Menopause, a phase that marks the permanent end of menstruation and fertility, is a natural biological process and is a normal part of every woman's health. While many women experience symptoms of fatigue, emotional and physical discomfort, and cramping, the earliest symptoms are often much more subtle.
A woman has officially begun to undergo menopause when it has been one year since her last period. In the United States, the average age for women undergoing menopause is 51.
When menopause begins, the ovaries begin making less estrogen and progesterone, two hormones that assist in regulating menstruation. This process generally begins in a woman's late 30s, when fewer potential eggs are ripening in the ovaries.
During this time, ovulation is less predictable, and thus fertility declines, perhaps due to hormonal changes in the body.
Symptoms of Perimenopause
Perimenopause, a natural process that occurs while a woman is still menstruating, is often the onset of menopause. Although the woman is still ovulating, she begins to experience menopausal symptoms, including rises and falls in hormone level and mood swings.
Women can also experience hot flashes and breast tenderness during this period. Generally, perimenopause lasts four to five years before giving way to menopause.
Early Symptoms of Menopause
The earliest symptom of menopause is a lack of regular periods. Because physicians consider menopause to occur one year after the last period, the first symptom a woman usually experiences is repeated missed periods.
Additional early symptoms include decreased fertility, vaginal dryness, disrupted sleep and mood swings. A woman can also experience hot flashes, and see an increase in abdominal fat and a thinning of hair.
Breasts sometimes also lose their fullness.
Earlier Onset of Menopause
Although the average age for women undergoing menopause is 51, some woman experience menopausal symptoms earlier if they have undergone prior medical procedures or conditions, including certain hysterectomy procedures, chemotherapy or radiation therapy, or premature ovarian failure. During a hysterectomy, a woman's uterus is removed but the ovaries continue to release eggs; however, if a woman undergoes a total hysterectomy or bilateral oophorectomy, menopause may begin with any pre-menopausal symptoms.
Chemotherapy and radiation therapy can also induce menopause, resulting in hot flashes and the onset of menopause. Premature ovarian failure also results in an earlier menopause.
Approximately one percent of women experience menopause before the age of 40.
Seeking Medical Attention
While menopause is a natural biological process, it is essential to communicate with your physician at the onset of perimenopause and menopause. If you have missed a period but are unsure if menopause has begun, it is important to meet with a doctor to determine whether you are pregnant.
Generally, physicians take a medical history, complete a pelvic exam and, if appropriate, order a pregnancy test. It is also essential to seek medical attention if you experience bleeding from the vagina after menopause.