Hot Flashes / Night Sweats   |   Weight Gain / Bloating   |   Lack of Sleep   |
|   Mood Swings / Depression / Anxiety  Memory Loss |   Sexual Dysfunction / Dryness

What is Menopause?

 The prevailing medical view of menopause is that when a woman runs out of eggs, she stops menstruating and goes into menopause.

A  woman is born with all her follicles (from which eggs can be matured) already formed.  Of the millions of follicles present before birth, about 300,000 are present at puberty. With every menstrual cycle, even those cycles when ovulation rarely occurs, estrogen production may remain adequate for menstruation. These women continue menstruation and are in a state of estrogen dominance. In other words, loss of fertility is due to the disappearance of follicles and their eggs rather than age.

Menopause occurs because as women age, the ovaries produce smaller and smaller amounts of estrogen and progesterone. Estrogen and progesterone are the hormones that control the monthly cycle of egg release. Thus, as women approach menopause, an egg is released in fewer and fewer cycles, and eventually, egg release stops. As a result, menstrual periods end and pregnancy is no longer possible.

A woman's last period can be identified only later, after she has had no periods for at least 6 months. (Women who do not wish to become pregnant should use birth control until 1 year has passed since their last menstrual period.)

Around 45 to 50, sometimes a little earlier or later, estrogen levels begin to fall. When they fall below the levels necessary to signal the uterine lining to thicken and gather blood, the menstrual flow becomes less and/or irregular, eventually stopping altogether.

Artificial menopause results from a medical treatment that reduces or stops hormone production by the ovaries. Examples are surgery to remove the ovaries, surgery that unintentionally reduces the blood supply to the ovaries, and chemotherapy or radiation therapy to the pelvis, including the ovaries, to treat cancer. Surgery to remove the uterus (hysterectomy) ends menstrual periods but does not cause menopause as long as the ovaries are functioning.

Symptoms Associated with Menopause

Hot flashes
Vaginal dryness and atrophy
Water retention
Fat and weight gain, especially in the hips and thighs and abdomen
Sleep disturbances
Decreased libido
Mood swings - depression, irritability
Headaches, fatigue
Short term memory lapses, lack of concentration
Dry, thin, wrinkly skin
Thinning of scalp hair, some increase of facial hair
Bone mineral loss (osteoporosis)
Diffuse body aches and pains

Excerpted from, "What Your Doctor May Not Tell You About Menopause" by John R. Lee, MD, and Virginia Hopkins. Visit www.johnleemd.com  for more information and to purchase the book. 

Also: excerpted from, "The Merck Manual of Medical Information" -Second Home Edition, edited by Mark H. Beers. Copyright 2003 by Merck & Co. , Inc., Whitehouse Station, N.J.

All Merck manuals are free online at  www.MerckBooks.com