Menopause is a natural stage in the lives of all women. Technically speaking, the menopause is a date. This date is fixed retrospectively, once 12 months have gone by with no menstrual flow at all. At this point a woman is considered to be infertile and no longer needs to take contraception. Once the 12 months have elapsed, a woman is considered to have entered postmenopause.
 
The term ‘menopause’ is actually an umbrella term, covering the years leading up to the cessation of periods, the perimenopause, the menopause itself, and then the years following, the postmenopause. The perimenopause is actually defined as ‘the period immediately before the menopause and for the first year after the menopause’.
 
The typical age for the menopause in the West is 51, although the whole menopausal process can last a number of years. Most women start the menopause between the ages of 45–55, although it can occur as early as 35 or as late as 60.
 
If the menopause occurs in a woman who is under 40 years of age, it is known as premature menopause, under 45 it is called the early menopause. It is estimated that premature menopause affects 1% of women under the age of 40 and 0.1% of women who are under the age of 30.
 
The menopause occurs as the female hormones oestrogen and progesterone begin to decrease, with progesterone virtually halting altogether. It is these fluctuating hormones which cause the menopausal symptoms, which about 70–80% of women experience to varying degrees in the perimenopause. Sometimes these side effects can be very unpleasant and therefore challenging.
 
However, the severity of the symptoms are dependent, to a great degree, on lifestyle, nutrition and psychology. It does not have to be the end of good health and vitality, nor the end of femininity and a good sex life. The menopause is sometimes referred to as ‘the change’, but with knowledge about how to deal with the side effects and practical lifestyle tips, it does not have to be a change for the worst.
 
Non ‘Natural’ Menopause (Induced Menopause)
 
For medical reasons, the uterus must sometimes be surgically removed (hysterectomy) in a younger woman. Her periods will cease permanently, and the woman will technically be infertile, but as long as at least one of her ovaries is still functioning, the woman will not have reached menopause. Even without the uterus, ovulation and the release of the sequence of reproductive hormones will continue to cycle on until menopause is reached.
 
But in circumstances when a woman's ovaries are removed (oophorectomy), even if the uterus were to be left intact, the woman will immediately be in "surgical menopause". 
 
Perimenopause
 
Postmenopause