The average age for menopause is 50 to 55. I’ve seen an occasional woman who has regular monthly periods and then one month has her last period and never has another. However, this is the exception rather than the rule. Typically, women begin with perimenopausal symptoms in their forties. As a woman approaches the end of perimenopause, the periods become lighter and start to become more infrequent. She may skip several months without a period, and then finally the periods stop completely. When the decline in hormones occurs very gradually, a woman may not experience severe symptoms because her body has had time to compensate for the decline in estrogen and progesterone. Often the age of menopause is genetically determined and it is helpful to ask when an older sister or mother went through menopause. A catastrophic, stressful life event can bring on menopause earlier than expected.
Some women are elated when their periods have stopped and experience few adverse symptoms. Other women respond to the loss of estrogen with severe symptoms and find it difficult to do their work. Because of such differences, women experiencing great difficulties are sometimes written off as “hysterical” or hypochondriacal, which is very unfair to these women. Overall, there can be tremendous variation in how menopause is experienced by different women. Every time I think I have seen every “variation on the theme,” I see yet another woman who is having a slightly different experience.
After menopause, the adrenal glands continue to produce androstenedione, a hormone that is converted in fat cells to another form of estrogen called estrone. This is a reason why obese women may have less severe hot flashes. It also explains why thin women often require higher doses of estrogen to control their low estrogen symptoms.
Excerpt from “Outliving Your Ovaries” © 2012 by Marina Johnson MD.
Dr. Johnson has no financial conflicts of interest or ties to any pharmaceutical company.
Her only objective is determining the most effective, safest therapy for patients.