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There is significant disagreement about the definition of menopause. Some confusion exists because there are several stages of the natural menopause process. Technically, natural menopause is the transition between perimenopause and postmenopause, the entire process culminating with the ceasing of the menses, generally around age 50 for most women.

This natural menopause process itself is usually identified retrospectively, when it's been a year since a last period. Susan Weed, in her book Menopausal Years: The Wise Woman Way, describes natural menopause as a metamorphosis, a change from one person to another, similar to puberty. It can be viewed as a hormonal shift mirroring puberty.

Natural menopause occurs when the monthly cycle of ovulation comes to an end. This is because the ovarian supply of follicles and eggs declines sharply as a woman approaches menopause. During this time, called perimenopause, which can last anywhere from five to fifteen years, the brain continues to send out hormones trying to stimulate the development of ovarian follicles, and it is common for a woman's ovaries to respond erratically, so that her hormones fluctuate a great deal from month to month. These fluctuations are responsible for many of the symptoms of perimenopause.

Eventually, though, the ovaries are no longer able to develop an egg for ovulation. Ovarian production of estrogen goes into a permanent decline, and progesterone is no longer produced. The lining of the uterus thins, since it isn't being stimulated by high estrogen levels each month, and monthly bleeding stops. Menopause has occurred. Don't discount the importance of the postmenopausal ovary, however! It continues to produce hormones even after ovulation ends, producing some estrogen and also androgens (male hormones) including testosterone. Some of the androgens are converted to estrogen (estrone) in a woman's fat tissue.

If you have questions about menopause or want to discuss treatment options, please contact Dr. Becton to schedule an appointment. 870.236.9988

Notes:

  • Symptom 1 (flashes) Hot flashes are due to the hypothalamic response to declining ovarian estrogen production. The declining estrogen state induces hypophysiotropic neurons in the arcuate nucleas of the hypothalamus to release gonadotropin-releasing hormone (GnRH) in a pulsatile fashion, which in turn stimulates release of luteinizing hormone (LH). Extremely high pulses of LH occur during the period of declining estrogen production. The LH has vasodilatory effects, which leads to flushing.
  • Symptom 7 (loss of libido) For some women the loss is so great that they actually find sex repulsive, in much the same way as they felt before puberty. What hormones give, loss of hormones can take away.
  • Symptom 8 (dry vagina) results in painful intercourse
  • Symptom 11 (doom thoughts) includes thoughts of death, picturing one's own death
  • Symptom 14(incontinence) reflects the ability to control the bladder
  • Symptom 15 (itchy, crawly skin) feeling of ants crawling under the skin, not just dry itchy skin
  • Symptom 16 (aching sore joints) may include such problems as carpal tunnel syndrome
  • Symptom 22 (depression) different from other depression, the inability to cope is overwhelming. There is a feeling of loss of self. Hormone therapy ameliorates the depression dramatically.
  • Symptom 25 (weight gain) often around the waist and thighs, resulting in 'the disappearing waistline'
  • Symptom 29 (shock sensation) "the feeling of a rubber band snapping in the layer of tissue between skin and muscle. It is a precursor to a hot flash"
  • Symptom 30 (tingling in extremities) can also be a symptom of B-12 deficiency, diabetes, alterations in the flexibility of blood vessels, or a depletion of potassium or calcium
  • Symptom 35* (tinnitus) one of those physical conditions that seems to manifest in some women at the same time as menopause. It can be associated with health conditions such as hypothyroidism and heart disease, and is a known side-effect of many medications, including aspirin (salicylates) and Prozac.

 

The 35 Signs of Menopause

  1. Hot flashes, flushes, night sweats and/or cold flashes, clammy feeling (see note)
  2. Irregular heart beat
  3. Irritability
  4. Mood swings, sudden tears
  5. Trouble sleeping through the night (with or without night sweats)
  6. Irregular periods; shorter, lighter periods; heavier periods, flooding; phantom periods, shorter cycles, longer cycles
  7. Loss of libido (see note)
  8. Dry vagina (see note)
  9. Crashing fatigue
  10. Anxiety, feeling ill at ease
  11. Feelings of dread, apprehension, doom (see note)
  12. Difficulty concentrating, disorientation, mental confusion
  13. Disturbing memory lapses
  14. Incontinence, especially upon sneezing, laughing; urge incontinence (see note)
  15. Itchy, crawly skin (see note)
  16. Aching, sore joints, muscles and tendons (see note)
  17. Increased tension in muscles
  18. Breast tenderness
  19. Headache change: increase or decrease
  20. Gastrointestinal distress, indigestion, flatulence, gas pain, nausea
  21. Sudden bouts of bloat
  22. Depression (see note)
  23. Exacerbation of existing conditions
  24. Increase in allergies
  25. Weight gain (see note)
  26. Hair loss or thinning, head, pubic, or whole body; increase in facial hair
  27. Dizziness, light-headedness, episodes of loss of balance
  28. Changes in body odor
  29. Electric shock sensation under the skin and in the head (see note)
  30. Tingling in the extremities (see note)
  31. Gum problems, increased bleeding
  32. Burning tongue, burning roof of mouth, bad taste in mouth, change in breath odor
  33. Osteoporosis (after several years)
  34. Changes in fingernails: softer, crack or break easier
  35. Tinnitus: ringing in ears, bells, 'whooshing,' buzzing etc. (see note)