Menopause

menopause, permanent cessation of menstruation that results from the loss of ovarian function and therefore represents the end of a woman’s reproductive life. At the time of menopause the ovaries contain very few follicles; they have decreased in size, and they consist mostly of atretic (shrunken) follicles, some interstitial cells, and fibrous tissue. Estrogen production decreases by 80 percent or more, and this along with the loss of follicles results in marked increases in the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Menstrual periods may cease abruptly or may be irregular for a year or so before ceasing. In a similar fashion, menopausal symptoms may occur abruptly or gradually. While menopausal symptoms may begin when the woman is still menstruating, they are more likely to begin after menstruation ceases.

The term male menopause is sometimes used to describe an equivalent aging-related decline in testicular function that results in testosterone deficiency in men. This process is alternatively referred to as late-onset hypogonadism or andropause. It affects about 2 percent of men and may begin at age 40. Unlike menopause in women, late-onset hypogonadism in men occurs gradually, with testosterone levels decreasing over the course of many years. Symptoms include decreased libido, fatigue, depression, and erectile dysfunction. Symptoms may be subtle initially, and hence the condition may go unnoticed for years.