As defined by the World Health Organization, menopause is the permanent cessation of menstruation due to the loss of ovarian follicular activity . This definition uses both a symptom that can be identified by a woman (the end of menstruation) and a sign that can be measured (the loss of follicular activity results in changes in levels of hormones). Investigators have generally agreed to define menopause as the last menstrual period followed by at least twelve months of amenorrhea (no menstrual bleeding). The advantage of this definition is that it identifies a single, measurable variable within the climacteric transition. This definition makes it possible to compute median or mean ages at menopause for inter- and intrapopulation comparisons. The definition also allows one to delineate a clinically normal range in age at menopause (for example, ages forty to sixty). Finally, this definition enables clinicians to identify
women who are postmenopausal for medical “management.” But while thelast menstrual period is a clinically useful marker of an event, the average woman’s sense of the process of the menopausal transition is better described by the term “perimenopause,” a gray, difficult-to-define time period during which a woman wonders if each period of bleeding is the last.
K. I know thats too complicated so take this:
Stages and Definitions of the Menopause Transition
Premenopause: Regular cycling. Having experienced a menstrual period
during the two months prior to study.
Perimenopause: Irregular cycling. Having experienced a menstrual period
from three to eleven months prior to study.
Postmenopause: Having experienced the last menstrual period at least
twelve months prior to study
That said, women still perceive menopause to be a marker for the end of childbearing because most women have no other “window” into the state of their ability to conceive. The end of menstruation can, therefore, be an emotionladen event. Some women react to the cessation of menstruation with relief (no more birth control); others describe deep sadness because they can no longer bear children.
Showing posts with label menstrual periods. Show all posts
Showing posts with label menstrual periods. Show all posts
Sunday, October 26, 2008
Menopause: Is it a one time event or an ongoing process?
Menopause is often treated as a onetime, life history event for cross-species and cross-cultural comparisons, as well as a medical event (a marker of estrogen decline). Women themselves, however, usually experience menopause as a more gradual, transitional process.
Menopause as a Process
The last menstrual period is an event that occurs within the transition from a reproductive to a postreproductive stage of life. In most countries this transition period is called the climacteric, but in the United States researchers speak more commonly of the “perimenopause”.
In general, the climacteric or perimenopausal transition begins when menstrual periods become irregular and ends one year after the last menstrual period. The word “climacteric” comes from the Latin word climactericus, meaning “of a dangerous period in life,” or from the Greek word klimakterikos, from klimakter, meaning “a dangerous point, the rung of a ladder.” “A dangerous period in life” may seem less favorable than “perimenopause”; however, because the word “climacteric” is used more often internationally, I employ both terms.
Menopause is related to the climacteric much as menarche is related to puberty. In other words,
menopause is the most prominent signal that the female body is exiting the reproductive period, just as menarche is the most prominent signal that the female body is entering it. There is a major difference, however, between menopause and menarche. While the first menstrual period is unmistakable, the last menstrual period is only certain in retrospect—enough time has to elapse before one can be sure.
Understanding menopause as a transitional process involves understanding
the hormonal changes that accompany the transition, the symptoms associated
with the process, as well as the various aspects of life that influence the
experience along the way
Menopause as a Process
The last menstrual period is an event that occurs within the transition from a reproductive to a postreproductive stage of life. In most countries this transition period is called the climacteric, but in the United States researchers speak more commonly of the “perimenopause”.
In general, the climacteric or perimenopausal transition begins when menstrual periods become irregular and ends one year after the last menstrual period. The word “climacteric” comes from the Latin word climactericus, meaning “of a dangerous period in life,” or from the Greek word klimakterikos, from klimakter, meaning “a dangerous point, the rung of a ladder.” “A dangerous period in life” may seem less favorable than “perimenopause”; however, because the word “climacteric” is used more often internationally, I employ both terms.
Menopause is related to the climacteric much as menarche is related to puberty. In other words,
menopause is the most prominent signal that the female body is exiting the reproductive period, just as menarche is the most prominent signal that the female body is entering it. There is a major difference, however, between menopause and menarche. While the first menstrual period is unmistakable, the last menstrual period is only certain in retrospect—enough time has to elapse before one can be sure.
Understanding menopause as a transitional process involves understanding
the hormonal changes that accompany the transition, the symptoms associated
with the process, as well as the various aspects of life that influence the
experience along the way
My thoughts on Menopause
There are three questions driving my interest in menopause:
Why did menopause evolve?
Why do some women experience menopause at forty-two, while others cycle like clockwork to the age of fifty-eight?
Why does menopause pass unnoticed for some women, while others suffer from unrelenting hot flashes?
Oh! sorry. Its not over I got some other 'SERIOUS' questions too;
Why do human females close down childbearing long before the end of life, while most chimpanzees reproduce until shortly before death?
Why didn’t my mother have any hot flashes, while other women remove strategic layers of clothing and visibly sweat?
Bring up the topic of menopause, and I’m more than happy to contribute curious observations, interesting hypotheses, and leaps of biological faith. Yet there are so many questions that I can’t answer. Friends and colleagues at work ask, “I can’t remember names anymore. Is that menopause?” “My left arm goes numb. Is that menopause?” “I want to have sex twice a day. Is that menopause?” “I’m more depressed than I have ever been. Is that menopause?”
