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Hi, I am Dr. Amy Rosenman, a urogynecologist and menopause expert with Rosenmanmd.com and today I am here on behalf of About.com to explain for you "What is menopause?" Menopause is defined as the end of reproductive life of the female, specifically when there has been 1 year without menstruation.  The average age of the last period is 51.4.  In the year 1900, a woman’s average life expectancy was 50.  But now, in the 21st century the average life expectancy of a woman in the United States is now 86 years old.  That’s a lot of time to consider, about one third of our life occurs after menopause.  We need to pay attention and manage it proactively.So how did we get to this menopausal state? We are born with all the ova, the eggs we will have in a lifetime.  Every month one is chosen to develop and be released into the fallopian tube with the hope of being fertilized and forming a baby.  When this does not happen, we get a period. The uterine lining sloughs, and the cycle starts over again.  If we take birth control pills, we may not ovulate for years, until stopping the pill. Then the process continues until menopause. We are genetically programmed for this process to stop at a certain age, somewhere between 40 and 60.  Prior to this day, the ovary tries to slow down, decreasing our levels of estrogen, but the master gland, the pituitary, at the base of our brain, says, no, not ready yet and stimulates the ovaries harder by increasing the levels of FSH, follicle stimulating hormone. This increased stimulation results in an increase in estrogen and the release of an egg and a period. Eventually the ovary hears the call of the pituitary but no longer rallies.  It stops and menopause occurs.  Periods typically become less frequent with less flow until they stop completely.  But there is a lot of variability among women.  Other causes of menopause are the surgical removal of the ovaries. This form of menopause is abrupt and can be very symptomatic. Chemotherapy, gynecologic surgery, and pelvic radiation can cause premature menopause as well.  Any woman facing cancer treatment during the reproductive years who wishes to hold onto some fertility should consider freezing embryos or eggs. Going from high levels of estrogen to low levels triggers hot flashes, mood swings, night sweats and insomnia. Sometimes, evening out these hormone swings with a short 1-2 year course of estrogen and progesterone when appropriate is the answer.  Discuss this option with your medical practitioner. There are safe and effective solutions for the symptoms of menopause.Thanks for watching and for more information visit us online at About.com.
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