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Menopause: Symptoms, Causes, Stages, And More


The beginning of menopause can be characterized by the discontinuance of both ovaries’ ability to function in women.

If a woman does not experience menstrual periods for a full 12 months, menopause is usually confirmed at this point.

Every woman experiences unique symptoms during the transitional phase from the perimenopausal to the menopausal stage.

Since the ovaries do not produce any hormones after menopause, doctors will prescribe medications that can fill in for your missing hormones.

Heart disease and osteoporosis are common complications that many women could experience following menopause.

Some other menopause symptoms may include irregular vaginal bleeding, urinary problems, vaginal problems, hot flashes, and mood swings.

There are various treatment options available that you can take to alleviate and get relief from postmenopausal symptoms.

However, the course of menopause treatment that each woman receives is unique. This article will provide in-depth insight into menopause.

What Is Menopause?

The term menopause describes[1] a woman’s end of the menstrual cycle.

A woman’s periods end permanently and she can no longer get pregnant once she reaches menopause.

Thus menopause is a progressive process[2] rather than an instantaneous one.

Menopause indicates that you cannot experience any bleeding as well as spotting for continuous 12 months.

Loss of ovarian follicles, follicular development, and ovulation during menopause cause[3] the cyclical production of progesterone and estrogen to stop.

Your ovaries might sometimes produce extremely low levels of estrogen and progesterone hormones after menopause.

These low hormonal levels increase the chance of developing certain medical conditions.

When Does Menopause Generally Begin?

Some women might experience menopause in their 40s while others might not experience it until 60 years old. Most women go through menopause around the age of 51.

Based on when your mother and your family’s other women went through menopause, you shall be able to have an estimate of when you might experience it as genetics have a crucial role in menopause.

Women usually go through menopause between 48 to 55 years. Sometimes menopause can happen in women who are less than 40 years old.

In medical terms, this is referred[4] to as premature menopause.

Women who reside in high altitudes and have never given birth, or smoked are more likely to experience premature menopause.

Cancer or premature ovarian failure are the other two major causes of early menopause affecting about one percent of females.

Causes Of Menopause

Menopause can happen for several reasons, including:

  • Oophorectomy: The procedure[5] in which the ovaries are removed is known as an oophorectomy.

    As soon as the ovaries get removed, instant menopause occurs because the ovaries can’t produce hormones anymore and thus periods would stop altogether.

  • Reproductive Hormones: The ovaries begin to produce fewer quantities[6] of the primary hormones responsible for menstruation, estrogen, and progesterone, as you approach your late 30s.

    This is a natural process that occurs in every woman. As a result, fertility decreases, and periods would eventually come to a stop when the ovaries can no longer produce eggs.

  • Chemotherapy And Radiation: Radiation and chemotherapy are cancer therapies that might contribute[7] to menopause.
  • Primary Ovarian Insufficiency: Primary ovarian insufficiency is a condition[8] wherein the ovaries are not able to produce enough hormones required for reproduction.

    This could be brought on by autoimmune or hereditary conditions that can also lead to premature menopause.

Symptoms Of Menopause

Your daily life, including work, family life, social life, and relationships might be significantly impacted by menopause symptoms.

Each woman might experience[9] these symptoms differently. There is a possibility that none of these symptoms will be present at all.

Before your period comes to an ultimate end, symptoms could begin months in advance.

Some symptoms might include:

  • Anger
  • Sadness
  • Agitation
  • Anxiety
  • Discomfort during intercourse
  • Muscle Or Joint Aches
  • Night sweats or hot flashes
  • fatigue
  • heart rate fluctuations
  • a sudden sensation of warmth in the chest and neck.
  • Insomnia (difficulty sleeping) and reduced energy levels
  • Your monthly periods may either become more frequent or less frequent

Stages Of Menopause

Menopause is a transition happening not by one specific event but over years. Every woman is bound to experience menopause in her life as she grows older.

She can no longer have her monthly periods and is also unable to conceive naturally because her ovaries stop releasing estrogen and eggs.

Menopause can be broken down into three transitional phases:

  1. Premenopause

    Premenopause is the beginning phase of menopause, during which a woman experiences a wide range of symptoms due to the abrupt change in their hormonal levels.

    Irregular menstrual cycles are the first primary indicator of premenopause followed by the steadily declining function of both ovaries.

    One thing to keep in mind is that several factors can cause abnormalities in menstrual bleeding.

    So, any medical illness needs to be ruled out at first, only after that one can become sure they have entered the premenopause phase.

    Premenopause usually lasts 3 to 4 years and can start several years before symptoms start showing up, which is normally felt in one’s late forties.

    The ovaries begin to decrease[6] the production of progesterone and estrogen during premenopause, which causes several symptoms.

    When the ovaries stop releasing eggs entirely, the premenopause stage is over.

  2. Menopause

    Women need to have a non-functional[2] monthly cycle for twelve months in a row to be regarded as in menopause.

    The ovaries at this stage have completely ceased to function and are no longer producing eggs.

    Women in their forties to sisters can experience menopause. However, most women, on average, begin to experience menopause around 51 years of age.

    The most prevalent discomfort menopausal women need to endure is hot flashes. Additionally, the pulse rate could also speed up with these hot flashes.

    As the pelvic floor after menopause becomes more relaxed, women might also experience incontinence in their urine, an increase in facial hair, thinner hair, and decreased fullness of their breasts.

  3. Postmenopause

    The term postmenopause is a reference to the absence of menstruation for more than a full year. A woman’s entire life will be spent in this stage.

    Hormone replacement medications[10] and a healthy[11] lifestyle are very much essential for women who have entered the postmenopausal period to prevent disorders arising from a lack of hormones.

    The danger for illnesses, such as heart disease and osteoporosis[12], might rise during the postmenopause phase as a result of the absence of estrogen levels.

