Natural Menopause
When menopause occurs naturally, it tends to take place anywhere between the ages of 48 and 52, but it can occur as early as your late 30s, or as late as your 50s. When menopause occurs before 35, it is technically considered premature menopause, but just as menarche is genetically predetermined, so is menopause. For an average woman with an unremarkable medical history, what she eats or does in terms of activity will not influence the timing of her menopause. Women who have had chemotherapy, though, or have been exposed to high levels of radiation (such as radiation therapy in their pelvic area for cancer treatment) may go into menopause earlier. In any event, the average age of menopause is 50.
Other possible causes of early menopause include mumps (in small groups of women, the infection causing the mumps has been known to spread to the ovaries, prematurely shutting them down) and specific auto-immune diseases, such as lupus or rheumatoid arthritis (in some of these women, their bodies develop antibodies and attack the ovaries). Smokers also tend to have earlier menopause.
The stages of natural menopause
Socially, the word menopause refers to a process, not a precise moment in the life of your menstrual cycle. Medically, the word menopause does indeed refer to one precise moment: the date of your last period. The events preceding and following menopause amount to a huge change for women, both physically and socially. Physically, this process has four stages:
1. Premenopause. Although some doctors may refer to a 32-year-old woman in her childbearing years as premenopausal, this is not really an appropriate label. The term premenopause ideally refers to women on the cusp of menopause. Their periods have just started to get irregular, but they do not yet experience any classic menopausal symptoms such as hot flashes or vaginal dryness. A woman in premenopause is usually in her mid-to-late 40s. If your doctor tells you that you’re premenopausal, you might want to ask him or her how he or she is using this term.
2. Perimenopause. This term refers to women who are in the thick of menopause. Their cycles may be wildly erratic, and they are experiencing hot flashes and vaginal dryness. This label is applicable for about four years, covering the first two years prior to the official “last” period to the next two years following the last menstrual period. Women who are perimenopausal will be in the age groups discussed above, averaging about age 51.
3. Menopause. This refers to your final menstrual period. You will not be able to pinpoint your final period until you’ve been completely free from periods for one year. Then, you count back to the last period you charted, and that date is the date of your menopause. Note: After more than one year of no menstrual periods, any vaginal bleeding is now considered abnormal.
4. Postmenopause. This term refers to the last third of most women’s lives, ranging from women who have been free of menstrual periods for at least one year to women celebrating their 100th birthday. In other words, once you’re past menopause, you’ll be referred to as postmenopausal for the rest of your life. The terms postmenopausal and perimenopausal are sometimes used interchangeably, but this is technically inaccurate.
Used in a social context, nobody really bothers to break down menopause as precisely. When you see the word menopausal in a magazine article, you are seeing what’s become acceptable medical slang, referring to women who are premenopausal and perimenopausal, a time frame that includes the actual menopause. When you see postmenopausal in a magazine article, you are seeing another accepted medical slang, which includes women who are in perimenopause and “official” postmenopause.
Source: The Gynaecological Sourcebook, Third Edition
(More on menopause next week)
