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	Menopause frequently asked Questions and Answers

	What is Menopause? What is peri-menopause?


	Menopause is the period marked by the physiological cessation of menstrual periods in the human female and the end of the reproductive years. Menopause is sometimes referred to as "the change of life" or climacteric. Menopause occurs as the ovaries stop producing oestrogen, causing the reproductive system to gradually shut down. Menopause is arbitrarily defined as a minimum of twelve months without menstruation.

	A natural or physiological menopause is that which occurs as a part of a woman's normal aging process. However, menopause can be surgically induced by such procedures as a hysterectomy.

	Menopause is as natural as menstruation, pregnancy and childbirth. Menopause is a natural part of growing older!

	Peri-menopause refers to the time preceding menopause, during which the production of hormones such as oestrogen and progesterone diminish and become irregular. During this period fertility diminishes. Peri-menopause can begin as early as age 35, although it usually begins much later. It can last for a few months or for several years. The duration of peri-menopause cannot be predicted in advance but usually lasts from 2 -8 years.

	What causes menopause?


	Normal changes in the reproductive and hormone system causes menopause. As the egg supply ages, the body begins to ovulate less often. This causes the hormone levels to fluctuate and in turn causes changes in the menstrual period and other symptoms. In time, oestrogen and progesterone levels drop so low that the menstrual cycle stops.

	Some medical reasons or therapy can cause the menstrual cycle to stop early, see premature menopause.

	Can I test for menopause?


	Menopause can be diagnosed by measuring the levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The levels of these hormones will increase during peri-menopause and will be raised when menopause has occurred.

	The base level of FSH is 3.3 -9.9 mIU/ml. FSH levels should normally be below 25mIU/ml, except during mid-cycle. A positive result above 25mIU/ml indicates that there has been some disruption to the menstrual cycle.

	As oestrogen levels decline, FSH levels increase to 25mIU/ml or more as the hormone tries to stimulate the ovaries to produce a healthy egg. Therefore, testing for FSH can help determine if the body is producing too much FSH because of low oestrogen levels which is an indication of lower fertility and menopause.

	FSH testing for menopause can be carried out any time during mid cycle. It should be carried during the day on two separate days two weeks apart. First morning urine is not recommended. Any other urine during the day can be used.

	What is premature menopause and when does it occur?


	Premature menopause is defined as menopause occurring before the age of 40. This occurs in 1% of women. Causes of premature menopause include cancer or other serious illness, chemotherapy, autoimmune disorders, thyroid disease, and diabetes mellitus.

	Premature menopause is diagnosed by measuring the levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The levels of these hormones will be raised when menopause has started.

	As oestrogen levels decline, FSH levels increase to 25mIU/ml or more as the hormone tries to stimulate the ovaries to produce a healthy egg. Therefore, testing for FSH can help determine if the body is producing too much FSH because of low oestrogen levels which is an indication of menopause.

	Premature menopause has been found to be significantly higher in both fraternal and identical twins (approximately 5% of twins reach menopause before the age of 40), people living at high altitudes, following a vegetarian diet, low body fat and smoking.

	Post-menopausal women are at an increased risk of osteoporosis and heart disease.
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What are the symptoms of menopause?

As the body adapts to the changing levels of natural hormones, symptoms such as hot flashes, palpitations (feeling that your heart is beating
too fast or unevenly), increased depression, anxiety, irritability, mood swings, insomnia (trouble sleeping), lack of concentration, headaches, vaginal dryness and urgency of urination appear. Together with these symptoms, the woman may also have increasingly scanty and erratic menstrual periods.

Some women have none or only a few mild symptoms and others have severe symptoms that disrupt their sleep and lives.

How long does menopause last?

Typically the process takes a year but may last as little as six months or more than five years./td>

At what age does menopause occur?

The average onset of menopause is 50.5 years, but some women enter menopause at a younger age, mid 40’s, especially if they have
suffered from cancer or another serious illness and undergone chemotherapy. This is termed premature menopause.

When is a FSH test useful?

Follicle Stimulating Hormone (FSH) tests can provide useful information to women seeking pregnancy or who are concerned about their fertility, ovarian health and function./td>

It is recommended for women experiencing irregular menstrual cycles or finding it difficult to conceive to determine if this is related to elevated
FSH levels or not.

FSH tests are commonly used to evaluate a woman’s egg supply, assist in evaluating menstrual problems, irregular or absent menstrual periods and to evaluate fertility, peri menopause and menopause.

FSH testing for menopause can be carried out any time during mid cycle. It should be carried during the day on two separate days two weeks apart. First morning urine is not recommended. Any other urine during the day can be used.

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