Menopause is the stage of life in people with ovaries that marks the end of their reproductive years. Menopausal people no longer get periods. It’s part of the normal aging process for people assigned female at birth, but some factors can cause menopause earlier than average.
Menopause usually begins between the ages of 45 and 55, with most people experiencing it at 52. During menopause and the years leading up to menopause—called perimenopause—many people experience a variety of symptoms, including menstrual cycle changes, hot flashes, sleep problems, and mood swings.
Menopause occurs when there is a decline in natural female hormones and loss of ovarian follicular function. Although this is often due to normal biological aging, menopause can sometimes occur early or due to other factors that affect hormones and ovarian function.
The ovaries are the female organs responsible for creating and releasing eggs and female reproductive hormones. Humans assigned female at birth are born with about 1-2 million eggs in their ovaries. By puberty, this number decreases to around 300,000-400,000 eggs. After puberty, an egg is released every month in people with regular cycles.
As you age, egg quality declines. Around the time of menopause, fewer than 1,000 eggs remain, and your ovaries stop releasing eggs. This change leads to menopause and also means you can no longer get pregnant.
As the ovaries stop releasing eggs, they also produce less progesterone and estrogen. These two hormones are vital for pregnancy and regulating the menstrual and ovarian cycles.
Low levels of progesterone and estrogen cause menopausal symptoms and various changes in the body, such as dryness and thinness of the vagina, increased risk of vaginal yeast infections, loss of bone density and changes in the urinary system.
Surgery to remove your ovaries – called an oophorectomy – can cause you to enter menopause immediately. This is known as surgical menopause and only occurs if both of them the ovaries are removed. One ovary is sufficient to produce the hormones needed to avoid menopause symptoms and preserve reproductive function.
The ovaries produce eggs and hormones needed to regulate the female reproductive cycle. Removal of the organ automatically stops reproductive function, causing menopause even in individuals who have not reached the typical age of menopause.
Surgical menopause symptoms start suddenly and are more severe than non-surgical menopause.
Cancer treatments such as chemotherapy and radiotherapy can cause menopause by causing the ovaries to stop functioning.
Induced menopause can be permanent, depending on factors such as the dose of treatment and your age. In some cases, it’s temporary, with regular periods continuing for a few months to two years after cancer treatment.
Primary ovarian insufficiency (POI) is when the ovaries stop working as they should before a person reaches the age of 40. This condition is linked to problems with ovarian follicles, the small sacs in the ovaries where eggs grow and mature before being released.
POI causes the body to produce little or no estrogen and progesterone and causes reduced fertility, irregular ovulation and irregular periods.
POI is not the same as premature menopause. It is still possible to get pregnant with POI, while the chances of getting pregnant are almost zero with premature menopause. POI can cause loss of ovarian function, and a drop in the hormone estrogen can cause people with the condition to experience menopausal symptoms, including night sweats, hot flashes, vaginal dryness and sleep disturbances.
Menopause itself is a natural biological process that everyone with female reproductive organs experiences as they age, regardless of genes or ethnic and racial background. However, the age at which you experience menopause may have some hereditary components.
Research has shown that early or premature menopause has a strong genetic component. Estrogen receptor 1 (ESR1) is one of the genes that can affect the age when menstruation starts. ESR1 plays an important role in sexual development and reproductive function.
Health experts also believe that you are more likely to have menopause before age 45 if you have a family history of menopause at a younger age.
Everyone with female reproductive organs experiences menopause when they get older. This usually happens between the ages of 45-55.
Menopause that occurs before the age of 40 is called premature menopause. Menopause that occurs at the age of 40-45 is called early menopause.
About 1% of women experience premature menopause, while early menopause occurs in about 5% of women. Both can occur gradually and naturally in some people, or they can be triggered by events such as chemotherapy or having your ovaries removed.
While menopause is a natural process, certain factors can increase the risk of menopause at a younger age. This includes people who:
- They were young (less than 8 years old) at the time of their first menstruation
- You are underweight
- Smoke
- You have a family history of early or premature menopause
- I’ve never been pregnant
- Undergo cancer treatment
- You live with certain medical conditions such as autoimmune diseases, HIV/AIDS and chronic fatigue syndrome (a condition characterized by extreme fatigue and muscle and joint pain)
Menopause is part of a natural biological process that occurs as people with ovaries age. It usually occurs around age 52, but it can occur earlier in some people.
Menopause is caused by a decline in ovarian function and little or no production of female reproductive hormones. While menopause usually occurs gradually and naturally with age, certain cancer treatments and removal of the ovaries will cause earlier and more immediate menopause.
Menopause can cause unpleasant symptoms and be challenging to deal with. If you have menopausal symptoms or are concerned about the transition to menopause, consider talking to your healthcare provider. They can help you manage your symptoms and navigate this stage of life.