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class="vector-toc-text"> 1.1 Vagina, uterus and bladder (urogenital tract) </div> </a> <ul id="toc-Vagina,_uterus_and_bladder_(urogenital_tract)-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_physical_effects" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_physical_effects"> <div class="vector-toc-text"> 1.2 Other physical effects </div> </a> <ul id="toc-Other_physical_effects-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Mood_and_memory_effects" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Mood_and_memory_effects"> <div class="vector-toc-text"> 1.3 Mood and memory effects </div> </a> <ul id="toc-Mood_and_memory_effects-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Long-term_effects" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Long-term_effects"> <div class="vector-toc-text"> 1.4 Long-term effects </div> </a> <ul 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class="vector-toc-list"> <li id="toc-Age" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Age"> <div class="vector-toc-text"> 2.1 Age </div> </a> <ul id="toc-Age-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Premature_ovarian_insufficiency" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Premature_ovarian_insufficiency"> <div class="vector-toc-text"> 2.2 Premature ovarian insufficiency </div> </a> <ul id="toc-Premature_ovarian_insufficiency-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Surgical_menopause" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Surgical_menopause"> <div class="vector-toc-text"> 2.3 Surgical menopause </div> </a> <ul id="toc-Surgical_menopause-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Mechanism" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Mechanism"> <div class="vector-toc-text"> 3 Mechanism </div> </a> <button aria-controls="toc-Mechanism-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Mechanism subsection </button> <ul id="toc-Mechanism-sublist" class="vector-toc-list"> <li id="toc-Ovarian_aging" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Ovarian_aging"> <div class="vector-toc-text"> 3.1 Ovarian aging </div> </a> <ul id="toc-Ovarian_aging-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> 4 Diagnosis </div> </a> <button aria-controls="toc-Diagnosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Diagnosis subsection </button> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> <li id="toc-Perimenopause" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Perimenopause"> <div class="vector-toc-text"> 4.1 Perimenopause </div> </a> <ul id="toc-Perimenopause-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Postmenopause" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Postmenopause"> <div class="vector-toc-text"> 4.2 Postmenopause </div> </a> <ul id="toc-Postmenopause-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Management" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Management"> <div class="vector-toc-text"> 5 Management </div> </a> <button aria-controls="toc-Management-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Management subsection </button> <ul id="toc-Management-sublist" class="vector-toc-list"> <li id="toc-Menopausal_hormone_therapy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Menopausal_hormone_therapy"> <div class="vector-toc-text"> 5.1 Menopausal hormone therapy </div> </a> <ul id="toc-Menopausal_hormone_therapy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Selective_estrogen_receptor_modulators" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Selective_estrogen_receptor_modulators"> <div class="vector-toc-text"> 5.2 Selective estrogen receptor modulators </div> </a> <ul id="toc-Selective_estrogen_receptor_modulators-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_medications" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_medications"> <div class="vector-toc-text"> 5.3 Other medications </div> </a> <ul id="toc-Other_medications-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Therapy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Therapy"> <div class="vector-toc-text"> 5.4 Therapy </div> </a> <ul id="toc-Therapy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Lifestyle_and_exercise" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Lifestyle_and_exercise"> <div class="vector-toc-text"> 5.5 Lifestyle and exercise </div> </a> <ul id="toc-Lifestyle_and_exercise-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Dietary_supplements" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Dietary_supplements"> <div class="vector-toc-text"> 5.6 Dietary supplements </div> </a> <ul id="toc-Dietary_supplements-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Alternative_medicine" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Alternative_medicine"> <div class="vector-toc-text"> 5.7 Alternative medicine </div> </a> <ul id="toc-Alternative_medicine-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_efforts" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_efforts"> <div class="vector-toc-text"> 5.8 Other efforts </div> </a> <ul id="toc-Other_efforts-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Society_and_culture" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Society_and_culture"> <div class="vector-toc-text"> 6 Society and culture </div> </a> <button aria-controls="toc-Society_and_culture-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Society and culture subsection </button> <ul id="toc-Society_and_culture-sublist" class="vector-toc-list"> <li id="toc-Attitudes_and_experiences" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Attitudes_and_experiences"> <div class="vector-toc-text"> 6.1 Attitudes and experiences </div> </a> <ul id="toc-Attitudes_and_experiences-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Impact_on_work" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Impact_on_work"> <div class="vector-toc-text"> 6.2 Impact on work </div> </a> <ul id="toc-Impact_on_work-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Etymology" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Etymology"> <div class="vector-toc-text"> 6.3 Etymology </div> </a> <ul id="toc-Etymology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-In_popular_culture,_law_and_politics" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#In_popular_culture,_law_and_politics"> <div class="vector-toc-text"> 6.4 In popular culture, law and politics </div> </a> <ul id="toc-In_popular_culture,_law_and_politics-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Other_animals" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Other_animals"> <div class="vector-toc-text"> 7 Other animals </div> </a> <ul id="toc-Other_animals-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Evolution" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Evolution"> <div class="vector-toc-text"> 8 Evolution </div> </a> <ul id="toc-Evolution-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> 9 See also </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> 10 References </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> 11 Further reading </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> 12 External links </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Table of Contents" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" > Toggle the table of contents </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading">Menopause</h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 84 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-84" aria-hidden="true" > 84 languages </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-af mw-list-item"><a href="https://af.wikipedia.org/wiki/Menopouse" title="Menopouse – Afrikaans" lang="af" hreflang="af" data-title="Menopouse" data-language-autonym="Afrikaans" data-language-local-name="Afrikaans" class="interlanguage-link-target">Afrikaans</a></li><li class="interlanguage-link interwiki-als mw-list-item"><a href="https://als.wikipedia.org/wiki/Menopause" title="Menopause – Alemannic" lang="gsw" hreflang="gsw" data-title="Menopause" data-language-autonym="Alemannisch" data-language-local-name="Alemannic" class="interlanguage-link-target">Alemannisch</a></li><li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%B3%D9%86_%D8%A7%D9%84%D9%8A%D8%A3%D8%B3" title="سن اليأس – Arabic" lang="ar" hreflang="ar" data-title="سن اليأس" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target">العربية</a></li><li class="interlanguage-link interwiki-as mw-list-item"><a href="https://as.wikipedia.org/wiki/%E0%A7%B0%E0%A6%9C%E0%A7%8B%E0%A6%A8%E0%A6%BF%E0%A6%AC%E0%A7%83%E0%A6%A4%E0%A7%8D%E0%A6%A4%E0%A6%BF" title="ৰজোনিবৃত্তি – Assamese" lang="as" hreflang="as" data-title="ৰজোনিবৃত্তি" data-language-autonym="অসমীয়া" data-language-local-name="Assamese" class="interlanguage-link-target">অসমীয়া</a></li><li class="interlanguage-link interwiki-ast mw-list-item"><a href="https://ast.wikipedia.org/wiki/Menopausia" title="Menopausia – Asturian" lang="ast" hreflang="ast" data-title="Menopausia" data-language-autonym="Asturianu" data-language-local-name="Asturian" class="interlanguage-link-target">Asturianu</a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/Klimaks" title="Klimaks – Azerbaijani" lang="az" hreflang="az" data-title="Klimaks" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target">Azərbaycanca</a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%B0%E0%A6%9C%E0%A7%8B%E0%A6%A8%E0%A6%BF%E0%A6%AC%E0%A7%83%E0%A6%A4%E0%A7%8D%E0%A6%A4%E0%A6%BF" title="রজোনিবৃত্তি – Bangla" lang="bn" hreflang="bn" data-title="রজোনিবৃত্তি" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target">বাংলা</a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%9C%D0%B5%D0%BD%D0%BE%D0%BF%D0%B0%D1%83%D0%B7%D0%B0" title="Менопауза – Bulgarian" lang="bg" hreflang="bg" data-title="Менопауза" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target">Български</a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Menopauza" title="Menopauza – Bosnian" lang="bs" hreflang="bs" data-title="Menopauza" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target">Bosanski</a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Menopausa" title="Menopausa – Catalan" lang="ca" hreflang="ca" data-title="Menopausa" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target">Català</a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Menopauza" title="Menopauza – Czech" lang="cs" hreflang="cs" data-title="Menopauza" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target">Čeština</a></li><li class="interlanguage-link interwiki-cy mw-list-item"><a href="https://cy.wikipedia.org/wiki/Menopos" title="Menopos – Welsh" lang="cy" hreflang="cy" data-title="Menopos" data-language-autonym="Cymraeg" data-language-local-name="Welsh" class="interlanguage-link-target">Cymraeg</a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Menopause" title="Menopause – Danish" lang="da" hreflang="da" data-title="Menopause" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target">Dansk</a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Menopause" title="Menopause – German" lang="de" hreflang="de" data-title="Menopause" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target">Deutsch</a></li><li class="interlanguage-link interwiki-dv mw-list-item"><a href="https://dv.wikipedia.org/wiki/%DE%87%DE%A8%DE%87%DE%B0%DE%8B%DE%A6%DE%87%DE%A8%DE%82%DE%B0_%DE%86%DE%AC%DE%82%DE%91%DE%AA%DE%82%DE%B0" title="އިއްދައިން ކެނޑުން – Divehi" lang="dv" hreflang="dv" data-title="އިއްދައިން ކެނޑުން" data-language-autonym="ދިވެހިބަސް" data-language-local-name="Divehi" class="interlanguage-link-target">ދިވެހިބަސް</a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Menopaus" title="Menopaus – Estonian" lang="et" hreflang="et" data-title="Menopaus" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target">Eesti</a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%95%CE%BC%CE%BC%CE%B7%CE%BD%CF%8C%CF%80%CE%B1%CF%85%CF%83%CE%B7" title="Εμμηνόπαυση – Greek" lang="el" hreflang="el" data-title="Εμμηνόπαυση" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target">Ελληνικά</a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Menopausia" title="Menopausia – Spanish" lang="es" hreflang="es" data-title="Menopausia" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target">Español</a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Menopa%C5%ADzo" title="Menopaŭzo – Esperanto" lang="eo" hreflang="eo" data-title="Menopaŭzo" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target">Esperanto</a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Menopausia" title="Menopausia – Basque" lang="eu" hreflang="eu" data-title="Menopausia" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target">Euskara</a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%DB%8C%D8%A7%D8%A6%D8%B3%DA%AF%DB%8C" title="یائسگی – Persian" lang="fa" hreflang="fa" data-title="یائسگی" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target">فارسی</a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/M%C3%A9nopause" title="Ménopause – French" lang="fr" hreflang="fr" data-title="Ménopause" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target">Français</a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Sos_m%C3%ADostraithe" title="Sos míostraithe – Irish" lang="ga" hreflang="ga" data-title="Sos míostraithe" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target">Gaeilge</a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Menopausa" title="Menopausa – Galician" lang="gl" hreflang="gl" data-title="Menopausa" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target">Galego</a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%ED%8F%90%EA%B2%BD%EA%B8%B0" title="폐경기 – Korean" lang="ko" hreflang="ko" data-title="폐경기" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target">한국어</a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%B4%D5%A1%D5%B7%D5%BF%D5%A1%D5%B6%D5%A1%D5%A4%D5%A1%D5%A4%D5%A1%D6%80" title="Դաշտանադադար – Armenian" lang="hy" hreflang="hy" data-title="Դաշտանադադար" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target">Հայերեն</a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%B0%E0%A4%9C%E0%A5%8B%E0%A4%A8%E0%A4%BF%E0%A4%B5%E0%A5%83%E0%A4%A4%E0%A5%8D%E0%A4%A4%E0%A4%BF" title="रजोनिवृत्ति – Hindi" lang="hi" hreflang="hi" data-title="रजोनिवृत्ति" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target">हिन्दी</a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Menopauza" title="Menopauza – Croatian" lang="hr" hreflang="hr" data-title="Menopauza" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target">Hrvatski</a></li><li