Menopause

The cessation of menstruation, which usually occurs between the ages of 45 and 55. The term is usually used to refer to a period of physical and psychological changes that occur as a result of reduced oestrogen production. Symptoms of menopause include hot flushes and night sweats; vaginal dryness caused by thinning of the vaginal skin; and a decrease in vaginal secretions. The vagina shrinks and loses elasticity, and becomes prone to minor infections. Vaginal dryness may also make sexual intercourse more difficult and painful (see vaginitis). The neck of the bladder and urethra undergo similar changes, which can result in a feeling of needing to urinate frequently. Psychological symptoms, such as poor concentration, tearfulness, loss of interest in sex, and depression, are also often attributed to the menopause. Changes in metabolism occur during the menopause but may not cause symptoms until later. Bones become thinner, and osteoporosis may develop. There is also an increased level of fats in the blood, which may cause an increase in atherosclerosis and a higher incidence of coronary artery disease and stroke. Hormone replacement therapy (HRT) may relieve menopausal symptoms. HRT reduces the risk of fractures associated with osteoporosis. However, it has been associated with a slightly increased risk of breast cancer. For most women, treatment is recommended for a duration of around 10 years.