Onset
Menopause marks the end of a woman's childbearing years, and some reach the milestone as early as 45 years of age. On average, most women reach menopause between the ages of 47 to 51. Natural menopause can occur between the ages of 45 to 55. A year or more of absent menstrual periods marks the onset of menopause. Before menopause, a transitional stage occurs, where the body prepares for menopause. After the body completes the transitional stage, a woman reaches menopause.
Perimenopause
Perimenopause is the transitional stage that occurs between the fruitful childbearing years and rewarding menopause years. The start of perimenopause could happen as early as 35, but most women experience perimenopause between the ages of 35 to 45. The body gradually adapts to the changes in hormone levels, particularly estrogen and progesterone levels, which gradually decrease and inhibit ovulation until menopause, when ovulation no longer occurs. Women may find it difficult to get pregnant in the perimenopause stage because ovulation may not take place each month.
Early Menopause
Some women may approach menopause early. Early menopause, defined as reaching menopause before the age of 40, is often the result of physical trauma or surgery, such as the removal of the ovaries or uterus. In the case of early menopause, such as from the removal of ovaries or ovarian failure, a woman experiences artificial or induced menopause. She will not enter a perimenopause stage, giving her an abrupt loss of estrogen that normally stimulates ovulation, and her body does not have the chance to adapt to the gradual decrease in estrogen and other hormone levels.
Other causes for early menopause may be due to smoking, psychiatric disorders such as depression, exposure to toxins, chemo and radiation therapy, or a family history of early menopause. Other women may have irregular menstrual periods, but have not biologically entered the perimenopause or menopause stage, even though a woman may be in the typical age group associated with transitional or menopause stage. Women on medications, such as those that treat psychiatric disorders, may produce side effects that may cause irregular menstrual cycles.
Confirmation
According to the Mayo Clinic, irregular periods are the hallmark of perimenopause, so irregular cycles are normal during the perimenopause stage. Tests cannot confirm if you have reached perimenopause as hormones fluctuate during the transition stage, so some tests would be unreliable. However, tests may rule out ovarian failure or other medical conditions. If you have concerns about your cycle or want to confirm that you have reached menopause, make a visit with your doctor. A thorough exam and an evaluation of your medical history will rule out medical conditions, such as pregnancy or diabetes, or other conditions thought to cause early menopause. Your doctor will take blood tests and evaluate your prescription and non-prescription medications, including herbal medicines such as anise, nettle, pennyroyal and fennel, among others. These herbs may cause irregular menstrual cycles.
Tests cannot confirm menopause, but two blood tests may help the doctor determine if you may have reached menopause when reviewing your medical file. Your doctor may order tests that reveal your luteinizing hormone levels, which rise after menopause, and your progesterone levels, which drop after menopause. The results of the two tests may be the indicators or mark that reveals a woman has reached menopause, the omega along the course of the female lifespan.
