Menopause is defined as the time of cessation of ovarian function resulting in permanent amenorrhoea. It takes  12 months of amenorrhoea to confirm that menopause.

Cessation before age 40, termed premature ovarian failure, is associated with an elevated  follicle-stimulating hormone (FSH)

Climacteric is the phase of waning ovarian activity, and may begin 2–3 years before menopause and continue for 2–5 years after it.

Menopause normally occurs between the ages of  45 and 50 years.

Hormone Levels

Reduction in androgen production

Reduction in oestrogen

Reduction in growth hormone

Menopausal Symptoms


The three classical ways in which the menstrual period ceases are as follows

  • Sudden cessation
  • Gradual diminution in the amount of blood loss with each regular period until menstruation stops
  • Gradual increase in the spacing of the periods until they cease for at least a period of 1 year

2.Hot Flushes

Hot flushes are the waves of vasodilation affecting the face and the neck and these last for 2–5 min each. These are followed by severe sweating.The hot flushes are sometimes preceded by headache. Palpitation and anginal pains may be felt. With passage of time, the frequency and severity of flushes diminish over a period of 1–2 years.

Hot flushes are caused by noradrenaline, which disturbs the thermoregulatory system. Oestrogen deficiency reduces hypothalamic endorphins, which release more norepinephrine and serotonin. This leads to inappropriate heat loss mechanism.


Sexual feeling and libido may increase in some, if they feel happy to get rid of menstruation and fear of pregnancy.

4.Urinary Tract

  • Dysuria,
  • Stress incontinence and urge
  • Recurrent infection (urethral syndrome)


  • Atrophic vagina reduces the vaginal secretion, and dry vagina can cause dyspareunia.
  • Postcoital bleeding
  • Poor arousal, orgasm, desire
  • Vulvovaginal: Urethral prolapse irritation, burning, itching


  • Depression
  • Loss of memory
  • Irritability
  • Poor concentration
  • Tiredness
  • Mood swings

7.Late Manifestations

  • Arthritis,
  • Osteoporosis and fracture,
  • Backache
  • Cardiovascular accidents such as Ischemic Heart Disease, Myocardial Infarction, Atherosclerosis and Hypertension
  • Stroke
  • Alzheimer’s disease
  • Ano-colonic cancer
  • Tooth decay
  • Prolapse genital tract
  • Stress incontinence of urine and faecal incontinence
  • Cataract, glaucoma and macular degeneration
  • Osteoarthritis


  • Obtain adequate sleep every night
  • Exercise regularly to reduce stress
  • Avoid long work hours and maintain your personal schedule
  • If stress is environmental, take vacations, switch jobs, or approach your company or family to help resolve sources of stress
  • Limit intake of alcohol, drugs, and nicotine
  • Eat a healthy, well-balanced diet
  • Drink adequate amounts water (8 to 10 glasses) during the early part of the day



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