Written by Jan Schroeder, Ph.D.
By the year 2025, the World Health Organization estimates that 1.1 billion women will be age 50 or over, all of whom are or will soon be experiencing menopause. In fact, menopause affects so many women that the International Menopause Society, in collaboration with the World Health Organization, has designated Oct. 18 as World Menopause Day.
Menopause literally means “the permanent ‘pause’ of menses,” which signifies the end of a woman’s ability to have children. Typically, menopause is a natural and gradual process in which the ovaries reduce their production of the female sex hormones – estrogen and progesterone. These hormones allow a woman to become pregnant, cause menstruation, and affect many other functions in the body, such as the circulatory system, urogenital system (urinary and vaginal) and the bones. When the production of these hormones drops, menopausal symptoms may occur. While some women experience no menopausal symptoms, approximately 75 percent will experience some type of symptoms varying in degree of severity.
Most women experience natural menopause between the ages of 40 and 58, with the average age of onset around 51 years of age. It is interesting to note that while the average life expectancy of women has increased, the average age of menopause onset has remained the same for centuries.
Stages of Menopause
The misuse of terminology in the field of menopause can cause confusion and spread misinformation. The stages of menopause are not distinct, but rather overlap. Menopause is only one of several stages in the reproductive life of a woman. The World Health Organization defines the stages of menopause as:
- Pre-menopause – The entire reproductive period up to the final menstrual cycle. It is best defined as a time of “normal” reproductive function in a woman.
- Peri-menopause – Includes the time immediately prior to menopause and the first year after menopause. This is the time when a woman’s body slowly makes less of the hormones estrogen and progesterone, resulting in menopause symptoms. The onset of peri-menopause is typically between 45 and 60 years old and can span a two- to six-year period. There is no way to tell in advance how long this stage will take.
- Menopause – The permanent cessation of menstruation and fertility resulting from the loss of ovarian follicular activity. This stage can only be confirmed a year or more after the final menstrual cycle. Most women will experience natural menopause; however, in a few cases, premature or induced menopause is experienced (see sidebar). Menopause can be confirmed by 12 consecutive months without a menstrual period.
- Post-menopause – The period of time after the final menstrual period. Post-menopause can bring up new health issues due to the reduced production of the female hormones estrogen and progesterone. Two possible health concerns in post-menopausal women are osteoporosis and heart disease.
While some women view menopause as a nuisance, it can actually be a very enjoyable time of life for many women. Understanding the stages of menopause, as well as how exercise, nutrition, and treatment aid in symptom relief and may reduce menopausal health concerns, may assist you through this natural process.
- Natural menopause is a gradual process in which the ovaries reduce their production of the female sex hormones.
- Induced menopause occurs when both ovaries are surgically removed (with or without a hysterectomy) or when the ovaries are damaged by medical treatment such as radiation, chemotherapy or medications. Induced menopause causes an immediate discontinuation of ovarian hormones, which may lead to more severe menopausal symptoms. Hot flashes may be more severe, more frequent and last longer and the female has a greater risk of heart disease, osteoporosis and depression.
- Premature menopause is when a female enters menopause before the age of 40, whether natural or induced. Unfortunately, these women spend a greater portion of their lives without the protective benefits of their own estrogen, which puts them at an even greater risk for menopause-related health problems.
View the full fall 2009 issue of the ACSM Fit Society® Page online.