What is Menopause?

Menopause is diagnosed after 12 months of amenorrhoea resulting from the permanent cessation of ovarian function. The mean age at menopause is 51 years. The perimenopause, a time of changing ovarian function, precedes the final menses by several years.

Body changes leading to the menopause

A woman is born with around seven million ovarian follicles, these contain eggs that are released in every ovulation cycle. This reduction increases for women in their mid-thirties and mid-forties, number of follicles rapidly decreases. After this time period, the body stimulates the remaining follicles and during this time period cycles become irregular; this may mean they become heavier or lighter.

Women in their forties have follicles that are not quiet stimulated by the FSH as they were before this age. FSH levels increase and peak to about 10-15 times more than what is seen normally, this means the woman is approaching menopause. A blood test can measure levels of FSH during this time, however, it must be noted that these levels fluctuate considerably and doctors argue if these levels can accurately predict approach of menopause.

Heavy bleeding Before Menopause

When a woman is approaching menopause ovulation cycle doesn’t occur with every cycle but a woman does menstruate with each cycle since the uterus builds up its lining through Estrogen(natural hormonal feedback) levels. These cycles appear to be irregular, painless and heavy since ovulation occurs without an egg being released from the follicle (this is part of the natural ovulation/menstruation cycle).

The average age of menopause in Pakistan is between the ages of 45 and 55.

What factors contribute to the age at which a woman experiences menopause:

• Smoking-women who smoke undergo menopause 1.5-2 years earlier than those who don’t.
• Weight-women with a greater body mass tend to experience menopause later than thinner women.
• Genetics-it has been shown that women and daughters tend to experience menopause at a similar age.

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