class="interlanguage-link interwiki-io mw-list-item"><a href="https://io.wikipedia.org/wiki/Menopauzo" title="Menopauzo – Ido" lang="io" hreflang="io" data-title="Menopauzo" data-language-autonym="Ido" data-language-local-name="Ido" class="interlanguage-link-target">Ido</a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Menopause" title="Menopause – Indonesian" lang="id" hreflang="id" data-title="Menopause" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target">Bahasa Indonesia</a></li><li class="interlanguage-link interwiki-ia mw-list-item"><a href="https://ia.wikipedia.org/wiki/Menopausa" title="Menopausa – Interlingua" lang="ia" hreflang="ia" data-title="Menopausa" data-language-autonym="Interlingua" data-language-local-name="Interlingua" class="interlanguage-link-target">Interlingua</a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Menopausa" title="Menopausa – Italian" lang="it" hreflang="it" data-title="Menopausa" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target">Italiano</a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%92%D7%99%D7%9C_%D7%94%D7%9E%D7%A2%D7%91%D7%A8_%D7%90%D7%A6%D7%9C_%D7%A0%D7%A9%D7%99%D7%9D" title="גיל המעבר אצל נשים – Hebrew" lang="he" hreflang="he" data-title="גיל המעבר אצל נשים" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target">עברית</a></li><li class="interlanguage-link interwiki-jv mw-list-item"><a href="https://jv.wikipedia.org/wiki/Menopause" title="Menopause – Javanese" lang="jv" hreflang="jv" data-title="Menopause" data-language-autonym="Jawa" data-language-local-name="Javanese" class="interlanguage-link-target">Jawa</a></li><li class="interlanguage-link interwiki-kn mw-list-item"><a href="https://kn.wikipedia.org/wiki/%E0%B2%AE%E0%B3%81%E0%B2%9F%E0%B3%8D%E0%B2%9F%E0%B3%81_%E0%B2%A8%E0%B2%BF%E0%B2%B2%E0%B3%8D%E0%B2%B2%E0%B3%81%E0%B2%B5%E0%B2%BF%E0%B2%95%E0%B3%86" title="ಮುಟ್ಟು ನಿಲ್ಲುವಿಕೆ – Kannada" lang="kn" hreflang="kn" data-title="ಮುಟ್ಟು ನಿಲ್ಲುವಿಕೆ" data-language-autonym="ಕನ್ನಡ" data-language-local-name="Kannada" class="interlanguage-link-target">ಕನ್ನಡ</a></li><li class="interlanguage-link interwiki-ka mw-list-item"><a href="https://ka.wikipedia.org/wiki/%E1%83%9B%E1%83%94%E1%83%9C%E1%83%9D%E1%83%9E%E1%83%90%E1%83%A3%E1%83%96%E1%83%90" title="მენოპაუზა – Georgian" lang="ka" hreflang="ka" data-title="მენოპაუზა" data-language-autonym="ქართული" data-language-local-name="Georgian" class="interlanguage-link-target">ქართული</a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%9C%D0%B5%D0%BD%D0%BE%D0%BF%D0%B0%D1%83%D0%B7%D0%B0" title="Менопауза – Kazakh" lang="kk" hreflang="kk" data-title="Менопауза" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target">Қазақша</a></li><li class="interlanguage-link interwiki-rw mw-list-item"><a href="https://rw.wikipedia.org/wiki/Gucura_k%E2%80%99umugore" title="Gucura k’umugore – Kinyarwanda" lang="rw" hreflang="rw" data-title="Gucura k’umugore" data-language-autonym="Ikinyarwanda" data-language-local-name="Kinyarwanda" class="interlanguage-link-target">Ikinyarwanda</a></li><li class="interlanguage-link interwiki-sw mw-list-item"><a href="https://sw.wikipedia.org/wiki/Kukoma_hedhi" title="Kukoma hedhi – Swahili" lang="sw" hreflang="sw" data-title="Kukoma hedhi" data-language-autonym="Kiswahili" data-language-local-name="Swahili" class="interlanguage-link-target">Kiswahili</a></li><li class="interlanguage-link interwiki-la mw-list-item"><a href="https://la.wikipedia.org/wiki/Menopausis" title="Menopausis – Latin" lang="la" hreflang="la" data-title="Menopausis" data-language-autonym="Latina" data-language-local-name="Latin" class="interlanguage-link-target">Latina</a></li><li class="interlanguage-link interwiki-lv mw-list-item"><a href="https://lv.wikipedia.org/wiki/Menopauze" title="Menopauze – Latvian" lang="lv" hreflang="lv" data-title="Menopauze" data-language-autonym="Latviešu" data-language-local-name="Latvian" class="interlanguage-link-target">Latviešu</a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Menopauz%C4%97" title="Menopauzė – Lithuanian" lang="lt" hreflang="lt" data-title="Menopauzė" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target">Lietuvių</a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Klimax" title="Klimax – Hungarian" lang="hu" hreflang="hu" data-title="Klimax" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target">Magyar</a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%9C%D0%B5%D0%BD%D0%BE%D0%BF%D0%B0%D1%83%D0%B7%D0%B0" title="Менопауза – Macedonian" lang="mk" hreflang="mk" data-title="Менопауза" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target">Македонски</a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%86%E0%B5%BC%E0%B4%A4%E0%B5%8D%E0%B4%A4%E0%B4%B5%E0%B4%B5%E0%B4%BF%E0%B4%B0%E0%B4%BE%E0%B4%AE%E0%B4%82" title="ആർത്തവവിരാമം – Malayalam" lang="ml" hreflang="ml" data-title="ആർത്തവവിരാമം" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target">മലയാളം</a></li><li class="interlanguage-link interwiki-mr mw-list-item"><a href="https://mr.wikipedia.org/wiki/%E0%A4%B0%E0%A4%9C%E0%A5%8B%E0%A4%A8%E0%A4%BF%E0%A4%B5%E0%A5%83%E0%A4%A4%E0%A5%8D%E0%A4%A4%E0%A5%80" title="रजोनिवृत्ती – Marathi" lang="mr" hreflang="mr" data-title="रजोनिवृत्ती" data-language-autonym="मराठी" data-language-local-name="Marathi" class="interlanguage-link-target">मराठी</a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Menopaus" title="Menopaus – Malay" lang="ms" hreflang="ms" data-title="Menopaus" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target">Bahasa Melayu</a></li><li class="interlanguage-link interwiki-mdf mw-list-item"><a href="https://mdf.wikipedia.org/wiki/%D0%90%D0%B2%D0%B0%D1%82%D1%8C_%D1%81%D0%B8%D1%80%D0%B5%D0%BB%D0%B3%D0%BE%D0%B4%D0%BE%D0%BC%D0%B0%D1%86" title="Авать сирелгодомац – Moksha" lang="mdf" hreflang="mdf" data-title="Авать сирелгодомац" data-language-autonym="Мокшень" data-language-local-name="Moksha" class="interlanguage-link-target">Мокшень</a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Menopauze" title="Menopauze – Dutch" lang="nl" hreflang="nl" data-title="Menopauze" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target">Nederlands</a></li><li class="interlanguage-link interwiki-ne mw-list-item"><a href="https://ne.wikipedia.org/wiki/%E0%A4%B0%E0%A4%9C%E0%A5%8B%E0%A4%A8%E0%A4%BF%E0%A4%B5%E0%A5%83%E0%A4%A4%E0%A5%8D%E0%A4%A4%E0%A4%BF" title="रजोनिवृत्ति – Nepali" lang="ne" hreflang="ne" data-title="रजोनिवृत्ति" data-language-autonym="नेपाली" data-language-local-name="Nepali" class="interlanguage-link-target">नेपाली</a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E6%9B%B4%E5%B9%B4%E6%9C%9F%E9%9A%9C%E5%AE%B3" title="更年期障害 – Japanese" lang="ja" hreflang="ja" data-title="更年期障害" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target">日本語</a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Menopause" title="Menopause – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Menopause" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target">Norsk bokmål</a></li><li class="interlanguage-link interwiki-nn mw-list-item"><a href="https://nn.wikipedia.org/wiki/Menopause" title="Menopause – Norwegian Nynorsk" lang="nn" hreflang="nn" data-title="Menopause" data-language-autonym="Norsk nynorsk" data-language-local-name="Norwegian Nynorsk" class="interlanguage-link-target">Norsk nynorsk</a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%8B%E0%AC%A4%E0%AD%81%E0%AC%AC%E0%AC%A8%E0%AD%8D%E0%AC%A6" title="ଋତୁବନ୍ଦ – Odia" lang="or" hreflang="or" data-title="ଋତୁବନ୍ଦ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target">ଓଡ଼ିଆ</a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Menopauza" title="Menopauza – Uzbek" lang="uz" hreflang="uz" data-title="Menopauza" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target">Oʻzbekcha / ўзбекча</a></li><li class="interlanguage-link interwiki-pa mw-list-item"><a href="https://pa.wikipedia.org/wiki/%E0%A8%AE%E0%A8%BE%E0%A8%B9%E0%A8%B5%E0%A8%BE%E0%A8%B0%E0%A9%80_%E0%A8%B0%E0%A9%81%E0%A8%95%E0%A8%A3%E0%A8%BE" title="ਮਾਹਵਾਰੀ ਰੁਕਣਾ – Punjabi" lang="pa" hreflang="pa" data-title="ਮਾਹਵਾਰੀ ਰੁਕਣਾ" data-language-autonym="ਪੰਜਾਬੀ" data-language-local-name="Punjabi" class="interlanguage-link-target">ਪੰਜਾਬੀ</a></li><li class="interlanguage-link interwiki-ps mw-list-item"><a href="https://ps.wikipedia.org/wiki/%D9%85%DB%8C%D9%86%DB%8C%D9%88%D9%BE%D8%B2" title="مینیوپز – Pashto" lang="ps" hreflang="ps" data-title="مینیوپز" data-language-autonym="پښتو" data-language-local-name="Pashto" class="interlanguage-link-target">پښتو</a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Przekwitanie" title="Przekwitanie – Polish" lang="pl" hreflang="pl" data-title="Przekwitanie" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target">Polski</a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Menopausa" title="Menopausa – Portuguese" lang="pt" hreflang="pt" data-title="Menopausa" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target">Português</a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Menopauz%C4%83" title="Menopauză – Romanian" lang="ro" hreflang="ro" data-title="Menopauză" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target">Română</a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%9C%D0%B5%D0%BD%D0%BE%D0%BF%D0%B0%D1%83%D0%B7%D0%B0" title="Менопауза – Russian" lang="ru" hreflang="ru" data-title="Менопауза" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target">Русский</a></li><li class="interlanguage-link interwiki-sah mw-list-item"><a href="https://sah.wikipedia.org/wiki/%D0%9C%D0%B5%D0%BD%D0%BE%D0%BF%D0%B0%D1%83%D0%B7%D0%B0" title="Менопауза – Yakut" lang="sah" hreflang="sah" data-title="Менопауза" data-language-autonym="Саха тыла" data-language-local-name="Yakut" class="interlanguage-link-target">Саха тыла</a></li><li class="interlanguage-link interwiki-sq mw-list-item"><a href="https://sq.wikipedia.org/wiki/Menopauza" title="Menopauza – Albanian" lang="sq" hreflang="sq" data-title="Menopauza" data-language-autonym="Shqip" data-language-local-name="Albanian" class="interlanguage-link-target">Shqip</a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Menopause" title="Menopause – Simple English" lang="en-simple" hreflang="en-simple" data-title="Menopause" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target">Simple English</a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Menopavza" title="Menopavza – Slovenian" lang="sl" hreflang="sl" data-title="Menopavza" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target">Slovenščina</a></li><li class="interlanguage-link interwiki-ckb mw-list-item"><a href="https://ckb.wikipedia.org/wiki/%D9%84%DB%95%D8%B2%DA%AF%D9%88%DB%95%D8%B3%D8%AA%D8%A7%D9%86" title="لەزگوەستان – Central Kurdish" lang="ckb" hreflang="ckb" data-title="لەزگوەستان" data-language-autonym="کوردی" data-language-local-name="Central Kurdish" class="interlanguage-link-target">کوردی</a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Menopauza" title="Menopauza – Serbian" lang="sr" hreflang="sr" data-title="Menopauza" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target">Српски / srpski</a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Menopauza" title="Menopauza – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Menopauza" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target">Srpskohrvatski / српскохрватски</a></li><li class="interlanguage-link interwiki-su mw-list-item"><a href="https://su.wikipedia.org/wiki/M%C3%A9nopause" title="Ménopause – Sundanese" lang="su" hreflang="su" data-title="Ménopause" data-language-autonym="Sunda" data-language-local-name="Sundanese" class="interlanguage-link-target">Sunda</a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Vaihdevuodet" title="Vaihdevuodet – Finnish" lang="fi" hreflang="fi" data-title="Vaihdevuodet" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target">Suomi</a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Menopaus" title="Menopaus – Swedish" lang="sv" hreflang="sv" data-title="Menopaus" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target">Svenska</a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Layog" title="Layog – Tagalog" lang="tl" hreflang="tl" data-title="Layog" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target">Tagalog</a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%AE%E0%AE%BE%E0%AE%A4%E0%AE%B5%E0%AE%BF%E0%AE%9F%E0%AE%BE%E0%AE%AF%E0%AF%8D_%E0%AE%A8%E0%AE%BF%E0%AE%B1%E0%AF%81%E0%AE%A4%E0%AF%8D%E0%AE%A4%E0%AE%AE%E0%AF%8D" title="மாதவிடாய் நிறுத்தம் – Tamil" lang="ta" hreflang="ta" data-title="மாதவிடாய் நிறுத்தம்" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target">தமிழ்</a></li><li class="interlanguage-link interwiki-te mw-list-item"><a href="https://te.wikipedia.org/wiki/%E0%B0%8B%E0%B0%A4%E0%B1%81%E0%B0%B5%E0%B0%BF%E0%B0%B0%E0%B0%A4%E0%B0%BF" title="ఋతువిరతి – Telugu" lang="te" hreflang="te" data-title="ఋతువిరతి" data-language-autonym="తెలుగు" data-language-local-name="Telugu" class="interlanguage-link-target">తెలుగు</a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B8%A7%E0%B8%B1%E0%B8%A2%E0%B8%AB%E0%B8%A1%E0%B8%94%E0%B8%9B%E0%B8%A3%E0%B8%B0%E0%B8%88%E0%B8%B3%E0%B9%80%E0%B8%94%E0%B8%B7%E0%B8%AD%E0%B8%99" title="วัยหมดประจำเดือน – Thai" lang="th" hreflang="th" data-title="วัยหมดประจำเดือน" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target">ไทย</a></li><li class="interlanguage-link interwiki-tcy mw-list-item"><a href="https://tcy.wikipedia.org/wiki/%E0%B2%A4%E0%B2%BF%E0%B2%82%E0%B2%97%E0%B3%8A%E0%B2%B2%E0%B3%8D%E0%B2%A6_%E0%B2%95%E0%B3%81%E0%B2%A6%E0%B2%BF_%E0%B2%89%E0%B2%82%E0%B2%A4%E0%B3%81%E0%B2%A8%E0%B2%BF" title="ತಿಂಗೊಲ್ದ ಕುದಿ ಉಂತುನಿ – Tulu" lang="tcy" hreflang="tcy" data-title="ತಿಂಗೊಲ್ದ ಕುದಿ ಉಂತುನಿ" data-language-autonym="ತುಳು" data-language-local-name="Tulu" class="interlanguage-link-target">ತುಳು</a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Menopoz" title="Menopoz – Turkish" lang="tr" hreflang="tr" data-title="Menopoz" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target">Türkçe</a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%9C%D0%B5%D0%BD%D0%BE%D0%BF%D0%B0%D1%83%D0%B7%D0%B0" title="Менопауза – Ukrainian" lang="uk" hreflang="uk" data-title="Менопауза" data-language-autonym="Українська" data-language-local-name="Ukrainian" 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<div class="vector-body-before-content"> <div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Time when menstrual periods stop permanently</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">This article is about the condition affecting women. For the condition called male menopause, see <a href="/wiki/Andropause" class="mw-redirect" title="Andropause">Andropause</a>. For the medical journal, see <a href="/wiki/Menopause_(journal)" title="Menopause (journal)">Menopause (journal)</a>.