menopause (mĕn´əpôz) or climacteric (klīmăk´tərĬk, klī´măktĕr´Ĭk), transitional phase in a woman's life when the ovaries stop releasing eggs, ovarian production of estrogen and other hormones tapers off, and menstruation ceases. It results from declining ovarian function due to aging of the ovaries and is usually a gradual process. In the United States, natural menopause occurs at age 51 on average. Premature menopause (due to premature aging of the ovaries, debilitating disease, or infection) and artificial menopause (due to destruction of the ovaries by surgery, irradiation, or purposeful hormone therapy, as in severe premenstrual syndrome) may occur much earlier.

Menopause may pass with no signs other than cessation of menstruation, or it may be accompanied by menstrual changes (heavy or erratic periods), night sweats, hot flashes, and vaginal dryness. There is some debate as to whether emotional symptoms and "mood swings" are any more common during menopause than at any other age. Lower levels of estrogen following menopause may be accompanied by a variety of physical changes. For example, the risk of osteoporosis, in which the bones lose elasticity and become brittle, increases. In addition, levels of high-density lipoproteins (HDLs) decrease as low-density lipoproteins (LDLs) increase, arteries lose elasticity, and more body weight is redistributed to the waist area—all heightening the risk of heart disease. Other possible estrogen-related changes include stress incontinence due to loss of muscle tone in the pelvis, loss of elasticity in the skin, and hair thinning.

Estrogen replacement therapy (ERT) is a controversial treatment introduced in the 1970s for bodily changes that occur in menopause; beginning in the 1980s progestins were added to reduce the risk of uterine cancer. Although ERT eases hot flashes and other physical changes and appears to decrease the risk of osteoporosis, it has been linked to increases in breast cancer, heart disease, and stroke.

Other approaches to dealing with the physical changes include exercise to help circulation, increase bone density and HDL levels, and lower stress; lubricants for vaginal dryness; avoidance of smoking and excess alcohol; and dietary changes limiting protein and fat and increasing fiber and calcium. Natural remedies such as vitamins E and B6 or ginseng and other foods that contain or mimic estrogen are sometimes recommended, but research as to their efficacy has been limited.

See also uterus.

See publications of the National Institute of Child Health and Human Development; J. E. Huston and L. D. Lanka, Perimenopause: Changes in a Woman's Health after 35 (1997); Boston Women's Health Book Collective, Our Bodies, Ourselves for the New Century (1998).

The Columbia Encyclopedia, 6th ed. Copyright© 2014, The Columbia University Press.

Menopause: Selected full-text books and articles

Natural Menopause: The Complete Guide
Susan Perry; Kate O'Hanlan.
Perseus Books, 1997 (Revised edition)
The Impact of Menopause: Implications for Mental Health Counselors
Baldo, Tracy D.; Schneider, Mercedes K.; Slyter, Marty.
Journal of Mental Health Counseling, Vol. 25, No. 4, October 2003
Peer-reviewed publications on Questia are publications containing articles which were subject to evaluation for accuracy and substance by professional peers of the article's author(s).
Hormone Use in Menopause & Male Andropause: A Choice for Women and Men
Sheldon J. Segal; Luigi D. Mastroianni.
Oxford University Press, 2003
The Other within Us: Feminist Explorations of Women and Aging
Marilyn Pearsall.
Westview Press, 1997
Librarian’s tip: Chap. 6 "Friends or Foes: Gerontological and Feminist Theory"
You Don't Need a Hysterectomy: New and Effective Ways of Avoiding Major Surgery
Ivan K. Strausz.
Perseus Books, 2001
Librarian’s tip: Chap. 14 "Your Ovaries and Menopause"
Myths of Gender: Biological Theories about Women and Men
Anne Fausto-Sterling.
Basic Books, 1992 (2nd edition)
Librarian’s tip: Chap. 4 "Hormonal Hurricanes: Menstruation, Menopause, and Female Behavior"
Behavior, Health, and Aging
Stephen B. Manuck; Richard Jennings; Bruce S. Rabin; Andrew Baum.
Lawrence Erlbaum Associates, 2000
Librarian’s tip: Chap. 4 "Menopause as a Turning Point in Midlife"
Women's Mental Health in Primary Care
Kathryn J. Zerbe.
W. B. Saunders, 1999
Librarian’s tip: Chap. 11 "Menstruation, Pregnance, and Menopause"
Relationship of Blood and Bone Lead to Menopause and Bone Mineral Density among Middle-Age Women in Mexico City. (Environmental Medicine)
Latorre, Francisco Garrido; Hernandez-Avila, Mauricio; Orozco, Juan Tamayo; Medina, Carlos A. Albores; Aro, Antonio; Palazuelos, Eduardo; Hu, Howard.
Environmental Health Perspectives, Vol. 111, No. 4, April 2003
Peer-reviewed publications on Questia are publications containing articles which were subject to evaluation for accuracy and substance by professional peers of the article's author(s).
Understanding Menopause
Karen Ballard.
Wiley, 2003
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