menopausal

Menopausal is the adjective used to describe things related to menopause or to a person who is in the stage of life when menstrual periods permanently cease. Menopause marks the end of a woman's reproductive years. Clinically, menopause is defined as the permanent cessation of menses for 12 consecutive months, with perimenopause referring to the transitional period before this event.

Physiologically, menopause involves a decline in ovarian production of estrogen and progesterone, accompanied by rising levels of follicle-stimulating hormone. After menopause, most estrogen is produced outside the ovaries, mainly by peripheral conversion in adipose tissue. Natural menopause typically occurs in the early 50s, with a usual range of about 45 to 55 years. Surgical menopause can occur after removal of both ovaries.

Common menopausal symptoms include hot flashes, night sweats, sleep disturbance, vaginal dryness, urinary symptoms, and changes in mood or libido. Symptoms often begin in perimenopause and may persist for several years, though many people have mild or no discomfort.

Diagnosis is usually clinical, based on age and cessation of menses. Laboratory testing is not routinely required unless there are atypical features, heavy bleeding, suspected premature ovarian insufficiency, or when another condition might be contributing to symptoms.

Management is individualized and may include hormonal therapies, non-hormonal medications, and lifestyle measures. Hormone replacement therapy can relieve vasomotor symptoms and help protect bone health in appropriate candidates, but its risks and benefits must be discussed with a clinician. Non-hormonal options such as certain antidepressants, gabapentin, or clonidine can help some individuals. Local vaginal estrogen can treat dryness and discomfort. Regular exercise, adequate calcium and vitamin D, smoking cessation, and weight management support overall health.

See also: menopause, perimenopause, hormone replacement therapy.