</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">Not to be confused with <a href="/wiki/Mesopause" title="Mesopause">mesopause</a>.</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox infobox-has-images-with-white-backgrounds"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Menopause</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Climacteric</td></tr><tr><td colspan="2" class="infobox-full-data"><a href="/wiki/File:Menopause_symbol.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/5b/Menopause_symbol.svg/250px-Menopause_symbol.svg.png" decoding="async" width="250" height="250" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/5b/Menopause_symbol.svg/375px-Menopause_symbol.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/5b/Menopause_symbol.svg/500px-Menopause_symbol.svg.png 2x" data-file-width="16" data-file-height="16" /></a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Gynecology" class="mw-redirect" title="Gynecology">Gynecology</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data">No <a href="/wiki/Menstrual_period" class="mw-redirect" title="Menstrual period">menstrual periods</a> for a year<a href="#cite_note-NIH2013-Basics-1">[1]</a></td></tr><tr><th scope="row" class="infobox-label">Duration</th><td class="infobox-data">~3 years</td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data">Usually a natural change. Can also be caused by surgery that removes both <a href="/wiki/Ovaries" class="mw-redirect" title="Ovaries">ovaries</a>, and some types of <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a>.<a href="#cite_note-NIH2013-Basics-1">[1]</a></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data">None, lifestyle changes<a href="#cite_note-NIH2013Tx-2">[2]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medication" title="Medication">Medication</a></th><td class="infobox-data"><a href="/wiki/Hormone_replacement_therapy" title="Hormone replacement therapy">Menopausal hormone therapy</a>, <a href="/wiki/Clonidine" title="Clonidine">clonidine</a>, <a href="/wiki/Gabapentin" title="Gabapentin">gabapentin</a>, <a href="/wiki/Selective_serotonin_reuptake_inhibitor" title="Selective serotonin reuptake inhibitor">selective serotonin reuptake inhibitors</a><a href="#cite_note-NIH2013Tx-2">[2]</a><a href="#cite_note-Kra2015-3">[3]</a></td></tr></tbody></table><style data-mw-deduplicate="TemplateStyles:r1236303919">@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}</style> Menopause, also known as the climacteric, is the time when <a href="/wiki/Menstruation" title="Menstruation">menstrual periods</a> permanently stop, marking the end of the <a href="/wiki/Human_reproduction" title="Human reproduction">reproductive stage</a> for the female human.<a href="#cite_note-NIH2013-Basics-1">[1]</a><a href="#cite_note-PubMed2013-4">[4]</a><a href="#cite_note-5">[5]</a> It typically occurs between the ages of 45 and 55, although the exact timing can vary.<a href="#cite_note-Tak2015-6">[6]</a> Menopause is usually a natural change related to a decrease in circulating blood <a href="/wiki/Estrogen" title="Estrogen">estrogen</a> levels.<a href="#cite_note-NIH2013-Basics-1">[1]</a> It can occur earlier in those who <a href="/wiki/Smoke_tobacco" class="mw-redirect" title="Smoke tobacco">smoke tobacco</a>.<a href="#cite_note-NIH2013-Basics-1">[1]</a><a href="#cite_note-7">[7]</a> Other causes include surgery that removes both <a href="/wiki/Ovaries" class="mw-redirect" title="Ovaries">ovaries</a>, some types of <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a>, or anything that leads to a decrease in hormone levels.<a href="#cite_note-8">[8]</a><a href="#cite_note-NIH2013-Basics-1">[1]</a> At the physiological level, menopause happens because of a decrease in the ovaries' production of the hormones estrogen and <a href="/wiki/Progesterone" title="Progesterone">progesterone</a>.<a href="#cite_note-NIH2013-Basics-1">[1]</a> While typically not needed, measuring hormone levels in the blood or urine can confirm a diagnosis.<a href="#cite_note-9">[9]</a> Menopause is the opposite of <a href="/wiki/Menarche" title="Menarche">menarche</a>, the time when periods start.<a href="#cite_note-10">[10]</a> In the years before menopause, a woman's periods typically become irregular,<a href="#cite_note-NIH2013Sym-11">[11]</a><a href="#cite_note-NIA2017-12">[12]</a> which means that periods may be longer or shorter in duration, or be lighter or heavier in the amount of flow.<a href="#cite_note-NIH2013Sym-11">[11]</a> During this time, women often experience <a href="/wiki/Hot_flash" title="Hot flash">hot flashes</a>; these typically last from 30 seconds to ten minutes and may be associated with shivering, <a href="/wiki/Night_sweats" title="Night sweats">night sweats</a>, and reddening of the skin.<a href="#cite_note-NIH2013Sym-11">[11]</a> Hot flashes<a href="#cite_note-NIH2013Sym-11">[11]</a> can recur for four to five years.<a href="#cite_note-PubMed2013-4">[4]</a> Other symptoms may include <a href="/wiki/Vaginal_dryness" class="mw-redirect" title="Vaginal dryness">vaginal dryness</a>,<a href="#cite_note-:3-13">[13]</a> trouble sleeping, and mood changes.<a href="#cite_note-NIH2013Sym-11">[11]</a><a href="#cite_note-14">[14]</a> The severity of symptoms varies between women.<a href="#cite_note-PubMed2013-4">[4]</a> Menopause before the age of 45 years is considered to be "early menopause", and when ovarian failure/surgical removal of the ovaries occurs before the age of 40 years this is termed "<a href="/wiki/Primary_ovarian_insufficiency" title="Primary ovarian insufficiency">premature ovarian insufficiency</a>".<a href="#cite_note-auto1-15">[15]</a> In addition to symptoms (hot flushes/flashes, night sweats, mood changes, <a href="/wiki/Arthralgia" title="Arthralgia">arthralgia</a> and vaginal dryness), the physical consequences of menopause include bone loss, increased central abdominal fat, and adverse changes in a woman's cholesterol profile and vascular function.<a href="#cite_note-auto1-15">[15]</a> These changes predispose postmenopausal women to increased risks of <a href="/wiki/Osteoporosis" title="Osteoporosis">osteoporosis</a> and bone fracture, and of <a href="/wiki/Metabolic_syndrome" title="Metabolic syndrome">cardio-metabolic disease</a> (<a href="/wiki/Diabetes" title="Diabetes">diabetes</a> and <a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">cardiovascular disease</a>).<a href="#cite_note-auto1-15">[15]</a> <a href="/wiki/Health_professional" title="Health professional">Medical professionals</a> often define menopause as having occurred when a woman has not had any menstrual bleeding for a year.<a href="#cite_note-NIH2013-Basics-1">[1]</a> It may also be defined by a decrease in <a href="/wiki/Hormone" title="Hormone">hormone</a> production by the <a href="/wiki/Ovary" title="Ovary">ovaries</a>.<a href="#cite_note-Sie2006-16">[16]</a> In those who have had <a href="/wiki/Hysterectomy" title="Hysterectomy">surgery</a> to remove their <a href="/wiki/Uterus" title="Uterus">uterus</a> but still have functioning ovaries, menopause is not considered to have yet occurred.<a href="#cite_note-auto1-15">[15]</a> Following the removal of the uterus, symptoms of menopause typically occur earlier.<a href="#cite_note-17">[17]</a> Iatrogenic menopause occurs when both ovaries are surgically removed (<a href="/wiki/Oophorectomy" title="Oophorectomy">Oophorectomy</a>) along with the uterus for medical reasons. Medical treatment of menopause is primarily to ameliorate symptoms and prevent bone loss.<a href="#cite_note-auto2-18">[18]</a> Mild symptoms may be improved with treatment. With respect to hot flashes, avoiding nicotine, caffeine, and alcohol is often recommended; sleeping naked in a cool room and using a fan may help. The most effective treatment for menopausal symptoms is <a href="/wiki/Menopausal_hormone_therapy" class="mw-redirect" title="Menopausal hormone therapy">menopausal hormone therapy</a> (MHT).<a href="#cite_note-:3-13">[13]</a><a href="#cite_note-auto2-18">[18]</a> Non-hormonal therapies for hot flashes include <a href="/wiki/Cognitive_behavioral_therapy" title="Cognitive behavioral therapy">cognitive-behavioral therapy</a>, <a href="/wiki/Hypnotherapy" title="Hypnotherapy">clinical hypnosis</a>, <a href="/wiki/Gabapentin" title="Gabapentin">gabapentin</a>, <a href="/wiki/Fezolinetant" title="Fezolinetant">fezolinetant</a> or <a href="/wiki/Selective_serotonin_reuptake_inhibitors" class="mw-redirect" title="Selective serotonin reuptake inhibitors">selective serotonin reuptake inhibitors</a>.<a href="#cite_note-:62-19">[19]</a><a href="#cite_note-Kra20152-20">[20]</a> These will not improve symptoms such as joint pain or vaginal dryness, which affect over 55% of women.<a href="#cite_note-auto2-18">[18]</a> Exercise may help with sleeping problems. Many of the concerns about the use of MHT raised by older studies are no longer considered barriers to MHT in healthy women.<a href="#cite_note-auto2-18">[18]</a> High-quality evidence for the effectiveness of <a href="/wiki/Alternative_medicine" title="Alternative medicine">alternative medicine</a> has not been found.<a href="#cite_note-PubMed2013-4">[4]</a> <style data-mw-deduplicate="TemplateStyles:r886046785">.mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 ul{display:none}</style><div class="toclimit-3"><meta property="mw:PageProp/toc" /></div> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2>[<a href="/w/index.php?title=Menopause&action=edit&section=1" title="Edit section: Signs and symptoms">edit</a>]</div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Symptoms_of_menopause_(vector).svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/9f/Symptoms_of_menopause_%28vector%29.svg/300px-Symptoms_of_menopause_%28vector%29.svg.png" decoding="async" width="300" height="303" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/9f/Symptoms_of_menopause_%28vector%29.svg/450px-Symptoms_of_menopause_%28vector%29.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/9f/Symptoms_of_menopause_%28vector%29.svg/600px-Symptoms_of_menopause_%28vector%29.svg.png 2x" data-file-width="1363" data-file-height="1377" /></a><figcaption>Symptoms of menopause</figcaption></figure> During early menopause transition, the <a href="/wiki/Menstrual_cycles" class="mw-redirect" title="Menstrual cycles">menstrual cycles</a> remain regular but the interval between cycles begins to lengthen. Hormone levels begin to fluctuate. Ovulation may not occur with each cycle.<a href="#cite_note-Hoffman20122-21">[21]</a> The term menopause refers to a point in time that follows one year after the last <a href="/wiki/Menstruation" title="Menstruation">menstruation</a>.<a href="#cite_note-Hoffman20122-21">[21]</a> During the menopausal transition and after menopause, women can experience a wide range of symptoms.<a href="#cite_note-NIH2013Sym-11">[11]</a> However, for women who enter the menopause transition without having regular menstrual cycles (due to prior surgery, other medical conditions or ongoing hormonal contraception) the menopause cannot be identified by bleeding patterns and is defined as the permanent loss of ovarian function.<a href="#cite_note-auto2-18">[18]</a> <div class="mw-heading mw-heading3"><h3 id="Vagina,_uterus_and_bladder_(urogenital_tract)">Vagina, uterus and bladder (urogenital tract)</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=2" title="Edit section: Vagina, uterus and bladder (urogenital tract)">edit</a>]</div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Vaginal_Canal_Normal_vs._Menopause.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/7/77/Vaginal_Canal_Normal_vs._Menopause.png/220px-Vaginal_Canal_Normal_vs._Menopause.png" decoding="async" width="220" height="170" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/77/Vaginal_Canal_Normal_vs._Menopause.png/330px-Vaginal_Canal_Normal_vs._Menopause.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/77/Vaginal_Canal_Normal_vs._Menopause.png/440px-Vaginal_Canal_Normal_vs._Menopause.png 2x" data-file-width="1200" data-file-height="927" /></a><figcaption>Size of the <a href="/wiki/Vaginal_canal" class="mw-redirect" title="Vaginal canal">vaginal canal</a> before and after menopause, demonstrating vaginal <a href="/wiki/Atrophy" title="Atrophy">atrophy</a></figcaption></figure> During the transition to menopause, <a href="/wiki/Menstrual_cycle" title="Menstrual cycle">menstrual patterns</a> can show shorter cycling (by 2–7 days);<a href="#cite_note-Hoffman20122-21">[21]</a> longer cycles remain possible.<a href="#cite_note-Hoffman20122-21">[21]</a> There may be <a href="/wiki/Irregular_menstruation" title="Irregular menstruation">irregular bleeding</a> (lighter, heavier, spotting).<a href="#cite_note-NIH2013Sym-11">[11]</a><a href="#cite_note-Hoffman20122-21">[21]</a> <a href="/wiki/Dysfunctional_uterine_bleeding" class="mw-redirect" title="Dysfunctional uterine bleeding">Dysfunctional uterine bleeding</a> is often experienced by women approaching menopause due to the hormonal changes that accompany the menopause transition. Spotting or bleeding may simply be related to vaginal <a href="/wiki/Atrophy" title="Atrophy">atrophy</a>, a benign sore (<a href="/wiki/Polyp_(medicine)" title="Polyp (medicine)">polyp</a> or lesion), or may be a functional endometrial response. The <a href="/wiki/European_Menopause_and_Andropause_Society" title="European Menopause and Andropause Society">European Menopause and Andropause Society</a> has released guidelines for assessment of the <a href="/wiki/Endometrium" title="Endometrium">endometrium</a>, which is usually the main source of spotting or bleeding.<a href="#cite_note-pmid236190092-22">[22]</a> In post-menopausal women, however, any unscheduled vaginal <a href="/wiki/Bleeding" title="Bleeding">bleeding</a> is of concern and requires an appropriate investigation to rule out the possibility of malignant diseases. Urogenital symptoms may appear during menopause and continue through <a href="/wiki/Postmenopause" class="mw-redirect" title="Postmenopause">postmenopause</a> and include <a href="/wiki/Dyspareunia" title="Dyspareunia">painful intercourse</a>, <a href="/wiki/Vaginal_dryness" class="mw-redirect" title="Vaginal dryness">vaginal dryness</a> and <a href="/wiki/Atrophic_vaginitis" title="Atrophic vaginitis">atrophic vaginitis</a> (thinning of the membranes of the <a href="/wiki/Vulva" title="Vulva">vulva</a>, the <a href="/wiki/Vagina" title="Vagina">vagina</a>, the <a href="/wiki/Cervix" title="Cervix">cervix</a> and the outer <a href="/wiki/Urinary_tract" class="mw-redirect" title="Urinary tract">urinary tract</a>). There may also be considerable shrinking and loss in elasticity of all of the outer and inner genital areas. <a href="/wiki/Urinary_urgency" class="mw-redirect" title="Urinary urgency">Urinary urgency</a> may also occur and <a href="/wiki/Urinary_incontinence" title="Urinary incontinence">urinary incontinence</a> in some women.