Natural menopause is a biological event heralded by the end of your period and your ability to become pregnant. A woman’s final menstrual period occurs when her ovaries run out of eggs. The process of natural menopause generally takes from 1 to 7 years, and typically ends in a woman’s 50s, although some women enter menopause prematurely, before age 40.
Induced menopause occurs when a woman’s ovaries are removed surgically, through total hysterectomy (also known as bilateral oophorectomy), or sometimes as a result of medical treatment such as chemotherapy or pelvic radiation.
In contrast to natural menopause, induced menopause is abrupt, with immediate cessation of periods and often more severe menopausal symptoms.
During your mid-thirties, progesterone levels slowly begin to decline, followed by estradiol during your forties. This decline accelerates closer to menopause. At this time, your testosterone levels also decline slightly.
Any time between the ages of 35 and 50, your monthly cycles may become markedly irregular and you may experience physical and emotional changes of ‘perimenopause’ – traditionally defined as the years surrounding your last menstrual period. Signs and symptoms of perimenopause vary in every woman. Some women experience gradual changes over several years, while others may have symptoms that are more intense but that last only a few months.
A perimenopausal woman will still have a menstrual cycle, although her cycle may become erratic and she may skip periods as her hormone levels fluctuate. She may also notice that PMS-like symptoms either begin, if she has not had them before, or become noticeably more intense. A perimenopausal woman may also experience symptoms such as hot flashes or night sweats, stress incontinence and other symptoms also reported during the post-menopausal phase.
Menopause is technically defined as a woman’s last menstrual period. Most physicians consider a woman to be post-menopausal when she has not menstruated for 12 months.