Menopause classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Rahmah Al-Edresi, M.D.[2]

Menopause is classified according to causes into three types including natural menopause, premature menopause/early menopause, and induced menopause. Natural menopause, does not happen suddenly, but it passes through 3 stages include perimenopause, premenopause, and postmenopause. Premature menopause because of premature ovarian failure and several medical diseases. Induced menopause because of bilateral oophorectomy, salpingo-oophorectomy, and hysterectomy. in addition to complication of chemotherapy and radiotherapy.

Menopause is classified according to causes into three types :

• Natural menopause
• Premature Menopause/Early menopause
• Surgical/Induced Menopause

Physiological menopause is amenorrhea, it passes gradually through 3 stages until it reaches the permanent cessation of the menstrual cycle

• Premenopause is a word used to describe the years leading up to the last period ever when the levels of reproductive hormones are already becoming lower and more erratic, and symptoms of hormone withdrawal may be present.
• Perimenopause or “menopause transition”means the menopause transition years, the years before and after the last period ever, when the majority of women find that they undergo at least some symptoms of hormonal change and fluctuation, such as hot flashes, mood changes, insomnia, fatigue, irregular menses. During perimenopause, the production of most of the reproductive hormones, including estrogens and progestin, diminishes and becomes more irregular, often with wide and unpredictable fluctuations in levels. During this period, fertility diminishes. Symptoms of perimenopause can begin as early as age 35, although most women become aware of them about 10 years later than this. Perimenopause can last for a few years, or ten years or even longer.
• Postmenopause, a woman has considered in post-menopause after amenorrhea more than 12 months, not even any spotting. When she reaches that point, she is one year into post-menopause. The reason for this delay in declaring a woman post-menopausal is because periods become very erratic at this time of life, and therefore a reasonably long period is necessary to be sure that the cycling has ceased. A woman’s reproductive hormone levels continue to drop and fluctuate for some time into post-menopause, so any hormone withdrawal symptoms that a woman may be experiencing do not necessarily stop right away but may take quite some time, even several years, to disappear completely.^[1]

• Premature menopause is the permanent cessation of the menstrual cycle under 40 of age and early menopause (between ages 40 and 45 years).^[2]
• It is because of premature ovarian failure and several medical diseases.^[3]

• Induced menopause is the permanent cessation of the menstrual cycle because of complication of medical treatment such as chemotherapy, and radiotherapy for treatment of cancer and surgery such as bilateral oophorectomy, salpingo-oophorectomy, and hysterectomy.
• The causes of menopause after these surgery are the sudden quickly drop in hormone levels after oophorectomy and decrease in the mechanism of feedback after Hysterectomy although ovarian hormones are still produced .The surgical menopausal symptoms may be more severe like hot flushes.^[4]

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