Here’s some basic menopause information about our big midlife non-event

Most menopause information concentrates on the medical definition that sees menopause as a purely biological event. Here on Natural-Menopause-Journey.com we believe there are different ways of understanding what menopause is depending on the context but we also recognise that the biomedical view is dominant in Western culture.

When we think of menopause as a biological event, then menopause facts are easier to define. On this page we provide some basic biomedical menopause information.

Biologically speaking, the term menopause refers to the end of a woman’s monthly periods and the start of the second infertile period of her life. Menstruation stops because our ovaries no longer release eggs.

Here’s the official definition, originally coined by the World Health Organisation, and which is also adopted by the International Menopause Society – an organisation of medical menopause experts:

"The term natural menopause is defined as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. Natural menopause is recognized to have occurred after 12 consecutive months of amenorrhea, for which there is no other obvious pathological or physiological cause. Menopause occurs with the final menstrual period (FMP) which is known with certainty only in retrospect a year or more after the event. An adequate biological marker for the event does not exist."

World Health Organisation, 1996. (1)

OK - so let's unpick this definition:

"The term natural menopause is defined as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity."

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No more eggs, means no more periods.

"Natural menopause is recognized to have occurred after 12 consecutive months of amenorrhea, for which there is no other obvious pathological or physiological cause."

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If a healthy (middle aged) woman goes 12 months without a period this is natural menopause.

Menopause occurs with the final menstrual period (FMP) which is known with certainty only in retrospect a year or more after the event. An adequate biological marker for the event does not exist."

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We can only recognise menopause by looking back in time. There is no reliable blood or urine test to diagnose menopause.

Medical menopause information also includes definitions of other aspects of menopause such as pre-menopause, menopausal transition and post-menopause. Read about these (click).

What causes the ovaries to run out of eggs?

When a baby girl is born her ovaries already contain all the eggs that she will ever have during her life. There are many millions of eggs in the ovaries at birth but these deteriorate during the first few decades of the girl's life and are reabsorbed naturally.

During a woman's monthly cycles an egg matures and is released, but if it is not fertilised, it soon decays and is lost. By the time we get to our mid-forties we are reaching the bottom of the barrel ... no more eggs, means no more monthly cycles and menopause happens.

How do I know when menopause has arrived?

The end of menstruation is the signal that a woman has stopped ovulating and that menopause has arrived. But the piece of menopause information that many people find most surprising is:

that nobody knows that the last period IS the last period until 12 months have elapsed without any further bleeding.

Before her final ever period a woman usually experiences a phase in which her normal monthly cycle is disrupted: periods may be shorter or longer than normal and there may be longer or shorter gaps between them.

After the menopause (post menopause), a healthy woman no longer has any monthly bleed at all and she can no longer conceive naturally with her own eggs.

How can I know that menopause has happened?

Although it sounds simple, it is extremely difficult to say exactly when menopause happens in any individual woman.

The reality is that the occurrence of menopause can only be pinpointed retrospectively – by looking back in time.

Germaine Greer has argued that menopause is a non-event because the term refers to ...

"the menstrual period that does not happen. It is the invisible Rubicon that a woman cannot know she is crossing until she has crossed it."

Germaine Greer, The Change. (2)

So although a theoretical definition seems neat and tidy in the menopause information of textbooks, deciding at what stage in her menopausal transition any individual woman is ... is quite another matter.

Bibliography

1. WHO Technical Report Series 866. Research on the menopause in the 1990s. World Health Organisation, Geneva 1996.

2. Greer G. The Change. Women, Aging and the Menopause. Hamish Hamilton Ltd. London 1991.

Published February 2010. Updated 9/5/2010

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