methods. Menopause
Ethnicity and geography play roles in the experience of menopause. American women of different ethnicities report significantly different types of menopausal effects. One major study found Caucasian women most likely to report what are sometimes described as psychosomatic symptoms, while African-American women were more likely to report vasomotor symptoms. Disability and women's health
Women with physical disabilities are at a greater risk of having lower bone mass and are at risk for osteoporosis. Women with ID and Down syndrome often go through menopause at an earlier age than other women. Women with various disabilities sometimes show different symptoms from decreased estrogen levels during menopause. Oophorectomy
Women who have had bilateral oophorectomy surgeries lose most of their ability to produce the hormones estrogen and progesterone, and lose about half of their ability to produce testosterone, and subsequently enter what is known as "surgical menopause" (as opposed to normal menopause, which occurs naturally in women as part of the aging process). In natural menopause the ovaries generally continue to produce low levels of hormones, especially androgens, long after menopause, which may explain why surgical menopause is generally accompanied by a more sudden and severe onset of symptoms than natural menopause, symptoms that may continue until the natural age of menopause. These symptoms are commonly addressed through hormone therapy, utilizing various forms of estrogen, testosterone, progesterone, or a combination. Woman
Menarche, the onset of menstruation, occurs on average at age 12–13. Many cultures have rites of passage to symbolize a girl's coming of age, such as confirmation in some branches of Christianity, bat mitzvah in Judaism, or even just the custom of a special celebration for a certain birthday (generally between 12 and 21), like the quinceañera of Latin America. Menopause
Removal of the uterus "without" removal of the ovaries does "not" directly cause menopause, although pelvic surgery of this type can often precipitate a somewhat earlier menopause, perhaps because of a compromised blood supply to the ovaries.. The time between surgery and possible early menopause is due to the fact that ovaries are still producing hormones. Menopause
Ways of assessing the impact on women of some of these menopause effects, include the Greene climacteric scale questionnaire, the Cervantes scale and the Menopause rating scale. Menopause The Musical
A national tour of Menopause the Musical was presented to raise funds and awareness for the fight against ovarian cancer.Leslie Fischer at chicagocritic.com said "bring the waterproof mascara because you’ll laugh so hard, you’ll cry. With humor and compassion, writer, producer, and lyricist Jeanie Linders has captured the experiences of every woman in her 40s and 50s." Genessee Kagy of the Daily Californian wrote that "Menopause's collection of great oldies, clever tongue-in-cheek lyrics and entertaining dance routines prevented me from making any I-Need-Air trips to the restroom despite the fact that I hadn't felt like such a fraud since I turned eighteen-years old. Over 90 percent of the audience were women more than twice my age..." Menopause
Menopause confers:
Women who experience menopause before 45 years of age have an increased risk of heart disease, death, and impaired lung function. Menopause
Hot flashes and other vasomotor symptoms accompany the menopausal transition. While many sources continue to claim that hot flashes during the menopausal transition are caused by low estrogen levels, this assertion was shown incorrect in 1935 and, in most cases, hot flashes are observed despite elevated estrogen levels. The exact cause of these symptoms is not yet understood, possible factors considered are higher and erratic variation of estradiol level during the cycle, elevated FSH levels which may indicate hypothalamic dysregulation perhaps caused by missing feedback by inhibin. It has been also observed that the vasomotor symptoms differ during early perimenopause and late menopausal transition and it is possible that they are caused by a different mechanism. Menopause
Dogs do not experience menopause; the canine estrus cycle simply becomes irregular and infrequent. Although older female dogs are not considered good candidates for breeding, offspring have been produced by older animals. Similar observations have been made in cats. Menopause
Additionally, while most women in the United States apparently have a negative view of menopause as a time of deterioration or decline, some studies seem to indicate that women from some Asian cultures have an understanding of menopause that focuses on a sense of liberation and celebrates the freedom from the risk of pregnancy. Postmenopausal Indian women can enter Hindu temples and participate in rituals, marking it as a celebration for reaching an age of wisdom and experience. Dynamical systems theory
According to this model, stage transitions between age intervals represent self-organization processes at multiple levels (e.g., molecules, genes, cell, organ, organ system, organism, behavior, and environment). For example, at the stage transition from adolescence to young adulthood, and after reaching the critical point of 18 years of age (young adulthood), a peak in testosterone is observed in males and the period of optimal fertility begins in females. Similarly, at age 30 optimal fertility begins to decline in females, and at the stage transition from middle adulthood to older adulthood at 48 years, the average age of onset of menopause occurs. Catamenial epilepsy
During menopause, there are drastic changes in the production of gonadal hormones. Most of the reproductive hormones, including the estrogens, progesterone and testosterone, diminish initially (perimenopause), becoming irregular, often showing wide and unpredictable fluctuations. As menopause progresses, there is cessation of estrogen production by the ovaries. Rosciszewska was one of the first researchers to report an increased risk of seizures during perimenopause, but found a marked decreased risk of seizures during menopause if there was a catamenial relationship. This difference may be associated with the radical fluctuations of estradiol and progesterone during the perimenopausal period than what is experienced during the menopausal period and menstrual cycles of reproductive years. Recall that estrone is the predominant estrogen present during menopause (from subcutaneous fat), and little is known about the effect of estrone specifically on epilepsy. Women with epilepsy who do not follow a catamenial pattern may have an unpredictable increase or decrease in seizure activity in perimenopause and menopause, but women with catamenial epilepsy typically follow a more predictable pattern.