<a href="#cite_note-Hoffman20122-21">[21]</a><a href="#cite_note-:4-23">[23]</a> <div class="mw-heading mw-heading3"><h3 id="Other_physical_effects">Other physical effects</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=3" title="Edit section: Other physical effects">edit</a>]</div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Menopause_-_Osteoporosis_--_Smart-Servier_(cropped).jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/7/74/Menopause_-_Osteoporosis_--_Smart-Servier_%28cropped%29.jpg/250px-Menopause_-_Osteoporosis_--_Smart-Servier_%28cropped%29.jpg" decoding="async" width="220" height="137" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/74/Menopause_-_Osteoporosis_--_Smart-Servier_%28cropped%29.jpg/330px-Menopause_-_Osteoporosis_--_Smart-Servier_%28cropped%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/74/Menopause_-_Osteoporosis_--_Smart-Servier_%28cropped%29.jpg/500px-Menopause_-_Osteoporosis_--_Smart-Servier_%28cropped%29.jpg 2x" data-file-width="7471" data-file-height="4649" /></a><figcaption>Bone mineral density, especially of the vertebrae, decreases with menopause.</figcaption></figure> The most common physical symptoms of menopause are heavy <a href="/wiki/Night_sweat" class="mw-redirect" title="Night sweat">night sweats</a>, and <a href="/wiki/Hot_flash" title="Hot flash">hot flashes</a> (also known as vasomotor symptoms).<a href="#cite_note-24">[24]</a> Sleeping problems and <a href="/wiki/Insomnia" title="Insomnia">insomnia</a> are also common.<a href="#cite_note-25">[25]</a> Other physical symptoms may be reported that are not specific to menopause but may be exacerbated by it, such as <a href="/wiki/Fatigue_(medical)" class="mw-redirect" title="Fatigue (medical)">lack of energy</a>, <a href="/wiki/Arthralgia" title="Arthralgia">joint soreness</a>, <a href="/wiki/Joint_stiffness" title="Joint stiffness">stiffness</a>, <a href="/wiki/Back_pain" title="Back pain">back pain</a>, breast enlargement, <a href="/wiki/Mastodynia" class="mw-redirect" title="Mastodynia">breast pain</a>, <a href="/wiki/Heart_palpitation" class="mw-redirect" title="Heart palpitation">heart palpitations</a>, <a href="/wiki/Headache" title="Headache">headache</a>, <a href="/wiki/Dizziness" title="Dizziness">dizziness</a>, <a href="/wiki/Xeroderma" title="Xeroderma">dry</a>, <a href="/wiki/Itch" title="Itch">itchy</a> skin, thinning, <a href="/wiki/Paresthesia" title="Paresthesia">tingling</a> skin, <a href="/wiki/Rosacea" title="Rosacea">rosacea</a>, <a href="/wiki/Obesity" title="Obesity">weight gain</a>.<a href="#cite_note-Hoffman20122-21">[21]</a><a href="#cite_note-26">[26]</a> <div class="mw-heading mw-heading3"><h3 id="Mood_and_memory_effects">Mood and memory effects</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=4" title="Edit section: Mood and memory effects">edit</a>]</div> Psychological symptoms are often reported but they are not specific to menopause and can be caused by other factors.<a href="#cite_note-:2-27">[27]</a><a href="#cite_note-:1-28">[28]</a> They include <a href="/wiki/Anxiety" title="Anxiety">anxiety</a>, poor memory, inability to concentrate, depressive mood, <a href="/wiki/Irritability" title="Irritability">irritability</a>, <a href="/wiki/Mood_swing" title="Mood swing">mood swings</a>, and less <a href="/wiki/Libido" title="Libido">interest in sexual activity</a>.<a href="#cite_note-Hoffman20122-21">[21]</a><a href="#cite_note-Llaneza2-29">[29]</a><a href="#cite_note-NIH2013Sym-11">[11]</a> <a href="/wiki/Postmenopausal_confusion" title="Postmenopausal confusion">Menopause-related cognitive impairment</a> can be confused with the <a href="/wiki/Mild_cognitive_impairment" title="Mild cognitive impairment">mild cognitive impairment</a> that precedes <a href="/wiki/Dementia" title="Dementia">dementia</a>.<a href="#cite_note-30">[30]</a> There is evidence of small decreases in verbal memory, on average, which may be caused by the effects of declining estrogen levels on the brain,<a href="#cite_note-:02-31">[31]</a> or perhaps by reduced blood flow to the brain during <a href="/wiki/Hot_flash" title="Hot flash">hot flashes</a>.<a href="#cite_note-32">[32]</a> However, these tend to resolve for most women during the postmenopause. Subjective reports of memory and concentration problems are associated with several factors, such as lack of sleep, and stress.<a href="#cite_note-:1-28">[28]</a><a href="#cite_note-:2-27">[27]</a> <div class="mw-heading mw-heading3"><h3 id="Long-term_effects">Long-term effects</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=5" title="Edit section: Long-term effects">edit</a>]</div> <div class="mw-heading mw-heading4"><h4 id="Cardiovascular_health">Cardiovascular health</h4>[<a href="/w/index.php?title=Menopause&action=edit&section=6" title="Edit section: Cardiovascular health">edit</a>]</div> Exposure to endogenous <a href="/wiki/Estrogen" title="Estrogen">estrogen</a> during reproductive years provides women with protection against <a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">cardiovascular disease</a>, which is lost around 10 years after the onset of menopause. The menopausal transition is associated with an increase in <a href="/wiki/Fat_mass" class="mw-redirect" title="Fat mass">fat mass</a> (predominantly in <a href="/wiki/Visceral_fat" class="mw-redirect" title="Visceral fat">visceral fat</a>), an increase in <a href="/wiki/Insulin_resistance" title="Insulin resistance">insulin resistance</a>, <a href="/wiki/Dyslipidemia" title="Dyslipidemia">dyslipidaemia</a>, and <a href="/wiki/Endothelial_dysfunction" title="Endothelial dysfunction">endothelial dysfunction</a>.<a href="#cite_note-33">[33]</a> Women with <a href="/wiki/Vasomotor_symptoms" class="mw-redirect" title="Vasomotor symptoms">vasomotor symptoms</a> during menopause seem to have an especially unfavorable cardiometabolic profile,<a href="#cite_note-34">[34]</a> as well as women with premature onset of menopause (before 45 years of age).<a href="#cite_note-35">[35]</a> These risks can be reduced by managing risk factors, such as tobacco smoking, <a href="/wiki/Hypertension" title="Hypertension">hypertension</a>, increased <a href="/wiki/Blood_lipid" class="mw-redirect" title="Blood lipid">blood lipids</a> and body weight.<a href="#cite_note-Souza20132-36">[36]</a><a href="#cite_note-ESHRE20112-37">[37]</a> <div class="mw-heading mw-heading4"><h4 id="Bone_health">Bone health</h4>[<a href="/w/index.php?title=Menopause&action=edit&section=7" title="Edit section: Bone health">edit</a>]</div> The annual rates of <a href="/wiki/Bone_density" title="Bone density">bone mineral density</a> loss are highest starting one year before the final menstrual period and continuing through the two years after it.<a href="#cite_note-38">[38]</a> Thus, post menopausal women are at increased risk of <a href="/wiki/Osteopenia" title="Osteopenia">osteopenia</a>, <a href="/wiki/Osteoporosis" title="Osteoporosis">osteoporosis</a> and <a href="/wiki/Fracture" title="Fracture">fractures</a>. <div class="mw-heading mw-heading2"><h2 id="Causes">Causes</h2>[<a href="/w/index.php?title=Menopause&action=edit&section=8" title="Edit section: Causes">edit</a>]</div> Menopause is a normal event in a woman's life and a natural part of aging.<a href="#cite_note-:4-23">[23]</a> Menopause can also be induced early.<a href="#cite_note-:12-39">[39]</a> Induced menopause occurs as a result of medical treatment such as <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a>, <a href="/wiki/Radiotherapy" class="mw-redirect" title="Radiotherapy">radiotherapy</a>, <a href="/wiki/Oophorectomy" title="Oophorectomy">oophorectomy</a>, or complications of <a href="/wiki/Tubal_ligation" title="Tubal ligation">tubal ligation</a>, <a href="/wiki/Hysterectomy" title="Hysterectomy">hysterectomy</a>, unilateral or bilateral salpingo-oophorectomy or <a href="/wiki/Leuprorelin" title="Leuprorelin">leuprorelin</a> usage.<a href="#cite_note-40">[40]</a> <div class="mw-heading mw-heading3"><h3 id="Age">Age</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=9" title="Edit section: Age">edit</a>]</div> Menopause typically occurs at some point between 47 and 54 years of age.<a href="#cite_note-Tak2015-6">[6]</a> According to various data, more than 95% of women have their last period between the ages of 44–56 (median 49–50). 2% of women under the age of 40, 5% between the ages of 40–45 and the same number between the ages of 55–58 have their last bleeding.<a href="#cite_note-41">[41]</a> The average age of the last period in the United States is 51 years, in Russia is 50 years, in Greece is 49 years, in Turkey is 47 years, in Egypt is 47 years and in India is 46 years.<a href="#cite_note-42">[42]</a> Beyond the influence of genetics, these differences are also due to early-life environmental conditions<a href="#cite_note-43">[43]</a> and associated with epigenetic effects.<a href="#cite_note-44">[44]</a> The menopausal transition or perimenopause leading up to menopause usually lasts 3–4 years (sometimes as long as 5–14 years).<a href="#cite_note-NIH2013-Basics-1">[1]</a><a href="#cite_note-NIA2017-12">[12]</a> Undiagnosed and untreated <a href="/wiki/Coeliac_disease" title="Coeliac disease">coeliac disease</a> is a risk factor for early menopause. Coeliac disease can present with several non-gastrointestinal symptoms, in the absence of gastrointestinal symptoms, and most cases escape timely recognition and go undiagnosed, leading to a risk of long-term complications. A strict <a href="/wiki/Gluten-free_diet" title="Gluten-free diet">gluten-free diet</a> reduces the risk. Women with early diagnosis and treatment of coeliac disease present a normal duration of fertile life span.<a href="#cite_note-TersigniCastellani2-45">[45]</a><a href="#cite_note-LasaZubiaurre2-46">[46]</a> Women who have undergone <a href="/wiki/Hysterectomy" title="Hysterectomy">hysterectomy</a> with ovary conservation go through menopause on average 1.5 years earlier than the expected age.<a href="#cite_note-auto2-18">[18]</a> <div class="mw-heading mw-heading3"><h3 id="Premature_ovarian_insufficiency">Premature ovarian insufficiency</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=10" title="Edit section: Premature ovarian insufficiency">edit</a>]</div> In rare cases, a woman's ovaries stop working at a very early age, ranging anywhere from the age of <a href="/wiki/Puberty" title="Puberty">puberty</a> to age 40. This is known as <a href="/wiki/Premature_ovarian_failure" class="mw-redirect" title="Premature ovarian failure">premature ovarian failure</a> or premature ovarian insufficiency (POI) and affects 1 to 2% of women by age 40.<a href="#cite_note-47">[47]</a><a href="#cite_note-Laissue20152-48">[48]</a><a href="#cite_note--Fenton20152-49">[49]</a> It is diagnosed or confirmed by high blood levels of <a href="/wiki/Follicle_stimulating_hormone" class="mw-redirect" title="Follicle stimulating hormone">follicle stimulating hormone</a> (FSH) and <a href="/wiki/Luteinizing_hormone" title="Luteinizing hormone">luteinizing hormone</a> (LH) on at least three occasions at least four weeks apart.<a href="#cite_note-Kalantaridou_10062-50">[50]</a> Premature ovarian insufficiency may be related to an auto immune disorder and therefore might co-occur with other <a href="/wiki/Autoimmune_disorder" class="mw-redirect" title="Autoimmune disorder">autoimmune disorders</a> such as <a href="/wiki/Thyroid" title="Thyroid">thyroid</a> disease, [adrenal insufficiency], and <a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">diabetes mellitus</a>.<a href="#cite_note--Fenton20152-49">[49]</a> Other causes include <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a>, being a carrier of the <a href="/wiki/Fragile_X_syndrome" title="Fragile X syndrome">fragile X syndrome</a> gene, and <a href="/wiki/Radiotherapy" class="mw-redirect" title="Radiotherapy">radiotherapy</a>.<a href="#cite_note--Fenton20152-49">[49]</a> However, in about 50–80% of cases of premature ovarian insufficiency, the cause is unknown, i.e., it is generally <a href="/wiki/Idiopathic" class="mw-redirect" title="Idiopathic">idiopathic</a>.<a href="#cite_note-Laissue20152-48">[48]</a><a href="#cite_note-Kalantaridou_10062-50">[50]</a> Early menopause can be related to <a href="/wiki/Cigarette" title="Cigarette">cigarette</a> smoking, higher <a href="/wiki/Body_mass_index" title="Body mass index">body mass index</a>, racial and ethnic factors, illnesses, and the removal of the uterus.<a href="#cite_note-Bucher,_et_al._19302-51">[51]</a> <div class="mw-heading mw-heading3"><h3 id="Surgical_menopause">Surgical menopause</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=11" title="Edit section: Surgical menopause">edit</a>]</div> Menopause can be surgically induced by bilateral <a href="/wiki/Oophorectomy" title="Oophorectomy">oophorectomy</a> (removal of ovaries),<a href="#cite_note-:12-39">[39]</a> which is often, but not always, done in conjunction with removal of the fallopian tubes (<a href="/wiki/Salpingo-oophorectomy" title="Salpingo-oophorectomy">salpingo-oophorectomy</a>) and uterus (<a href="/wiki/Hysterectomy" title="Hysterectomy">hysterectomy</a>).<a href="#cite_note-STRAW2-52">[52]</a> Cessation of menses as a result of removal of the ovaries is called "surgical menopause". Surgical treatments, such as the removal of ovaries, might cause periods to stop altogether.<a href="#cite_note-Womenshealth.gov2-53">[53]</a> The sudden and complete drop in hormone levels may produce extreme withdrawal symptoms such as hot flashes, etc. The symptoms of early menopause may be more severe.<a href="#cite_note-Womenshealth.gov2-53">[53]</a> Removal of the uterus without removal of the ovaries does not directly cause menopause, although pelvic surgery of this type can often precipitate a somewhat earlier menopause, perhaps because of a compromised blood supply to the ovaries.[<a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)">medical citation needed</a>] The time between surgery and possible early menopause is due to the fact that ovaries are still producing hormones.