MENOPAUSE: WHAT IS IT?
For some unknown reason the ovaries have a ‘use-by’ date. After a time of useful function, when they can produce eggs to make babies, they and their neighbour (the uterus) down tools and walk off the job, so to speak. Usually the rest of the body has a couple of decades to go, but not the reproductive hardware.
The term ‘change of life’ has been used for generations to describe the various changes women experience around menopause. In many ways it is a suitable description, because it implies a major adjustment, and for many women menopause involves dramatic changes on many levels. It is also vague, and nonspecific. This is appropriate too, because different women may experience
different feelings and physical changes; it is not like chicken pox, when most people who have will describe the same symptoms.
Doctors have a specific definition of menopause. It is the last ever menstrual period a woman has. So in fact you don’t know you’ve had it till it’s gone. The average age at which this occurs is 51. Periods tent tobe erratic towards the end of reproductive years, a woman may have two or three a year before they eventually disappear. Some woman experience regular periods until an abrupt stop. The periods are deemed to have stopped if there have been none for six consecutive months. Peri-menopausal symptoms (peri- means around), the most common being hot flushes, may be experienced for many years either side of the last period. The time in which the symptoms are experienced is called the climacteric.
The reason for all these changes is that the ovaries slow down production of the sex hormones, namely oestrogen, progesterone and testosterone. It does not mean that there are no hormones produced after menopause, just that they are in much lower concentrations, and in different forms. The body is able to convert one type of hormone to another. In some women this conversion creates enough oestrogen-like hormone to prevent oestrogen deficiency symptoms. This may explain why some women have fewer noticeable symptoms than others.
Towards menopause the ovaries have also slackened off a little in their egg-producing duties. Not as many follicles start off, and the ones that do start may not make it to ovulation as reliably, so natural fertility starts to wane (it actually hits its peak in the twenties). By the forties fertility is significantly lower, but it is not recommended for couples to rely on this as a method of contraception. Many ’surprises’ are toddling around now as you read this.
As the hormone levels drop they dip below the threshold level required to build up a lining in the uterus. There is therefore nothing to shed, and so no period.
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