All women who live long enough experience menopause. Strictly speaking, menopause means "the cessation of menstruation," and refers to the period of life that follows a woman's final menstrual period. In common usage, however, "menopause" also refers to the years on either side of the final menstrual period, during which symptoms such as hot flashes occur. (The technical term for this period is climacteric.) Post-menopause is another non-technical term that usually refers to the years of a woman's life after the final menstrual period during which the symptoms of menopause are reduced or absent.

Because your periods can be spaced far apart in the months leading up to menopause, you cannot be certain that a menstrual period is truly the last one until you have gone 12 months in a row without a period. You can then accurately date the start of menopause to that last period 12 months ago.

Menopause occurs when a woman's store of eggs (called ova) run out, so that she no longer ovulates and the ovaries cease to function. The cessation of ovulation is accompanied by a rapid drop in the level of estrogen (the female sexual and reproductive hormone), which is secreted primarily by the very ovaries that are now failing. This fall in estrogen levels can produce a number of symptoms, including hot flashes, sleep disturbance, vaginal dryness and irritability.

Menopause is aptly called the "change of life" because the sudden decrease in estrogen levels causes a number of physical and mental changes. Chief among these is a decrease in bone density (the amount of calcium in the bones) that can make one more susceptible to fractures. When bone density declines far enough, it is called osteoporosis. (To learn more about your personal risk for osteoporosis, take our Osteoporosis Risk Profile.)

Another important change that occurs with menopause that is often overlooked is a marked increase in heart disease risk. Ten years after her last menstrual period, a woman's risk for heart attack is equal to that of a man the same age. (See our Heart Disease Risk Profile to learn about your risk for heart disease and the many ways to reduce your heart disease risk both before and after menopause.)

Not all of the symptoms associated with menopause are the result of falling estrogen levels or other physiological changes that occur at this time of life. Those that clearly are include hot flashes and vaginal dryness. Sleep disturbance and irritability may or may not be related to low estrogen levels, while depression only rarely is. In the Menopause Assessment, we tell you which symptoms are probably related to menopause and what to do to relieve them.

Many women who have experienced the change of life know that the process is rarely sudden. There is often a period of several years (typically 4 to 5) prior to the final menstrual period during which menstruation becomes irregular and symptoms such as hot flashes start. This period is called "perimenopause" and affects a significant percentage of women. The Menopause Assessment will tell you whether you are likely to be in perimenopause and how best to treat its symptoms.

While menopause is inevitable, bothersome symptoms or complications such as osteoporosis are not. The Menopause Assessment will help you determine whether you are in menopause or perimenopause, help you deal with any symptoms and give you valuable suggestions on avoiding complications and maximizing your quality of life during your menopausal years.