<a href="#cite_note-Womenshealth.gov2-53">[53]</a> <div class="mw-heading mw-heading2"><h2 id="Mechanism">Mechanism</h2>[<a href="/w/index.php?title=Menopause&action=edit&section=12" title="Edit section: Mechanism">edit</a>]</div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:615_Age_and_Bone_Mass.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/91/615_Age_and_Bone_Mass.jpg/220px-615_Age_and_Bone_Mass.jpg" decoding="async" width="220" height="141" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/91/615_Age_and_Bone_Mass.jpg/330px-615_Age_and_Bone_Mass.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/91/615_Age_and_Bone_Mass.jpg/440px-615_Age_and_Bone_Mass.jpg 2x" data-file-width="860" data-file-height="553" /></a><figcaption><a href="/wiki/Bone_mass" class="mw-redirect" title="Bone mass">Bone loss</a> due to menopause occurs due to changes in a <a href="/wiki/Female_hormones" class="mw-redirect" title="Female hormones">woman's hormone levels</a>.</figcaption></figure> The menopausal transition, and postmenopause itself, is a natural change, not usually a disease state or a disorder. The main cause of this transition is the natural depletion and aging of the finite amount of <a href="/wiki/Oocytes" class="mw-redirect" title="Oocytes">oocytes</a> (<a href="/wiki/Ovarian_reserve" title="Ovarian reserve">ovarian reserve</a>). This process is sometimes accelerated by other conditions and is known to occur earlier after a wide range of gynecologic procedures such as <a href="/wiki/Hysterectomy" title="Hysterectomy">hysterectomy</a> (with and without <a href="/wiki/Ovariectomy" class="mw-redirect" title="Ovariectomy">ovariectomy</a>), <a href="/wiki/Endometrial_ablation" title="Endometrial ablation">endometrial ablation</a> and <a href="/wiki/Uterine_artery_embolisation" class="mw-redirect" title="Uterine artery embolisation">uterine artery embolisation</a>. The depletion of the ovarian reserve causes an increase in circulating <a href="/wiki/Follicle-stimulating_hormone" title="Follicle-stimulating hormone">follicle-stimulating hormone</a> (FSH) and <a href="/wiki/Luteinizing_hormone" title="Luteinizing hormone">luteinizing hormone</a> (LH) levels because there are fewer <a href="/wiki/Oocyte" title="Oocyte">oocytes</a> and follicles responding to these hormones and producing estrogen.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] The transition has a variable degree of effects.<a href="#cite_note-54">[54]</a> The stages of the menopause transition have been classified according to a woman's reported bleeding pattern, supported by changes in the pituitary <a href="/wiki/Follicle-stimulating_hormone" title="Follicle-stimulating hormone">follicle-stimulating hormone</a> (FSH) levels.<a href="#cite_note-55">[55]</a> In younger women, during a normal <a href="/wiki/Menstrual_cycle" title="Menstrual cycle">menstrual cycle</a> the ovaries produce <a href="/wiki/Estradiol" title="Estradiol">estradiol</a>, <a href="/wiki/Testosterone" title="Testosterone">testosterone</a> and <a href="/wiki/Progesterone" title="Progesterone">progesterone</a> in a cyclical pattern under the control of FSH and <a href="/wiki/Luteinizing_hormone" title="Luteinizing hormone">luteinizing hormone</a> (LH), which are both produced by the <a href="/wiki/Pituitary_gland" title="Pituitary gland">pituitary gland</a>. During perimenopause (approaching menopause), <a href="/wiki/Estradiol" title="Estradiol">estradiol</a> levels and patterns of production remain relatively unchanged or may increase compared to young women, but the cycles become frequently shorter or irregular.<a href="#cite_note-Prior_20132-56">[56]</a> The often observed increase in estrogen is presumed to be in response to elevated FSH levels that, in turn, is hypothesized to be caused by decreased feedback by <a href="/wiki/Inhibin" class="mw-redirect" title="Inhibin">inhibin</a>.<a href="#cite_note-ReferenceB2-57">[57]</a> Similarly, decreased inhibin feedback after <a href="/wiki/Hysterectomy" title="Hysterectomy">hysterectomy</a> is hypothesized to contribute to increased ovarian stimulation and earlier menopause.<a href="#cite_note-cite_journal|pmid=127376732-58">[58]</a><a href="#cite_note-cite_journal|pmid=156619472-59">[59]</a> The menopausal transition is characterized by marked, and often dramatic, variations in FSH and estradiol levels. Because of this, measurements of these hormones are not considered to be reliable guides to a woman's exact menopausal status.<a href="#cite_note-ReferenceB2-57">[57]</a> Menopause occurs because of the sharp decrease of estradiol and progesterone production by the ovaries. After menopause, estrogen continues to be produced mostly by <a href="/wiki/Aromatase" title="Aromatase">aromatase</a> in fat tissues and is produced in small amounts in many other tissues such as ovaries, bone, blood vessels, and the brain where it acts locally.<a href="#cite_note-60">[60]</a> The substantial fall in circulating estradiol levels at menopause impacts many tissues, from brain to skin. In contrast to the sudden fall in estradiol during menopause, the levels of total and free testosterone, as well as <a href="/wiki/Dehydroepiandrosterone_sulfate" title="Dehydroepiandrosterone sulfate">dehydroepiandrosterone sulfate</a> (DHEAS) and <a href="/wiki/Androstenedione" title="Androstenedione">androstenedione</a> appear to decline more or less steadily with age. An effect of natural menopause on circulating <a href="/wiki/Androgen" title="Androgen">androgen</a> levels has not been observed.<a href="#cite_note-61">[61]</a> Thus specific tissue effects of natural menopause cannot be attributed to loss of androgenic hormone production.<a href="#cite_note-Ovarian_Androgen_Production_in_Postmenopausal_Women2-62">[62]</a> Hot flashes and other vasomotor and body symptoms accompanying the menopausal transition are associated with estrogen insufficiency and changes that occur in the brain, primarily the <a href="/wiki/Hypothalamus" title="Hypothalamus">hypothalamus</a> and involve complex interplay between the neurotransmitters <a href="/wiki/Kisspeptin" title="Kisspeptin">kisspeptin</a>, <a href="/wiki/Neurokinin_B" title="Neurokinin B">neurokinin B</a>, and <a href="/wiki/Dynorphin" title="Dynorphin">dynorphin</a>, which are found in KNDy neurons in the infundibular nucleus.<a href="#cite_note-63">[63]</a> <div class="mw-heading mw-heading3"><h3 id="Ovarian_aging">Ovarian aging</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=13" title="Edit section: Ovarian aging">edit</a>]</div> Decreased inhibin feedback after <a href="/wiki/Hysterectomy" title="Hysterectomy">hysterectomy</a> is hypothesized to contribute to increased ovarian stimulation and earlier menopause. Hastened ovarian aging has been observed after <a href="/wiki/Endometrial_ablation" title="Endometrial ablation">endometrial ablation</a>. While it is difficult to prove that these surgeries are causative, it has been hypothesized that the <a href="/wiki/Endometrium" title="Endometrium">endometrium</a> may be producing endocrine factors contributing to the endocrine feedback and regulation of the ovarian stimulation. Elimination of these factors contributes to faster depletion of the ovarian reserve. Reduced blood supply to the ovaries that may occur as a consequence of hysterectomy and <a href="/wiki/Uterine_artery_embolisation" class="mw-redirect" title="Uterine artery embolisation">uterine artery embolisation</a> has been hypothesized to contribute to this effect.<a href="#cite_note-cite_journal|pmid=127376732-58">[58]</a><a href="#cite_note-cite_journal|pmid=156619472-59">[59]</a> Impaired <a href="/wiki/DNA" title="DNA">DNA</a> repair mechanisms may contribute to earlier depletion of the ovarian reserve during aging.<a href="#cite_note-Titus2-64">[64]</a> As women age, double-strand breaks accumulate in the DNA of their primordial follicles. Primordial follicles are immature primary oocytes surrounded by a single layer of granulosa cells. An enzyme system is present in oocytes that ordinarily accurately repairs DNA double-strand breaks. This repair system is called "<a href="/wiki/Homologous_recombination" title="Homologous recombination">homologous recombinational</a> repair", and it is especially effective during meiosis. Meiosis is the general process by which germ cells are formed in all sexual eukaryotes; it appears to be an adaptation for efficiently removing damages in germ line DNA.<a href="#cite_note-65">[65]</a> Human primary oocytes are present at an intermediate stage of meiosis, termed prophase I (see <a href="/wiki/Oogenesis" title="Oogenesis">Oogenesis</a>). Expression of four key DNA repair genes that are necessary for homologous recombinational repair during meiosis (BRCA1, MRE11, Rad51, and ATM) decline with age in oocytes.<a href="#cite_note-Titus2-64">[64]</a> This age-related decline in ability to repair DNA double-strand damages can account for the accumulation of these damages, that then likely contributes to the depletion of the ovarian reserve. <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2>[<a href="/w/index.php?title=Menopause&action=edit&section=14" title="Edit section: Diagnosis">edit</a>]</div> Ways of assessing the impact on women of some of these menopause effects, include the <a href="/wiki/Greene_Menopause_Index" title="Greene Menopause Index">Greene climacteric scale</a> questionnaire,<a href="#cite_note-pmid96435142-66">[66]</a> the Cervantes scale<a href="#cite_note-pmid225491662-67">[67]</a> and the Menopause rating scale.<a href="#cite_note-pmid199452372-68">[68]</a> <div class="mw-heading mw-heading3"><h3 id="Perimenopause">Perimenopause</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=15" title="Edit section: Perimenopause">edit</a>]</div> The term "perimenopause", which literally means "around the menopause", refers to the menopause transition years before the date of the final episode of flow.<a href="#cite_note-NIH2013-Basics-1">[1]</a><a href="#cite_note-NIA2017-12">[12]</a><a href="#cite_note-:42-69">[69]</a><a href="#cite_note-70">[70]</a> According to the <a href="/wiki/North_American_Menopause_Society" title="North American Menopause Society">North American Menopause Society</a>, this transition can last for four to eight years.<a href="#cite_note-71">[71]</a> The <a href="/wiki/Centre_for_Menstrual_Cycle_and_Ovulation_Research" title="Centre for Menstrual Cycle and Ovulation Research">Centre for Menstrual Cycle and Ovulation Research</a> describes it as a six- to ten-year phase ending 12 months after the last menstrual period.<a href="#cite_note-cemcor2-72">[72]</a> During perimenopause, <a href="/wiki/Estrogen" title="Estrogen">estrogen</a> levels average about 20–30% higher than during premenopause, often with wide fluctuations.<a href="#cite_note-cemcor2-72">[72]</a> These fluctuations cause many of the physical changes during perimenopause as well as menopause, especially during the last 1–2 years of perimenopause (before menopause).<a href="#cite_note-:42-69">[69]</a><a href="#cite_note-73">[73]</a> Some of these changes are <a href="/wiki/Hot_flash" title="Hot flash">hot flashes</a>, <a href="/wiki/Night_sweats" title="Night sweats">night sweats</a>, difficulty sleeping, mood swings, <a href="/wiki/Vaginal_dryness" class="mw-redirect" title="Vaginal dryness">vaginal dryness</a> or <a href="/wiki/Vaginal_atrophy" class="mw-redirect" title="Vaginal atrophy">atrophy</a>, <a href="/wiki/Fecal_incontinence" title="Fecal incontinence">incontinence</a>, <a href="/wiki/Osteoporosis" title="Osteoporosis">osteoporosis</a>, and heart disease.<a href="#cite_note-cemcor2-72">[72]</a> Perimenopause is also associated with a higher likelihood of depression (affecting from 45 percent to 68 percent of perimenopausal women), which is twice as likely to affect those with a history of depression.<a href="#cite_note-Gilbert2-74">[74]</a> During this period, <a href="/wiki/Fertility" title="Fertility">fertility</a> diminishes but is not considered to reach zero until the official date of menopause. The official date is determined retroactively, once 12 months have passed after the last appearance of menstrual blood. The menopause transition typically begins between 40 and 50 years of age (average 47.5).<a href="#cite_note-75">[75]</a><a href="#cite_note-McN20152-76">[76]</a> The duration of perimenopause may be for up to eight years.<a href="#cite_note-McN20152-76">[76]</a> Women will often, but not always, start these transitions (perimenopause and menopause) about the same time as their mother did.<a href="#cite_note-77">[77]</a> Some research appears to show that <a href="/wiki/Melatonin" title="Melatonin">melatonin</a> supplementation in perimenopausal women can improve thyroid function and gonadotropin levels, as well as restoring fertility and menstruation and preventing depression associated with menopause.<a href="#cite_note-Bellipanni_20052-78">[78]</a> <div class="mw-heading mw-heading3"><h3 id="Postmenopause">Postmenopause</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=16" title="Edit section: Postmenopause">edit</a>]</div> The term "postmenopausal" describes women who have not experienced any menstrual flow for a minimum of 12 months, assuming that they have a <a href="/wiki/Uterus" title="Uterus">uterus</a> and are not pregnant or <a href="/wiki/Lactation" title="Lactation">lactating</a>.<a href="#cite_note-STRAW2-52">[52]</a> The reason for this delay in declaring postmenopause is that periods are usually erratic during menopause. Therefore, a reasonably long stretch of time is necessary to be sure that the cycling has ceased. At this point a woman is considered infertile; however, the possibility of becoming pregnant has usually been very low (but not quite zero) for a number of years before this point is reached.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] In women with or without a uterus, menopause or postmenopause can also be identified by a blood test showing a very high <a href="/wiki/Follicle-stimulating_hormone" title="Follicle-stimulating hormone">follicle-stimulating hormone</a> level, greater than 25 IU/L in a random blood draw; it rises as ovaries become inactive.<a href="#cite_note-STRAW2-52">[52]</a> FSH continues to rise, as its counterpart estradiol continues to drop for about 2 years after the last menstrual period, after which the levels of each of these hormones stabilize. The stabilization period after the begin of early postmenopause has been estimated to last 3 to 6 years, so early postmenopause lasts altogether about 5 to 8 years, during which hormone withdrawal effects such as hot flashes disappear.