    However, thankfully, during this period, other symptoms that characterized the premenopausal and menopausal years start to fade away, making most women physically comfortable.

Diagnosis Of Menopause

Laboratory tests may be used by doctors to confirm menopause[13] although the diagnosis can be easily made by the patient’s history itself.

Your doctor may check your prolactin level and thyroid function and could also order further tests depending on your physical examination and medical history.

Low estradiol (estrogen) levels and elevated FSH (follicle-stimulating hormone) levels are prime indicators of menopause.

However, the estradiol and FSH tests will be invalidated if you are on hormonal medication pills, such as using birth control tablets.

Living With Menopause

Lifestyle change is crucial[11] for women who have attained menopause.

Regular aerobic exercises, like jogging and swimming, as well as low-intensity exercises, like meditation and yoga, may be highly beneficial.

You can also take prescribed medications and over-the-counter medications to get relief from several menopausal symptoms. Before starting any medications, always consult with your doctor.

A healthy lifestyle could aid in reducing the risks of night sweats, hot flashes, cardiovascular disease, bone fractures, and osteoporosis, which women often face after menopause.

Make a habit to include healthy foods in your diet, drink less caffeine, take vitamin D and calcium supplements, give up alcohol and smoking, and engage in weight-bearing exercises.

Testosterone, progesterone, and estrogen are hormone replacement therapies[14] suggested by doctors that might help to lessen menopausal symptoms.

However, to lessen the risks of breast cancer, blood clots, stroke, or myocardial infarction, it is advised to use hormone replacement therapies at the lowest dose for the shortest amount of time possible.

If you choose to opt[15] for non-hormonal treatments, your doctor might prescribe you low-dose antidepressants (such as sertraline, citalopram, paroxetine, and fluoxetine), clonidine, and gabapentin.

Non-hormonal bisphosphonates (like ibandronate, risedronate, and alendronate) and estrogen receptor modulators are further treatment options for osteoporosis.


Women might experience several mid-life crises around their middle age and menopause is one of them.

However, most women could lead a healthy and active life throughout and for decades even after menopause.

A general health examination is often advised during menopause. This examination could include bone density scans, mammograms, breast examinations, cervical smears, and blood pressure checks.

Menopause might often significantly alter home life, employment, and relationships. It can feel overwhelming when these changes happen suddenly in one’s life.

But with the appropriate lifestyle and effective medications, you can remove its impact from your life.

Additionally, you should also talk to your healthcare professional about how to maintain your overall health in the upcoming years.


Working4Health prefers using primary and verified references. We have strict sourcing guidelines and our primary references include peer-reviewed research, academic, and medical institution studies.

  1. What Is Menopause? Content reviewed: September 30, 2021 Available from: https://www.nia.nih.gov/health/what-menopause
  2. Kimberly Peacock; Kari M. Ketvertis. Menopause Last Update: February 2, 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507826/
  3. Nanette Santoro and John F Randolph, Jr. Reproductive Hormones and the Menopause Transition Obstet Gynecol Clin North Am. 2011 Sep; 38(3): 455–466.doi: 10.1016/j.ogc.2011.05.004
  4. Early or premature menopause Page last updated: February 22, 2021 Available from: https://www.womenshealth.gov/menopause/early-or-premature-menopause
  5. Ashli A. Lawson; Rebecca M. Rentea. Oophorectomy Last Update: May 8, 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559235/
  6. Aging changes in the female reproductive system Available from: https://medlineplus.gov/ency/article/004016.htm
  7. Giok S. Liem, Frankie K. F. Mo, Elizabeth Pang, et al. Chemotherapy-Related Amenorrhea and Menopause in Young Chinese Breast Cancer Patients: Analysis on Incidence, Risk Factors and Serum Hormone Profiles PLoS One. 2015; 10(10): e0140842.Published online 2015 Oct 20. doi: 10.1371/journal.pone.0140842
  8. Lawrence M. Nelson Primary Ovarian Insufficiency N Engl J Med. 2009 Feb 5; 360(6): 606–614.doi: 10.1056/NEJMcp0808697
  9. Nanette Santoro, C. Neill Epperson, and Sarah B. Mathews Menopausal Symptoms and Their Management Endocrinol Metab Clin North Am. 2015 Sep; 44(3): 497–515.doi: 10.1016/j.ecl.2015.05.001
  10. Tomas Fait Menopause hormone therapy: latest developments and clinical practice Drugs Context. 2019; 8: 212551.
    Published online 2019 Jan 2. doi: 10.7573/dic.212551
  11. Hye-Ryoung Kim and Hwa-Mi Yang Facilitators and Inhibitors of Lifestyle Modification and Maintenance of KOREAN Postmenopausal Women: Revealing Conversations from FOCUS Group Interview Int J Environ Res Public Health. 2020 Nov; 17(21): 8178.Published online 2020 Nov 5. doi: 10.3390/ijerph17218178
  12. Meng-Xia Ji and Qi Yu Primary osteoporosis in postmenopausal women Chronic Dis Transl Med. 2015 Mar; 1(1): 9–13.
    Published online 2015 Mar 21. doi: 10.1016/j.cdtm.2015.02.006
  13. Menopause: diagnosis and management Available from: https://www.ncbi.nlm.nih.gov/books/NBK552590/
  14. Gina Harper-Harrison; Meaghan M. Shanahan. Hormone Replacement Therapy Last Update: February 17, 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493191/
  15. Nicoletta Biglia, Valentina E Bounous, Francesco De Seta, et al. Non-hormonal strategies for managing menopausal symptoms in cancer survivors: an update Ecancermedicalscience. 2019; 13: 909.Published online 2019 Mar 11. doi: 10.3332/ecancer.2019.909

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