What is menopause?
Women usually experience menopause, the cessation of the menstrual period, when they're about 50 years old. However, the decrease in hormones, called climacteric, is a long process that begins when a woman is in her 40's and ends during her 70's. Changes occur in four main hormones that orchestrate the menstrual cycle: estrogen, progesterone, follicle stimulating hormone (FSH) and luteinizing hormone (LH).

After a woman has menstruated for 30 years, fewer of her follicles (the layer of cells that surround each egg in the ovary) mature each month, and the ones that do are less sensitive to hormones. As a result, cycles shorten or become irregular. Estrogen levels decrease and FSH levels increase. After 10 years of slowing down, there comes a day when estrogen is so low that menstruation stops and menopause begins. Medically, a woman is considered menopausal when she has no period for six to 12 months after age 45.

Although we recognize now that menopause is a natural part of life, not a disease or Weakness, it's difficult to erase years of myths and stereotypes. Menopause was basically ignored by doctors until the mid-nineteenth century. When it was finally acknowledged, many physicians spent the next 60 years perpetuating the image of the irascible menopausal woman. Even today, women are seen as overanxious about their health leading some doctors to judge "women's complaints" as emotionally based (1).

Opinions about menopause vary between cultures. In Japan, for example, menopause is seen as a natural transition into the latter part of life. One survey reported under 10 percent of Japanese women have hot flushes, whereas some American physicians claim that 85 percent of their menopausal patients experience these symptoms (2).

What causes menopausal symptoms? Psychologists may point to early, unresolved conflicts that resurface during climacteric as the cause. Sociologists emphasize life changes, such as the death of parents. Physicians list deficient estrogen levels as the reason (2).

Menopausal Symptoms
Most of us are familiar with the most common menopausal symptom: the hot flush or flash. Reddening of the head, neck and chest accompanied by heat and perspiration can last for seconds or half an hour. Flushes can plague a women for one, five or even 10 years. They are most severe at night, during stress or following alcohol consumption.

Atrophic vaginitis, a dry, itching vagina, can also result from estrogen decline. This and a change or decrease in libido can temporarily alter a woman's sexual activity. However, when older married women are compared to older married men, the percentage who has sex is almost identical.

A group of more subjective complaints has been labeled "menopausal syndrome". These include fatigue, nervousness, headaches, insomnia, depression, irritability, dizziness, palpitations, and joint and muscle pains. Some of these vague symptoms are blamed on hot flushes. For instance, wouldn't waking up in the middle of the night drenched in sweat give you insomnia, make you feel tired and subsequently irritable, nervous and perhaps give you headaches?