Menopause is derived from the Greek word menos (month) and pause (to stop) refers to the last menstrual period and is generally considered to have occurred after 1 year of amenorrhea. At the age of 45- 50 years:

• The sexual cycles in a female usually become irregular;

• Ovulation fails to occur during many of the cycles.

After a few months to a few years, the cycles cease and the female sex hormones diminish rapidly to almost none at all. Sometimes the phrase the change of life is used and often doctors use the term climacteric.

Whom does menopause affect

Menopause, occurring on an average at the age of 45, is a normal event but it leads to much pathology in excess of that of the normal aging process. The average age of menopause has not changed for centuries. The age of menopause seems unrelated to socioeconomic factors, race, weight or height although severe malnutrition or cigarette smoking may result in an earlier onset.

The real importance of menopause today lies in the increasing longevity of the 20th century woman. With the increased longevity, women will now spend a third of their lives in the postmenopausal state (characterized by estrogen deficiency) attendant to many long-term symptomatic and metabolic complications.

Why does menopause occur

The cause of menopause is burning out of the ovaries. The aging of the ovary begins even before birth when a progressive decline in the number of primordial follicles compresses. The percentage of growing follicles increases substantially at puberty and is maintained throughout reproductive life and declines in the climacteric period (period of time around menopause).

• Natural menopause: Estrogens are produced in sub critical quantities for a short time after menopause, but over a few years falls almost to zero.

• Artificial menopause: Besides natural menopause, loss of ovarian function can also occur in patients receiving pelvic radiation or chemotherapy or those having ovarian failure or bilateral surgical removal of ovaries.

What are the different phases of menopause

Menopause can be divided into three phases:

• Pre-menopause: There is a little disruption of the ovarian function and the menstrual cycle remains regular. Some symptoms may begin to occur in this phase.

• Peri-menopause: This phase represents declining ovarian function with menstrual irregularities and symptoms commonly start or become troublesome during this time.

• Post-menopause: Once there have been no menses for 12 months the post-menopause phase is entered.