What Is Menopause ?
There is significant disagreement about the definition of menopause. Some confusion exists because there are several stages of the natural menopause process. Technically, natural menopause is the transition between perimenopause and postmenopause, the entire process culminating with the ceasing of the menses, generally around age 50 for most women. During the time, called perimenopause, which can last anywhere from five to fifteen years, the brain continues to send out hormones trying to stimulate the development of ovarian follicles, and it is common for a woman’s ovaries to respond erratically, so that her hormones fluctuate a great deal from month to month. These fluctuations are responsible for many of the symptoms of perimenopause.
This natural menopause process itself is usually identified retrospectively, when it’s been a year since a last period. Susan Weed, in her book Menopausal Years: The Wise Woman Way, describes natural menopause as a metamorphosis, a change from one person to another, similar to puberty. It can be viewed as a hormonal shift mirroring puberty. The natural smooth hormonal rises and falls in our monthly cycle can become more like the waves of a rough sea, with pronounced peaks and valleys. Natural menopause occurs when the monthly cycle of ovulation comes to an end. This occurs because the ovarian supply of follicles and eggs decline sharply as a woman approaches menopause.
Eventually, though, the ovaries are no longer able to develop an egg for ovulation. Ovarian production of estrogen goes into a permanent decline, and progesterone is no longer produced. The lining of the uterus thins, since it isn’t being stimulated by high estrogen levels each month and monthly bleeding stops. At this time menopause has occurred, however, most refer to the term ‘menopause’ for both the perimenopausal years as well as the few years following menopause.
We cannot discount the importance of the postmenopausal ovary as it continues to produce hormones even after ovulation ends, producing some estrogen and also androgens (male hormones) including testosterone. Some of the androgens are converted to estrogen (estrone) in a woman’s fat tissue.
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