What is Postmenopause?

Post Menopause

The term "postmenopausal" describes women who have not experienced any menstrual flow for a minimum of 12 months, assuming that they have a uterus and are not pregnant or lactating. In women without a uterus, menopause or postmenopause can be identified by a blood test showing a very high FSH level. Thus postmenopause the time in a woman's life that take place after her last period or, more accurately, after the point when her ovaries become inactive.

The reason for this delay in declaring postmenopause is because periods are usually erratic at this time of life. Therefore, a reasonably long stretch of time is necessary to be sure that the cycling has ceased. At this point a woman is considered infertile; however, the possibility of becoming pregnant has usually been very low (but not quite zero) for a number of years before this point is reached.

Symptoms Related to Post Menopause

A woman's reproductive hormone levels continue to drop and fluctuate for some time into post-menopause, so hormone withdrawal effects such as hot flashes may take several years to disappear.

Any period-like flow during postmenopause, even spotting, must be reported to a doctor. The cause may be minor, but the possibility of endometrial cancer must be checked for.

What is Perimenopause?

Peri Menopause

The term "perimenopause", which literally means "around the menopause", refers to the menopause transition years, a time before and after the date of the final episode of flow. According to the North American Menopause Society, this transition can last for four to eight years. The Centre for Menstrual Cycle and Ovulation Research describes it as a six- to ten-year phase ending 12 months after the last menstrual period.

During perimenopause, estrogen levels average about 20–30% higher than during premenopause, often with wide fluctuations. These fluctuations cause many of the physical changes during perimenopause as well as menopause. Some of these changes are hot flashes, night sweats, difficulty sleeping, vaginal dryness or atrophy, incontinence, osteoporosis, and heart disease. During this period, fertility diminishes but is not considered to reach zero until the official date of menopause. The official date is determined retroactively, once 12 months have passed after the last appearance of menstrual blood.

The menopause transition typically begins between 40 and 50 years of age (average 47.5). The duration of perimenopause may be for up to eight years. Women will often, but not always, start these transitions (perimenopause and menopause) about the same time as their mother did.

In some women, menopause may bring about a sense of loss related to the end of fertility. In addition, this change often occurs when other stressors may be present in a woman's life:

• Caring for,  and/or the death of, elderly parents
• Empty nest syndrome when children leave home
• The birth of grandchildren, which places people of "middle age" into a new category of "older people" (especially in cultures where being older is a state that is looked down on)

Some research appears to show that melatonin supplementation in perimenopausal women can improve thyroid function and gonadotropin levels, as well as restoring fertility and menstruation and preventing depression associated with menopause.

What is Premenopause?

Premenopause

Premenopause is a term used to mean the years leading up to the last period, when the levels of reproductive hormones are becoming more variable and lower, and the effects of hormone withdrawal are present. Premenopause starts some time before the monthly cycles become noticeably irregular in timing

ABOUT PREMENOPAUSE
Premenopause is the first stage of the menopause process. Some experts define it as the time in a woman's life in which she is fully fertile. It starts with a woman's first period and finishes with the first symptoms of menopause, such as hot flashes and mood swings.

During premenopause, many women experience bodily discomforts, commonly known as premenstrual syndrome (PMS).

In this section, women can find information about the differences between premenopause and perimenopause, the average age range in which premenopause manifests in women, and the various tests they may choose to undergo to identify premenopause.

PREMENOPAUSE VS. PERIMENOPAUSE
For people who are not familiar with the terms premenopause and perimenopause, they can be very confusing. In order to set them apart, professionals in the medical field have proposed a basic difference:

• Premenopause. The time before perimenopause; women are typically fertile.
• Perimenopause. The time around menopause when menopause symptoms appear and periods are irregular.

PREMENOPAUSE AGE
It is hard to tell exactly how long premenopause will last. It begins when a girl has her first period and ends with the first typical signs of menopause, like hot flashes and loss of libido.

In most women, their first period usually appears in their early teens. On the other side of the spectrum, the first signs of hormone changes that lead to menopause usually show up in their early forties. For approximately 30 years, women are fully fertile, as long as they remain healthy and their hormones remain within the normal levels. Logically, as time passes by, women start experiencing hormone fluctuations. In order to identify them, read about some premenopause tests described in the next section.

PREMENOPAUSE TESTS
Women can order a series of tests to determine if she is still in premenopause, or if the typical hormonal changes related to menopause have already started.

The most common tests for women to identify if they are either in premenopause, or getting close to menopause, are:

Pregnancy Test
If irregular or missed periods occur, pregnancy needs to be ruled out. Women may mistake symptoms of pregnancy for premenopause, so it is important to determine the actual cause of the symptoms.

Thyroid Stimulating Hormone Test
Like a pregnancy test, women who are experiencing these symptoms might also want to rule out the possibility of an underlying thyroid problem, rather than premenopause symptoms.

Follicle Stimulating Hormone Test
This test is done to determine the amount of follicle stimulating hormone (FSH) that is present in a woman's body. This hormone maintains the regularity of a woman's menstrual cycle. This test can help determine how far along a woman is in the menopause transition.

What is Surgical Menopause?

Surgical Menopause

Menopause can be surgically induced by bilateral oophorectomy (removal of ovaries), which is often, but not always, done in conjunction with removal of the Fallopian tubes (salpingo-oophorectomy) and uterus (hysterectomy).[35] Cessation of menses as a result of removal of the ovaries is called "surgical menopause". The sudden and complete drop in hormone levels usually produces extreme withdrawal symptoms such as hot flashes, etc.

Removal of the uterus without removal of the ovaries does not directly cause menopause, although pelvic surgery of this type can often precipitate a somewhat earlier menopause, perhaps because of a compromised blood supply to the ovaries