Menopause

Definition and Symptomology

There is no definitive medical definition of menopause. Menopause is diagnosed retrospectively after 12 full months without menstruation. Despite the fact that there is no clear linkage between chronological and reproductive age, most medical professionals still use age as a marker to identify when menopause occurs. In Western countries, doctors place the age of menopause around 50 years, although hormone levels often decline in women in the preceding 8 to 10 years. In general terms, menopause, or climacteric, as it is characterized in medical terminology, occurs when the ovaries become less sensitive and/or resistant to certain hormones, which, in turn, causes a decrease in the production of estrogen. The reduction in hormone levels is categorized in terms of vasomotor (e.g., hot flashes, fatigue), atrophie (e.g., complaints related to urinary and reproductive systems), and psychological or sexual (e.g., breast tenderness, vaginal dryness) symptoms.

It is generally assumed that age of symptom onset is due to a combination of genetics and maternal activity during pregnancy. It is also assumed that the external environment and the female's behavior have an impact on eventual menopause experience. For instance, smoking and having multiple births (e.g., twins) are associated with significantly earlier menopause, while women who are married, from higher socioeconomic classes, and taking hormone replacements experience menopause later in life. It is unclear how such variables impact the onset of menopause, but clear associations have been demonstrated, and it has been established that late-stage menopause results in increased health risks, such as endometrial and breast cancers. Current research is unable to distinguish between the effects of the aging process and menopausal symptoms. For instance, the fatigue a woman in her 40s or 50s may experience could also be due to taking care of ailing parents, work-related stress, marital difficulties, or children leaving home for college. Menopause occurs during a normally stressful and challenging time in a woman's life, and any discussion of symptomology should be placed within such a context. Moreover, minimal research has been conducted on how menopause is experienced by lesbians, women of color, low-income women, and women with mental illness. As such, it is important to study menopause from a life span perspective, noting that symptoms vary according to the interaction between biology and sociocultural and sociosexual factors.

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