Menopause is chronologically the second major change that occurs in female development and is controlled by hormones. Menopause is the time when ovulation and menstruation cease and fertility ends. Climacteric is a term used to refer to the transition from the reproductive phase to the non-reproductive phase in a woman's life. Menopause typically occurs between ages 49 and 52 and is caused by a decrease in production of estrogen and progesterone. Through the natural hormonal feedback loop, decreases in estrogen and progesterone cause higher levels of FSH and LH to be released from the pituitary. However, menopause can occur earlier for women who have a hysterectomy (surgical removal of the uterus) or surgical removal of the ovaries, as well as for women who undergo certain types of chemotherapy.
Because of fluctuations in estrogen and progesterone levels, menopause is often preceded by irregular menstrual periods, in which menstruation may become lighter or heavier and duration may shorten or lengthen. Other symptoms, such as difficulty sleeping, mood changes, vaginal dryness, and hot flashes, the sudden sensation of feeling hot and sweaty, can occur during this time as well. A woman is not considered to have gone through menopause until she has had no menstrual periods for at least one year. As menopause occurs, other signs may be present, such as shrinking of the genitals, weight gain, incontinence, headaches, backache, flattened breasts, loosened teeth, dry skin, and dizziness. Hot flashes and vaginal dryness may make day-to-day living for some women very uncomfortable. One treatment option to help women through this period of their life is hormone replacement therapy, or HRT. HRT supplies women with estrogen replacement to help control these symptoms. Estrogen can be prescribed in the form of an oral tablet, skin patch, topical cream or ointment, or vaginal ring or tablet.Women who have experienced menopause are at higher risk for cardiovascular disease, osteoporosis, and decrease in lung function, although it is unclear whether this increase in risk is associated with menopause itself or with the aging that menopause accompanies.