<a href="#cite_note-STRAW2-52">[52]</a> Finally, late postmenopause has been defined as the remainder of a woman s lifespan, when reproductive hormones do not change any more.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] A period-like flow during postmenopause, even spotting, may be a sign of <a href="/wiki/Endometrial_cancer" title="Endometrial cancer">endometrial cancer</a>. <div class="mw-heading mw-heading2"><h2 id="Management">Management</h2>[<a href="/w/index.php?title=Menopause&action=edit&section=17" title="Edit section: Management">edit</a>]</div> Perimenopause is a natural stage of life. It is not a disease or a disorder. Therefore, it does not automatically require any kind of medical treatment. However, in those cases where the physical, mental, and emotional effects of perimenopause are strong enough that they significantly disrupt the life of the woman experiencing them, palliative medical therapy may sometimes be appropriate. <div class="mw-heading mw-heading3"><h3 id="Menopausal_hormone_therapy">Menopausal hormone therapy</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=18" title="Edit section: Menopausal hormone therapy">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Hormone_replacement_therapy" title="Hormone replacement therapy">Hormone replacement therapy</a></div> In the context of the menopause, <a href="/wiki/Menopausal_hormone_therapy" class="mw-redirect" title="Menopausal hormone therapy">menopausal hormone therapy</a> (MHT) is the use of <a href="/wiki/Estrogen" title="Estrogen">estrogen</a> in women without a uterus and estrogen plus <a href="/wiki/Progestogen" title="Progestogen">progestogen</a> in women who have an intact uterus.<a href="#cite_note-79">[79]</a> MHT may be reasonable for the treatment of menopausal symptoms, such as hot flashes.<a href="#cite_note-80">[80]</a> It is the most effective treatment option, especially when delivered as a skin patch.<a href="#cite_note-HRT20172-81">[81]</a><a href="#cite_note-82">[82]</a> Its use, however, appears to increase the risk of <a href="/wiki/Stroke" title="Stroke">strokes</a> and <a href="/wiki/Blood_clots" class="mw-redirect" title="Blood clots">blood clots</a>.<a href="#cite_note-boardman20152-83">[83]</a> When used for menopausal symptoms the global recommendation is MHT should be prescribed for a long as there are defined treatment effects and goals for the individual woman.<a href="#cite_note-auto2-18">[18]</a> MHT is also effective for preventing bone loss and <a href="/wiki/Osteoporosis" title="Osteoporosis">osteoporotic</a> fracture,<a href="#cite_note-84">[84]</a> but it is generally recommended only for women at significant risk for whom other therapies are unsuitable.<a href="#cite_note-:22-85">[85]</a> MHT may be unsuitable for some women, including those at increased risk of cardiovascular disease, increased risk of thromboembolic disease (such as those with obesity or a history of venous thrombosis) or increased risk of some types of cancer.<a href="#cite_note-:22-85">[85]</a> There is some concern that this treatment increases the risk of breast cancer.<a href="#cite_note-ChlebowskiAnderson20152-86">[86]</a> Women at increased risk of cardiometabolic disease and VTE may be able to use transdermal estradiol which does not appear to increase risks in low to moderate doses.<a href="#cite_note-auto2-18">[18]</a> Adding <a href="/wiki/Testosterone" title="Testosterone">testosterone</a> to hormone therapy has a positive effect on sexual function in postmenopausal women, although it may be accompanied by hair growth or acne if used in excess. Transdermal testosterone therapy in appropriate dosing is generally safe.<a href="#cite_note-87">[87]</a> <div class="mw-heading mw-heading3"><h3 id="Selective_estrogen_receptor_modulators">Selective estrogen receptor modulators</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=19" title="Edit section: Selective estrogen receptor modulators">edit</a>]</div> <a href="/wiki/Selective_estrogen_receptor_modulator" title="Selective estrogen receptor modulator">SERMs</a> are a category of drugs, either synthetically produced or derived from a botanical source, that act selectively as agonists or antagonists on the <a href="/wiki/Estrogen_receptor" title="Estrogen receptor">estrogen receptors</a> throughout the body. The most commonly prescribed SERMs are <a href="/wiki/Raloxifene" title="Raloxifene">raloxifene</a> and <a href="/wiki/Tamoxifen" title="Tamoxifen">tamoxifen</a>. Raloxifene exhibits oestrogen agonist activity on bone and lipids, and antagonist activity on breast and the endometrium.<a href="#cite_note-88">[88]</a> Tamoxifen is in widespread use for treatment of hormone sensitive breast cancer. Raloxifene prevents vertebral fractures in postmenopausal, osteoporotic women and reduces the risk of invasive breast cancer.<a href="#cite_note-89">[89]</a> <div class="mw-heading mw-heading3"><h3 id="Other_medications">Other medications</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=20" title="Edit section: Other medications">edit</a>]</div> Some of the <a href="/wiki/SSRIs" class="mw-redirect" title="SSRIs">SSRIs</a> and <a href="/wiki/SNRIs" class="mw-redirect" title="SNRIs">SNRIs</a> appear to provide some relief from vasomotor symptoms.<a href="#cite_note-Kra20152-20">[20]</a><a href="#cite_note-:62-19">[19]</a> The most effective SSRIs and SNRIs are <a href="/wiki/Paroxetine" title="Paroxetine">paroxetine</a>, <a href="/wiki/Escitalopram" title="Escitalopram">escitalopram</a>, <a href="/wiki/Citalopram" title="Citalopram">citalopram</a>, <a href="/wiki/Venlafaxine" title="Venlafaxine">venlafaxine</a>, and <a href="/wiki/Desvenlafaxine" title="Desvenlafaxine">desvenlafaxine</a>.<a href="#cite_note-:62-19">[19]</a> They may, however, be associated with appetite and sleeping problems, constipation and nausea.<a href="#cite_note-Kra20152-20">[20]</a><a href="#cite_note-:52-90">[90]</a> <a href="/wiki/Gabapentin" title="Gabapentin">Gabapentin</a> or <a href="/wiki/Fezolinetant" title="Fezolinetant">fezolinetant</a> can also improve the frequency and severity of vasomotor symptoms.<a href="#cite_note-Kra20152-20">[20]</a><a href="#cite_note-:62-19">[19]</a> Side effects of using gabapentin include drowsiness and headaches.<a href="#cite_note-Kra20152-20">[20]</a><a href="#cite_note-:52-90">[90]</a> <div class="mw-heading mw-heading3"><h3 id="Therapy">Therapy</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=21" title="Edit section: Therapy">edit</a>]</div> <a href="/wiki/Cognitive_behavioural_therapy" class="mw-redirect" title="Cognitive behavioural therapy">Cognitive behavioural therapy</a> and <a href="/wiki/Hypnotherapy" title="Hypnotherapy">clinical hypnosis</a> can decrease the amount women are affected by hot flashes.<a href="#cite_note-:62-19">[19]</a> <a href="/wiki/Mindfulness" title="Mindfulness">Mindfulness</a> is not yet proven to be effective in easing vasomotor symptoms.<a href="#cite_note-91">[91]</a><a href="#cite_note-92">[92]</a><a href="#cite_note-:62-19">[19]</a> <div class="mw-heading mw-heading3"><h3 id="Lifestyle_and_exercise">Lifestyle and exercise</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=22" title="Edit section: Lifestyle and exercise">edit</a>]</div> Exercise has been thought to reduce postmenopausal symptoms through the increase of endorphin levels, which decrease as estrogen production decreases.<a href="#cite_note-:32-93">[93]</a> However, there is insufficient evidence to suggest that exercise helps with the symptoms of menopause.<a href="#cite_note-:62-19">[19]</a> Similarly, yoga has not been shown to be useful as a treatment for vasomotor symptoms.<a href="#cite_note-:62-19">[19]</a> However a high <a href="/wiki/Body_mass_index" title="Body mass index">BMI</a> is a risk factor for vasomotor symptoms in particular. Weight loss may help with symptom management.<a href="#cite_note-94">[94]</a><a href="#cite_note-:62-19">[19]</a> There is no strong evidence that cooling techniques such as using specific clothing or environment control tools (for example fans) help with symptoms.<a href="#cite_note-:62-19">[19]</a> Paced breathing and <a href="/wiki/Relaxation_technique" title="Relaxation technique">relaxation</a> are not effective in easing symptoms.<a href="#cite_note-:62-19">[19]</a> <div class="mw-heading mw-heading3"><h3 id="Dietary_supplements">Dietary supplements</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=23" title="Edit section: Dietary supplements">edit</a>]</div> There is no evidence of consistent benefit of taking any <a href="/wiki/Dietary_supplement" title="Dietary supplement">dietary supplements</a> or <a href="/wiki/Herbal_medicine" title="Herbal medicine">herbal products</a> for menopausal symptoms.<a href="#cite_note-:62-19">[19]</a><a href="#cite_note-95">[95]</a><a href="#cite_note-ReferenceA2-96">[96]</a> These widely marketed but ineffective supplements include <a href="/wiki/Soy_isoflavones" class="mw-redirect" title="Soy isoflavones">soy isoflavones</a>, <a href="/wiki/Pollen" title="Pollen">pollen extracts</a>, <a href="/wiki/Actaea_racemosa" title="Actaea racemosa">black cohosh</a>, <a href="/wiki/Omega-3_fatty_acid" title="Omega-3 fatty acid">omega-3</a> among many others.<a href="#cite_note-:62-19">[19]</a><a href="#cite_note-Franco20162-97">[97]</a><a href="#cite_note-98">[98]</a> <div class="mw-heading mw-heading3"><h3 id="Alternative_medicine">Alternative medicine</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=24" title="Edit section: Alternative medicine">edit</a>]</div> There is no evidence of consistent benefit of <a href="/wiki/Alternative_therapies" class="mw-redirect" title="Alternative therapies">alternative therapies</a> for menopausal symptoms despite their popularity.<a href="#cite_note-ReferenceA2-96">[96]</a><a href="#cite_note-:62-19">[19]</a> As of 2023, there is no evidence to support the efficacy of <a href="/wiki/Acupuncture" title="Acupuncture">acupuncture</a> as a management for menopausal symptoms.<a href="#cite_note-:62-19">[19]</a><a href="#cite_note-99">[99]</a><a href="#cite_note-ReferenceA2-96">[96]</a> The <a href="/wiki/Cochrane_review" class="mw-redirect" title="Cochrane review">Cochrane review</a> found not enough evidence in 2016 to show a difference between Chinese herbal medicine and placebo for the <a href="/wiki/Vasomotor" title="Vasomotor">vasomotor</a> symptoms.<a href="#cite_note-Cochrane_review_2016_on_Chinese_herbal_medicine_for_menopausal_symptoms2-100">[100]</a> <div class="mw-heading mw-heading3"><h3 id="Other_efforts">Other efforts</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=25" title="Edit section: Other efforts">edit</a>]</div> <ul><li>Lack of lubrication is a common problem during and after perimenopause. Vaginal moisturizers can help women with overall dryness, and lubricants can help with lubrication difficulties that may be present during intercourse. It is worth pointing out that moisturizers and lubricants are different products for different issues: some women complain that their genitalia are uncomfortably dry all the time, and they may do better with moisturizers. Those who need only lubricants do well using them only during intercourse.</li> <li>Low-dose prescription vaginal estrogen products such as estrogen creams are generally a safe way to use estrogen topically, to help vaginal thinning and dryness problems (see <a href="/wiki/Vaginal_atrophy" class="mw-redirect" title="Vaginal atrophy">vaginal atrophy</a>) while only minimally increasing the levels of estrogen in the bloodstream.</li> <li>Individual counseling or support groups can sometimes be helpful to handle sad, depressed, anxious or confused feelings women may be having as they pass through what can be for some a very challenging transition time.</li> <li><a href="/wiki/Osteoporosis" title="Osteoporosis">Osteoporosis</a> can be minimized by <a href="/wiki/Smoking_cessation" title="Smoking cessation">smoking cessation</a>, adequate <a href="/wiki/Vitamin_D" title="Vitamin D">vitamin D</a> intake and regular weight-bearing exercise. The bisphosphonate drug alendronate may decrease the risk of a fracture, in women that have both bone loss and a previous fracture and less so for those with just osteoporosis.<a href="#cite_note-101">[101]</a></li> <li>A surgical procedure where a part of one of the ovaries is removed earlier in life and frozen and then over time thawed and returned to the body (<a href="/wiki/Ovarian_tissue_cryopreservation" title="Ovarian tissue cryopreservation">ovarian tissue cryopreservation</a>) has been tried. While at least 11 women have undergone the procedure and paid over £6,000, there is no evidence it is safe or effective.<a href="#cite_note-102">[102]</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2>[<a href="/w/index.php?title=Menopause&action=edit&section=26" title="Edit section: Society and culture">edit</a>]</div> <div class="mw-heading mw-heading3"><h3 id="Attitudes_and_experiences">Attitudes and experiences</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=27" title="Edit section: Attitudes and experiences">edit</a>]</div> The menopause transition is a process, involving hormonal, menstrual, and typically vasomotor changes. However, the experience of the menopause as a whole is very much influenced by psychological and social factors, such as past experience, lifestyle, social and cultural meanings of menopause, and a woman's social and material circumstances. Menopause has been described as a <a href="/wiki/Biopsychosocial_model" title="Biopsychosocial model">biopsychosocial</a> experience, with social and cultural factors playing a prominent role in the way menopause is experienced and perceived.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] The paradigm within which a woman considers menopause influences the way she views it: women who understand menopause as a medical condition rate it significantly more negatively than those who view it as a life transition or a symbol of aging.<a href="#cite_note-103">[103]</a> There is some evidence that negative attitudes and expectations, held before the menopause, predict symptom experience during the menopause,<a href="#cite_note-:0-104">[104]</a> and beliefs and attitudes toward menopause tend to be more positive in postmenopausal than in premenopausal women.<a href="#cite_note-105">[105]</a> Women with more negative attitudes towards the menopause report more symptoms during this transition.<a href="#cite_note-:0-104">[104]</a> Menopause is a stage of life experienced in different ways. It can be characterized by personal challenges, changes in personal roles within the family and society. Women's approaches to changes during menopause are influenced by their personal, family and sociocultural background.