Menopause
La menopause corresponds to the end of the woman’s reproductive period, usually around the age of 50. It is marked by the cessation of menstruation as well as the cessation of ovulation and the secretion by the ovaries of sex hormones (estrogen and progesterone).
Medically speaking, a woman is known to be postmenopausal when she has not no period during 12 consecutive months. However, the onset of menopause, i.e. the permanent cessation of periods, is at the start of these 12 months. It can therefore only be established retrospectively.
The period of 2-7 years that precedes menopause is called perimenopause (and not premenopause). Ovulation becomes more irregular. The estrogen level can vary dramatically. It is during these years of transition that menstrual irregularities and bothersome symptoms appear: hot flashes, sleep disturbances, mood swings, etc.
Premenopause: | Period of fertility, from puberty |
Perimenopause: | Irregular periods: 2 to 7 years |
Menopause *: | No menstruation for at least 1 year |
* Some people use the term postmenopause to describe the period of time after menopause, which is not entirely appropriate since menopause is a definitive state. A woman will be said to be “menopausal”.
The intensity of symptoms varies from woman to woman: some have no symptoms other than stopping the menstruation, while others have moderate to severe symptoms (20-30% of women).
Note. After menopause, although the ovaries no longer secrete estrogen, the adrenal glands and adipose tissue (fat stores) continue to release small amounts of it.
Premature menopause
What triggers menopause? Each woman begins her life with a specific quantity of oocytes, the female sex cells. However, menopause is not triggered when all the oocytes have been used. A woman has about 30 oocytes. Only 000 of them will go through the ovulation cycle. The age of menopause is mostly determined by genes. It can also be influenced by the state of health. |
When the menopause occurs before the age of 40, it is considered premature. Premature menopause can occur spontaneously or be caused by illness, medication, surgery, or radiation or chemotherapy treatment.
For example, the surgical removal of the 2 ovaries causes menopause. On the other hand, removing the uterus (hysterectomy) alone is not enough to cause menopause (because the ovaries continue to produce estrogen), but stops the periods. Cancer treatments, such as chemotherapy or radiotherapy, can lead to a more gradual cessation of periods. The effect of these treatments on the menstrual cycle depends on their potency. Periods may return when treatment is stopped.
More or less long term consequences
The drop in estrogen puts women at greater risk for various health problems, such as osteoporosis, stress urinary incontinence, and cardiovascular problems. This is one risk factor among others. To learn more about the prevention of these conditions, consult these sheets.