Variation in age at menopause and in symptom experience can be understood
at the level of the population by combining a familiarity with biology with observations of cultural difference. I have summarized much of what is known across a wide variety of populations, including those that are most familiar to me: upstate New York (where women talk about menopause as something natural, ordained by God), western Massachusetts
(where women proactively smear themselves with yam cream and eat blue-green algae for menopausal health), Puebla, Mexico (where marital stress is a constant topic of concern among women of menopausal age), the Selsa ka Valley, Slovenia (where menopause is an uncomfortable, taboo topic of conversation), and Asunción, Paraguay (where some women describe menopause as un alivio, a relief, but others volunteer the word desesparación, despair, as a menopausal symptom).
I focus on menopause both as a onetime event, the last menstrual period, and as an ongoing process, the transition from pre- to postreproductive life. These two points of view—event and process—reflect different approaches to the study of menopause, and both are necessary. I also examine the evolution and contemporary experience of menopause in a particular way—from a biocultural perspective.
Why did menopause evolve?
Why do some women experience menopause at forty-two, while others cycle like clockwork to the age of fifty-eight?
Why does menopause pass unnoticed for some women, while others suffer from unrelenting hot flashes?
Oh! sorry. Its not over I got some other 'SERIOUS' questions too;
Why do human females close down childbearing long before the end of life, while most chimpanzees reproduce until shortly before death?
Why didn’t my mother have any hot flashes, while other women remove strategic layers of clothing and visibly sweat?
Bring up the topic of menopause, and I’m more than happy to contribute curious observations, interesting hypotheses, and leaps of biological faith. Yet there are so many questions that I can’t answer. Friends and colleagues at work ask, “I can’t remember names anymore. Is that menopause?” “My left arm goes numb. Is that menopause?” “I want to have sex twice a day. Is that menopause?” “I’m more depressed than I have ever been. Is that menopause?”
Variation in age at menopause and in symptom experience can be understood
at the level of the population by combining a familiarity with biology with observations of cultural difference. I have summarized much of what is known across a wide variety of populations, including those that are most familiar to me: upstate New York (where women talk about menopause as something natural, ordained by God), western Massachusetts
(where women proactively smear themselves with yam cream and eat blue-green algae for menopausal health), Puebla, Mexico (where marital stress is a constant topic of concern among women of menopausal age), the Selsa ka Valley, Slovenia (where menopause is an uncomfortable, taboo topic of conversation), and Asunción, Paraguay (where some women describe menopause as un alivio, a relief, but others volunteer the word desesparación, despair, as a menopausal symptom).
I focus on menopause both as a onetime event, the last menstrual period, and as an ongoing process, the transition from pre- to postreproductive life. These two points of view—event and process—reflect different approaches to the study of menopause, and both are necessary. I also examine the evolution and contemporary experience of menopause in a particular way—from a biocultural perspective.
“Oh, this must be menopause.”
We talk about the onset of menopause in various ways. Many cite the first time their menstrual period failed to make its regular appearance. Others describe the first time they threw off the blankets in the middle of the night. Some women complain of menstrual periods that flood more and more heavily each month; others encounter dusty, unused tampons in a bathroom cabinet. Although many women in the United States disdain the fuss made about menopause in the popular press, resent having to seek treatment for hot flashes, and dislike being reminded that the process of aging is marching forward, every woman who lives to sixty years of age with her uterus and ovaries intact is compelled, at one time or another, to say, “Oh, this must be menopause.”
In general, ovarian biology is experienced as down there somewhere, internal, private, seemingly immutable. Women tell me that menopause is “out of our control,” “natural,” “biological.” It is all of those things. Menopause—technically, the last menstrual period—is also a cultural phenomenon, “a time of despair,” “a new phase of life.” Culture, generally unacknowledged, alters the experience of menopause, the recognition of menopause, the timing of menopause, and the symptoms attributed to menopause. Culture is public, shared, and created. Culture is made visible in medical interventions, attitudes about aging, birth control policy, indications for hysterectomy, smoking practices, food resources, diet preferences, marital norms, breastfeeding customs, and timing of motherhood. All of these aspects of culture influence biology and contribute to variation in the age and individual experience of menopause.
In general, ovarian biology is experienced as down there somewhere, internal, private, seemingly immutable. Women tell me that menopause is “out of our control,” “natural,” “biological.” It is all of those things. Menopause—technically, the last menstrual period—is also a cultural phenomenon, “a time of despair,” “a new phase of life.” Culture, generally unacknowledged, alters the experience of menopause, the recognition of menopause, the timing of menopause, and the symptoms attributed to menopause. Culture is public, shared, and created. Culture is made visible in medical interventions, attitudes about aging, birth control policy, indications for hysterectomy, smoking practices, food resources, diet preferences, marital norms, breastfeeding customs, and timing of motherhood. All of these aspects of culture influence biology and contribute to variation in the age and individual experience of menopause.
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