<a href="#cite_note-106">[106]</a> Women from different regions and countries also have different attitudes. Postmenopausal women had more positive attitudes toward menopause compared with peri- or premenopausal women. Other influencing factors of attitudes toward menopause include age, menopausal symptoms, psychological and socioeconomical status, and profession and ethnicity.<a href="#cite_note-107">[107]</a> Ethnicity and geography play roles in the experience of menopause. American women of different ethnicities report significantly different types of menopausal effects. One major study found Caucasian women most likely to report what are sometimes described as psychosomatic symptoms, while African-American women were more likely to report vasomotor symptoms.<a href="#cite_note-108">[108]</a> There may be variations in experiences of women from different ethnic backgrounds regarding menopause and care. Immigrant women reported more vasomotor symptoms and other physical symptoms and poorer mental health than non-immigrant women and were mostly dissatisfied with the care they had received. Self-management strategies for menopausal symptoms were also influenced by culture.<a href="#cite_note-109">[109]</a> Two multinational studies of Asian women, found that hot flushes were not the most commonly reported symptoms, instead body and joint aches, memory problems, sleeplessness, irritability and migraines were.<a href="#cite_note-110">[110]</a> In another study comparing experiences of menopause amongst White Australian women and women in Laos, Australian women reported higher rates of depression, as well as fears of aging, weight gain and cancer – fears not reported by Laotian women, who positioned menopause as a positive event.<a href="#cite_note-111">[111]</a> <a href="/wiki/Japanese_women" class="mw-redirect" title="Japanese women">Japanese women</a> experience menopause effects, or kōnenki (更年期), in a different way from American women.<a href="#cite_note-Lock_1998,_pp._4102-112">[112]</a> Japanese women report lower rates of hot flashes and night sweats; this can be attributed to a variety of factors, both biological and social. Historically, kōnenki was associated with wealthy middle-class housewives in Japan, i.e., it was a "luxury disease" that women from traditional, inter-generational rural households did not report. Menopause in Japan was viewed as a symptom of the inevitable process of aging, rather than a "revolutionary transition", or a "deficiency disease" in need of management.<a href="#cite_note-Lock_1998,_pp._4102-112">[112]</a> As of 2005, in Japanese culture, reporting of vasomotor symptoms has been on the increase, with research finding that of 140 Japanese participants, hot flashes were prevalent in 22.1%.<a href="#cite_note-pmid161543012-113">[113]</a> This was almost double that of 20 years prior.<a href="#cite_note-Lock,_M_2010,_p.872-114">[114]</a> Whilst the exact cause for this is unknown, possible contributing factors include dietary changes, increased medicalisation of middle-aged women and increased media attention on the subject.<a href="#cite_note-Lock,_M_2010,_p.872-114">[114]</a> However, reporting of vasomotor symptoms is still "significantly" lower than in North America.<a href="#cite_note-pmid151919362-115">[115]</a> Additionally, while most women in the United States apparently have a negative view of menopause as a time of deterioration or decline, some studies seem to indicate that women from some Asian cultures have an understanding of menopause that focuses on a sense of liberation and celebrates the freedom from the risk of pregnancy.<a href="#cite_note-116">[116]</a> Diverging from these conclusions, one study appeared to show that many American women "experience this time as one of liberation and <a href="/wiki/Self-actualization" title="Self-actualization">self-actualization</a>".<a href="#cite_note-117">[117]</a> In some women, menopause may bring about a sense of loss related to the end of fertility. In addition, this change often aligns with other stressors, such as the responsibility of looking after elderly parents or dealing with the emotional challenges of "<a href="/wiki/Empty_nest_syndrome" title="Empty nest syndrome">empty nest syndrome</a>" when children move out of the family home. This situation can be accentuated in cultures where <a href="/wiki/Ageism" title="Ageism">being older is negatively perceived</a>. <div class="mw-heading mw-heading3"><h3 id="Impact_on_work">Impact on work</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=28" title="Edit section: Impact on work">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Menopause_in_the_workplace" title="Menopause in the workplace">Menopause in the workplace</a></div> Midlife is typically a life stage when men and women may be dealing with demanding life events and responsibilities, such as work, health problems, and caring roles. For example, in 2018 in the UK women aged 45–54 report more work-related stress than men or women of any other age group.<a href="#cite_note-118">[118]</a> Hot flashes are often reported to be particularly distressing at work and lead to embarrassment and worry about potential <a href="/wiki/Social_stigma" title="Social stigma">stigmatisation</a>.<a href="#cite_note-119">[119]</a> A June 2023 study by the Mayo Clinic estimated an annual loss of $1.8 billion in the United States due to workdays missed as a result of menopause symptoms.<a href="#cite_note-120">[120]</a> This was one of the largest studies to date examining the impact of menopause symptoms on work outcomes. The research concluded there was a strong need to improve medical treatment for menopausal women and make the workplace environment more supportive to avoid such productivity losses. <div class="mw-heading mw-heading3"><h3 id="Etymology">Etymology</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=29" title="Edit section: Etymology">edit</a>]</div> Menopause literally means the "end of monthly cycles" (the end of <a href="/wiki/Monthly_period" class="mw-redirect" title="Monthly period">monthly periods</a> or <a href="/wiki/Menstruation" title="Menstruation">menstruation</a>), from the Greek word pausis ("pause") and mēn ("month"). This is a medical coinage; the Greek word for <a href="/wiki/Menses" class="mw-redirect" title="Menses">menses</a> is actually different. In Ancient Greek, the menses were described in the plural, ta emmēnia ("the monthlies"), and its modern descendant has been clipped to ta emmēna. The Modern Greek medical term is emmenopausis in <a href="/wiki/Katharevousa" title="Katharevousa">Katharevousa</a> or emmenopausi in <a href="/wiki/Demotic_Greek" title="Demotic Greek">Demotic Greek</a>. The Ancient Greeks did not produce medical concepts about any symptoms associated with end of menstruation and did not use a specific word to refer to this time of a woman's life. The word menopause was invented by French doctors at the beginning of the nineteenth century. Greek etymology was reconstructed at this time and it was the Parisian student doctor Charles-Pierre-Louis de Gardanne who invented a variation of the word in 1812, which was edited to its final French form in 1821.<a href="#cite_note-121">[121]</a> Some of them noted that peasant women had no complaints about the end of menses, while urban middle-class women had many troubling symptoms. Doctors at this time considered the symptoms to be the result of urban lifestyles of sedentary behaviour, alcohol consumption, too much time indoors, and over-eating, with a lack of fresh fruit and vegetables.<a href="#cite_note-122">[122]</a> The word "menopause" was coined specifically for female humans, where the end of fertility is traditionally indicated by the permanent stopping of monthly menstruations. However, menopause exists in some other animals, many of which do not have monthly menstruation;<a href="#cite_note-Walker22-123">[123]</a> in this case, the term means a natural end to fertility that occurs before the end of the natural lifespan. <div class="mw-heading mw-heading3"><h3 id="In_popular_culture,_law_and_politics">In popular culture, law and politics</h3>[<a href="/w/index.php?title=Menopause&action=edit&section=30" title="Edit section: In popular culture, law and politics">edit</a>]</div> In the 21st century, celebrities have spoken out about their experiences of the menopause, which has led to it becoming less of a taboo as it has boosted awareness of the debilitating symptoms. Subsequently, TV shows have been running features on the menopause to help women experiencing symptoms. In the UK <a href="/wiki/Lorraine_Kelly" title="Lorraine Kelly">Lorraine Kelly</a> has been an advocate for getting women to speak about their experiences including sharing her own. This has led to an increase in women seeking treatment such as HRT.<a href="#cite_note-124">[124]</a> <a href="/wiki/Davina_McCall" title="Davina McCall">Davina McCall</a> also led an awareness campaign based on a documentary on <a href="/wiki/Channel_4" title="Channel 4">Channel 4</a>.<a href="#cite_note-125">[125]</a> In the UK, <a href="/wiki/Carolyn_Harris" title="Carolyn Harris">Carolyn Harris</a> sponsored the Menopause (Support and Services) Bill in June 2021. It was to exempt hormone replacement therapy from National Health Service <a href="/wiki/Prescription_charges" title="Prescription charges">prescription charges</a> and to make provisions about menopause support and services, including public education and communication in supporting perimenopausal and post-menopausal women, and to raise awareness of menopause and its effects. The bill was withdrawn on 29 October 2021.<a href="#cite_note-126">[126]</a> In the US, <a href="/wiki/David_McKinley" title="David McKinley">David McKinley</a>, Republican from West Virginia introduced the Menopause Research Act in September 2022 for $100 million in 2023 and 2024, but it stalled.<a href="#cite_note-127">[127]</a> <div class="mw-heading mw-heading2"><h2 id="Other_animals">Other animals</h2>[<a href="/w/index.php?title=Menopause&action=edit&section=31" title="Edit section: Other animals">edit</a>]</div> The majority of mammal species reach menopause when they cease the production of ovarian follicles, which contain eggs (oocytes), between one-third and two-thirds of their maximum possible lifespan.<a href="#cite_note-128">[128]</a> However, few live long enough in the wild to reach this point. Humans are joined by a limited number of other species in which females live substantially longer than their ability to reproduce. Examples of others include <a href="/wiki/Cetaceans" class="mw-redirect" title="Cetaceans">cetaceans</a>: <a href="/wiki/Beluga_whales" class="mw-redirect" title="Beluga whales">beluga whales</a>,<a href="#cite_note-ReferenceC2-129">[129]</a> <a href="/wiki/Narwhal" title="Narwhal">narwhals</a>,<a href="#cite_note-ReferenceC2-129">[129]</a> <a href="/wiki/Orca" title="Orca">orcas</a>,<a href="#cite_note-130">[130]</a> <a href="/wiki/False_killer_whale" title="False killer whale">false killer whales</a><a href="#cite_note-R10-131">[131]</a> and <a href="/wiki/Short-finned_pilot_whale" title="Short-finned pilot whale">short-finned pilot whales</a>.<a href="#cite_note-132">[132]</a> Menopause has been reported in a variety of other vertebrate species, but these examples tend to be from captive individuals, and thus are not necessarily representative of what happens in natural populations in the wild. Menopause in captivity has been observed in several species of nonhuman <a href="/wiki/Primates" class="mw-redirect" title="Primates">primates</a>,<a href="#cite_note-Walker22-123">[123]</a> including <a href="/wiki/Rhesus_monkeys" class="mw-redirect" title="Rhesus monkeys">rhesus monkeys</a><a href="#cite_note-Walker3-133">[133]</a> and <a href="/wiki/Common_chimpanzee" class="mw-redirect" title="Common chimpanzee">chimpanzees</a>.<a href="#cite_note-Bowden_19842-134">[134]</a> Some research suggests that wild chimpanzees do not experience menopause, as their fertility declines are associated with declines in overall health.<a href="#cite_note-135">[135]</a> Menopause has been reported in elephants in captivity<a href="#cite_note-136">[136]</a> and <a href="/wiki/Guppy" title="Guppy">guppies</a>.<a href="#cite_note-137">[137]</a> Dogs do not experience menopause; the <a href="/wiki/Canine_reproduction#The_female_reproductive_cycle" title="Canine reproduction">canine estrus cycle</a> simply becomes irregular and infrequent. Although older female dogs are not considered good candidates for breeding, offspring have been produced by older animals, see <a href="/wiki/Canine_reproduction" title="Canine reproduction">Canine reproduction</a>. Similar observations have been made in cats.<a href="#cite_note-138">[138]</a> <a href="/wiki/Biological_life_cycle" title="Biological life cycle">Life histories</a> show a varying degree of <a href="/wiki/Senescence" title="Senescence">senescence</a>; rapid senescing organisms (e.g., <a href="/wiki/Pacific_salmon" class="mw-redirect" title="Pacific salmon">Pacific salmon</a> and <a href="/wiki/Annual_plants" class="mw-redirect" title="Annual plants">annual plants</a>) do not have a post-reproductive life-stage. Gradual senescence is exhibited by all <a href="/wiki/Placental_mammal" class="mw-redirect" title="Placental mammal">placental mammalian</a> life histories.[<a href="/wiki/Wikipedia:No_original_research" title="Wikipedia:No original research">original research?</a>] <div class="mw-heading mw-heading2"><h2 id="Evolution">Evolution</h2>[<a href="/w/index.php?title=Menopause&action=edit&section=32" title="Edit section: Evolution">edit</a>]</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Evolution_of_menopause" title="Evolution of menopause">Evolution of menopause</a></div> There are various theories on the origin and process of the <a href="/wiki/Evolution_of_menopause" title="Evolution of menopause">evolution of the menopause</a>. These attempt to suggest evolutionary benefits to the human species stemming from the cessation of women's reproductive capability before the end of their natural lifespan. It is conjectured that in highly social groups <a href="/wiki/Natural_selection" title="Natural selection">natural selection</a> favors females that stop reproducing and devote that post-reproductive life span to continuing to care for existing offspring, both their own and those of others to whom they are related, especially their granddaughters and grandsons.