Menopause

What does menopause mean?

Menopause is derived from the Greek words mensis (month) and pauses (cessation). It means the permanent end of menstruation (menstrual periods). Menopause is considered permanent when a woman has not had a menstrual period for 12 months, without another medical cause.

When does menopause usually occur?

Menopause can happen naturally, commonly around the age of 50. However, some women stop menstruating at an earlier age (at age 45 or younger) or at a later age than usual. Menopause can also occur following surgical removal of both ovaries (known as bilateral ovariectomy or bilateral oophorectomy). Women who undergo surgical menopause have an abrupt menopause that may take place at an earlier age than would have happened naturally. Early menopause is also common in women who have had radiation to the pelvic area or some types of chemotherapy to treat cancer.

Why does menopause occur?

Menopause is triggered by a decrease in the estrogen and progesterone levels produced by the ovaries. Estrogen is a female hormone that has many functions. One function of estrogen is to protect bone by reducing bone loss.

Why is menopause a primary cause of osteoporosis?

The drop in estrogen level that happens at menopause increases a woman's risk of bone loss and osteoporosis. In the first five years after menopause, a woman can lose up to 15% of her lifetime skeleton without estrogen protection. When the natural onset of menopause comes earlier than expected or when it is caused by the surgical removal of both ovaries, a woman's estrogen protection is reduced for a longer period of time.

What can be done to prevent the bone loss associated with menopause?

Knowledge of what to expect at menopause can empower a woman to make this phase of her life a new beginning. When you reach menopause, it is important to consult your medical professional to discuss your risk factors for osteoporosis, to see if a bone density test is recommended, and to discuss the best strategies to prevent bone loss.

All women should follow the strategies to promote healthy bones. These include reducing modifiable risk factors for osteoporosis, achieving optimal nutrition, and making healthy lifestyle choice. In some cases, medical professionals may prescribe estrogen therapy (ET) or hormone therapy (HT) for women who have an early menopause. ET or HT is often prescribed for the relief of the most common menopausal symptoms experienced by women including hot flashes, night sweats and other genitourinary symptoms including vaginal dryness. You and your medical professional must carefully weigh the benefits and risks of taking estrogen therapy or hormone therapy, taking into consideration your menopausal status as well as your personal and family history of osteoporosis, heart disease, and certain cancers. See Estrogen Therapy and Hormone Therapy.

For more information about menopause, click on The North American Menopause Society website.