What is Menopause?
Menopause is the age when a woman’s ovaries stop producing hormones. This results in cessation of menstrual cycles. A woman is postmenopausal when she has had no menstrual cycles for 12 months. In the United States, the average age of menopause is 51. Prior to periods stopping, the hormones gradually decline. This time period is called peri-menopause and is typically from age 45-55. During the peri-menopausal transition, women may experience irregular menstrual cycles, hot flashes and night sweats due to declining estrogen levels.

Why does menopause occur?
The ovaries release two hormones called estrogen and progestin. Estrogen causes the lining of your uterus (called the endometrium) to grow and thicken. Typically on day 14, an egg is release from one of your ovaries. This is called ovulation. That egg then travels down the fallopian tube to your uterus. If the egg is not fertilized, you do not become pregnant. This causes your hormones to decrease which signals the uterus to shed the lining. This results in menstrual bleeding.

What happens during peri-menopause?
During peri-menopause, the hormones start to decline. This can result in:
• Changes in menstrual cycles – may be longer between periods, skipped periods, bleeding between periods, longer or heavier periods
• Vasomotor symptoms – such as hot flashes, night sweats
• Vaginal dryness or pain with intercourse
• Increased urinary tract infections and vaginal infections
• Decreased bone density, which can result in osteoporosis

If I had a hysterectomy, does that mean I am in menopause?
Not necessarily. A hysterectomy will not cause you to go into menopause unless the ovaries were removed as well. Removal of the ovaries, called oophorectomy, will result in immediate menopause if you are not menopausal already.

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