The beginning of menopause is often noticed when the interval between the periods starts to get longer with each cycle. As the hormone levels fluctuate, the duration and the flow patterns all fluctuate. The woman often does not know when the periods will start and is often caught unaware.

During this period the women experience hot flashes starting somewhere on the upper body like neck, face, and the back which spreads either upward or down wards depending on where it started.

They may persist for 20 seconds to 10 minutes. At this time, they start developing red patches on the skin. When this occurs in the night it is called night sweat’. Most women do not require any specific treatment and these subside and disappear in about a year or two. These symptoms are found to be less in physically better people. These symptoms subside as one exercises and improve their fitness. Some women do not have any symptoms and it suddenly stops one day. There is no relation between the date of menarche and date of menopause. An early or late menarche does not mean an early or late menopause.

Any vaginal bleeding post menopause is considered serious enough to pay a visit to the doctor. This may happen during the transition period and can be due to hormonal fluctuations. There are symptoms like painful intercourse, dry vagina thinning and loss of elasticity of the vaginal wall etc. Women may suffer breast enlargement, pain, dizziness, heart palpitation, incontinence etc. They may suffer psychological disturbances like anxiety, forgetfulness, inability to concentrate, depression, mood swings, irritability, decreased interest in sexual activity, sleep disturbances etc. Lifestyle changes, physical activity and improved fitness etc. normally are adequate to meet the requirements. Systematic treatment is rarely needed.

Menopause can be the result of certain abdominal surgery like radical Hysterectomy with salpingo-oophorectomy (removing of uterus, ovaries and the two Fallopian tubes). Menopause caused by the removal of the ovaries is called Surgical menopause. Removal of uterus does not directly lead to menopause. Smoking is found to considerably advance the onset of menopause. Another condition causing premature menopause is premature ovarian failure. Vastly, majority ovarian failure is idiopathic, or are not for any established causes. However, a large number of diseases can cause premature ovarian failure. Some of the better known are fragile x chromosome, diabetes, hypothyroidism, radiotherapy, chemotherapy, Addison’s disease, Down’s syndrome, enzyme deficiencies, and Turner’s syndrome.