Menopause is a part of the normal life cycle of women. Research
has discovered ways of effectively preventing or managing some
of the problems that can be associated with menopause.
Menopause is the cessation of ovulation; that is, the ovaries no
longer release eggs. It may occur prematurely as a result of the
failure of the ovaries to develop properly, because of immune
problems, or due to the surgical removal of the ovaries.
After menopause, the ovaries no longer secrete two critical
steroid hormones in the amount or pattern characteristic of a
regular menstrual cycle. These two hormones are estrogen and
Who is affected?
The average age of menopause is about 48 to 52 years. Fewer than
one of every 100 women experience menopause before age 40
(premature menopause). The transition from regular ovarian
function to its absence is often called the perimenopause or
climacteric. It can occur rapidly or slowly. The time involved
can range from a month or two to up to 5 years. Nowadays, the
average woman who reaches menopause will probably live another
30 or more years. Thus, the management of menopause, like that
of aging in general, is a medical and social issue.
What are its effects?
The loss of female hormone production can cause both acute and
chronic consequences in hormone-dependent tissues such as the
brain, bones, heart, blood vessels, and skin. After menopause,
women are at increased risk for osteoporosis, heart disease,
urinary incontinence, acute burning or itching of the vulva or
vagina, and painful sexual intercourse. At least half of women
also report symptoms such as night sweats and hot flashes,
insomnia, changes in mood and sexual desire, and a decrease in
memory or concentration. Changes in body or scalp hair or in
skin tone may also occur. After menopause, 70 percent of women
develop cardiovascular disease, and 30 percent develop
What is the role of endocrinology?
The medical management of menopause is in its infancy. The goal
is to improve the quality of the last third to one-half of a
woman's life by preventing the harmful consequences of estrogen
hormone deprivation. Preventing these problems will delay or
eliminate the need for medical treatment and nursing home care.
Estrogen and progesterone replacement therapy decreases symptoms
associated with menopause. The proper dosage, treatment
schedule, hormone preparation, and routes of administration of
estrogen replacement may vary for each individual.
Menopausal women should also think about other areas of their
health apart from those related to hormonal deficiency. Problems
like diabetes, osteoporosis, lipid disorders, hypertension all
increase in frequency with advancing age. These should also be