<a href="#cite_note-139">[139]</a> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2>[<a href="/w/index.php?title=Menopause&action=edit&section=33" title="Edit section: See also">edit</a>]</div> <ul><li><a href="/wiki/European_Menopause_and_Andropause_Society" title="European Menopause and Andropause Society">European Menopause and Andropause Society</a></li> <li><a href="/wiki/Menopause_in_the_workplace" title="Menopause in the workplace">Menopause in the workplace</a></li> <li><a href="/wiki/Menopause_in_incarceration" title="Menopause in incarceration">Menopause in incarceration</a></li> <li><a href="/wiki/Pregnancy_over_age_50" title="Pregnancy over age 50">Pregnancy over age 50</a></li> <li><a href="/wiki/Age_and_female_fertility" title="Age and female fertility">Biological clock</a></li> <li><a href="/wiki/Evolution_of_menopause" title="Evolution of menopause">Evolution of menopause</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2>[<a href="/w/index.php?title=Menopause&action=edit&section=34" title="Edit section: References">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns 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PLOS Biology. 4 (1): e7. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1371%2Fjournal.pbio.0040007">10.1371/journal.pbio.0040007</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1318473">1318473</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16363919">16363919</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=PLOS+Biology&rft.atitle=The+evolution+of+senescence+and+post-reproductive+lifespan+in+guppies+%28Poecilia+reticulata%29&rft.volume=4&rft.issue=1&rft.pages=e7&rft.date=2006-01&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1318473%23id-name%3DPMC&rft_id=info%3Apmid%2F16363919&rft_id=info%3Adoi%2F10.1371%2Fjournal.pbio.0040007&rft.aulast=Reznick&rft.aufirst=D&rft.au=Bryant%2C+M&rft.au=Holmes%2C+D&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1318473&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMenopause" class="Z3988"> </li> <li id="cite_note-138"><a href="#cite_ref-138">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation news cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20151114211824/https://www.animalplanet.com/pets/how-long-is-a-cat-in-heat/">"How long is a cat in heat?"</a>. Animal Planet. 15 May 2012. Archived from <a rel="nofollow" class="external text" href="http://www.animalplanet.com/pets/how-long-is-a-cat-in-heat/">the original</a> on 14 November 2015. Retrieved 12 June 2018.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Animal+Planet&rft.atitle=How+long+is+a+cat+in+heat%3F&rft.date=2012-05-15&rft_id=http%3A%2F%2Fwww.animalplanet.com%2Fpets%2Fhow-long-is-a-cat-in-heat%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMenopause" class="Z3988"> </li> <li id="cite_note-139"><a href="#cite_ref-139">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFAlmansa2022" class="citation web cs1">Almansa JC (16 November 2022). <a rel="nofollow" class="external text" href="https://theconversation.com/the-evolutionary-origins-of-menopause-explained-192543">"The evolutionary origins of menopause explained"</a>. The Conversation. Retrieved 20 September 2023.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=The+Conversation&rft.atitle=The+evolutionary+origins+of+menopause+explained&rft.date=2022-11-16&rft.aulast=Almansa&rft.aufirst=Juan+Carranza&rft_id=http%3A%2F%2Ftheconversation.com%2Fthe-evolutionary-origins-of-menopause-explained-192543&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMenopause" class="Z3988"> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2>[<a href="/w/index.php?title=Menopause&action=edit&section=35" title="Edit section: Further reading">edit</a>]</div> <ul><li><a href="/wiki/Rebecca_Mead" title="Rebecca Mead">Rebecca Mead</a>, "If You Can't Stand the Heat: Why menopause never gets old", <a href="/wiki/The_New_Yorker" title="The New Yorker">The New Yorker</a>, 10 March 2025, pp. 28–31. "If you've got <a href="/wiki/Ovary" title="Ovary">ovaries</a>, you'll go through it. Why do so many feel so blindsided?" (p. 28.)</li></ul> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2>[<a href="/w/index.php?title=Menopause&action=edit&section=36" title="Edit section: External links">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid #aaa;font-size:88%;line-height:1.25em;background-color:var(--background-color-interactive-subtle,#f8f9fa);display:flow-root}.mw-parser-output .side-box-abovebelow,.mw-parser-output .side-box-text{padding:0.25em 0.9em}.mw-parser-output .side-box-image{padding:2px 0 2px 0.9em;text-align:center}.mw-parser-output .side-box-imageright{padding:2px 0.9em 2px 0;text-align:center}@media(min-width:500px){.mw-parser-output .side-box-flex{display:flex;align-items:center}.mw-parser-output .side-box-text{flex:1;min-width:0}}@media(min-width:720px){.mw-parser-output .side-box{width:238px}.mw-parser-output .side-box-right{clear:right;float:right;margin-left:1em}.mw-parser-output .side-box-left{margin-right:1em}}</style><style data-mw-deduplicate="TemplateStyles:r1237033735">@media print{body.ns-0 .mw-parser-output .sistersitebox{display:none!important}}@media screen{html.skin-theme-clientpref-night .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}</style><div class="side-box side-box-right plainlinks sistersitebox"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style> <div class="side-box-flex"> <div class="side-box-image"><a href="/wiki/File:Commons-logo.svg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/40px-Commons-logo.svg.png" decoding="async" width="30" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/60px-Commons-logo.svg.png 1.5x" data-file-width="1024" data-file-height="1376" /></a></div> <div class="side-box-text plainlist">Wikimedia Commons has media related to <a href="https://commons.wikimedia.org/wiki/Category:Menopause" class="extiw" title="commons:Category:Menopause">Menopause</a>.</div></div> </div> <ul><li><a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/menopause.html">Menopause: MedlinePlus</a></li> <li><a rel="nofollow" class="external text" href="https://www.nia.nih.gov/health/what-menopause">What Is Menopause?</a>, National Institute on Aging</li> <li><a rel="nofollow" class="external text" href="https://www.menopause.org/for-women">Menopause & Me</a>, The North American Menopause Society</li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output .navbox-group,.mw-parser-output .navbox-title,.mw-parser-output .navbox-abovebelow{padding:0.25em 1em;line-height:1.5em;text-align:center}.mw-parser-output .navbox-group{white-space:nowrap;text-align:right}.mw-parser-output .navbox,.mw-parser-output .navbox-subgroup{background-color:#fdfdfd}.mw-parser-output .navbox-list{line-height:1.5em;border-color:#fdfdfd}.mw-parser-output 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style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q177708" class="extiw" title="d:Q177708">D</a></div><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-11" title="ICD-11">11</a>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#1965418440">GA30.0</a></li><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/N95.1">N95.1</a></li><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=627.2">627.2</a></li><li><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D008593">D008593</a></li><li><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb8034.htm">8034</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000894.htm">000894</a></li><li><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/article/264088-overview">article/264088</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235" 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a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Human_reproductive_physiology" title="Template:Human reproductive physiology"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Human_reproductive_physiology" title="Template talk:Human reproductive physiology"><abbr title="Discuss this template">t</abbr></a></li><li 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title="Ovulation">Ovulation</a></li> <li><a href="/wiki/Luteal_phase" title="Luteal phase">Luteal phase</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gametogenesis" title="Gametogenesis">Gametogenesis</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Spermatogenesis" title="Spermatogenesis">Spermatogenesis</a> <ul><li><a href="/wiki/Spermatogonium" title="Spermatogonium">spermatogonium</a></li> <li><a href="/wiki/Spermatocyte" title="Spermatocyte">spermatocyte</a></li> <li><a href="/wiki/Spermatid" title="Spermatid">spermatid</a></li> <li><a href="/wiki/Sperm" title="Sperm">sperm</a></li></ul></li> <li><a href="/wiki/Oogenesis" title="Oogenesis">Oogenesis</a> <ul><li><a href="/wiki/Oogonium" title="Oogonium">oogonium</a></li> <li><a href="/wiki/Oocyte" title="Oocyte">oocyte</a></li> <li><a href="/wiki/Immature_ovum" title="Immature ovum">ootid</a></li> <li><a href="/wiki/Egg_cell" title="Egg cell">ovum</a></li></ul></li> <li><a href="/wiki/Germ_cell" title="Germ cell">Germ cell</a> <ul><li><a href="/wiki/Gonocyte" title="Gonocyte">gonocyte</a></li> <li><a href="/wiki/Gamete" title="Gamete">gamete</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_sexual_activity" title="Human sexual activity">Human sexual activity</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Sexual_arousal" title="Sexual arousal">Sexual arousal</a></li> <li><a href="/wiki/Sexual_intercourse" title="Sexual intercourse">Sexual intercourse</a></li> <li><a href="/wiki/Masturbation" title="Masturbation">Masturbation</a></li> <li>Erection <ul><li><a href="/wiki/Erection" title="Erection">Penile</a></li> <li><a href="/wiki/Clitoral_erection" title="Clitoral erection">Clitoral</a></li></ul></li> <li><a href="/wiki/Orgasm" title="Orgasm">Orgasm</a></li> <li>Ejaculation <ul><li><a href="/wiki/Ejaculation" title="Ejaculation">Male</a></li> <li><a href="/wiki/Female_ejaculation" title="Female ejaculation">Female</a></li></ul></li> <li><a href="/wiki/Insemination" title="Insemination">Insemination</a></li> <li><a href="/wiki/Human_fertilization" title="Human fertilization">Fertilization</a> / <a href="/wiki/Fertility" title="Fertility">Fertility</a></li> <li><a href="/wiki/Implantation_(embryology)" title="Implantation (embryology)">Implantation</a></li> <li><a href="/wiki/Pregnancy" title="Pregnancy">Pregnancy</a></li> <li><a href="/wiki/Postpartum_period" title="Postpartum period">Postpartum period</a></li> <li><a href="/wiki/Mechanics_of_human_sexuality" title="Mechanics of human sexuality">Mechanics of sex</a></li> <li><a href="/wiki/Vaginal_lubrication" title="Vaginal lubrication">Vaginal lubrication</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Development_of_the_reproductive_system" title="Development of the reproductive system">Development of the reproductive system</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Sexual_differentiation_in_humans" title="Sexual differentiation in humans">Sexual differentiation</a> <ul><li><a href="/wiki/Sexual_dimorphism" title="Sexual dimorphism">Sexual dimorphism</a></li> <li><a href="/wiki/Feminization_(biology)" title="Feminization (biology)">Feminization</a></li> <li><a href="/wiki/Virilization" title="Virilization">Virilization</a></li></ul></li> <li><a href="/wiki/Puberty" title="Puberty">Puberty</a> <ul><li><a href="/wiki/Gonadarche" title="Gonadarche">Gonadarche</a></li> <li><a href="/wiki/Tanner_scale" title="Tanner scale">Tanner scale</a></li> <li><a href="/wiki/Pubarche" title="Pubarche">Pubarche</a></li> <li><a href="/wiki/Menarche" title="Menarche">Menarche</a></li> <li><a href="/wiki/Spermarche" title="Spermarche">Spermarche</a></li> <li><a href="/wiki/Adrenarche" title="Adrenarche">Adrenarche</a></li></ul></li> <li><a href="/wiki/Advanced_maternal_age" title="Advanced maternal age">Maternal age</a> / <a href="/wiki/Paternal_age_effect" title="Paternal age effect">Paternal age</a></li> <li><a class="mw-selflink selflink">Menopause</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Egg" title="Egg">Egg</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Egg_cell" title="Egg cell">Ovum</a></li> <li><a href="/wiki/Viviparity" title="Viviparity">Vivipary</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Reproductive_endocrinology_and_infertility" title="Reproductive endocrinology and infertility">Reproductive endocrinology and infertility</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93gonadal_axis" title="Hypothalamic–pituitary–gonadal axis">Hypothalamic–pituitary–gonadal axis</a></li> <li><a href="/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93prolactin_axis" title="Hypothalamic–pituitary–prolactin axis">Hypothalamic–pituitary–prolactin axis</a></li> <li><a href="/wiki/Andrology" title="Andrology">Andrology</a></li> <li><a href="/wiki/Hormone" title="Hormone">Hormone</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Breast" title="Breast">Breast</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Thelarche" title="Thelarche">Thelarche</a></li> <li><a href="/wiki/Breast_development" title="Breast development">Development</a></li> <li><a href="/wiki/Lactation" title="Lactation">Lactation</a></li> <li><a href="/wiki/Breastfeeding" title="Breastfeeding">Breastfeeding</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_reproductive_system" title="Human reproductive system">Human reproductive system</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Male_reproductive_system" title="Male reproductive system">Male</a></li> <li><a href="/wiki/Female_reproductive_system" title="Female reproductive system">Female</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Diseases and disorders</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anorgasmia" title="Anorgasmia">Anorgasmia</a></li> <li><a href="/wiki/Dysorgasmia" title="Dysorgasmia">Dysorgasmia</a></li> <li><a href="/wiki/Dyspareunia" title="Dyspareunia">Dyspareunia</a></li> <li><a href="/wiki/Erectile_dysfunction" title="Erectile dysfunction">Erectile dysfunction</a></li> <li><a href="/wiki/Hard_flaccid_syndrome" title="Hard flaccid syndrome">Hard flaccid syndrome</a></li> <li><a href="/wiki/Premature_ejaculation" title="Premature ejaculation">Premature ejaculation</a></li> <li><a href="/wiki/Vaginismus" title="Vaginismus">Vaginismus</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235" /></div><div role="navigation" class="navbox" aria-labelledby="Menstrual_cycle245" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231" /><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Menstrual_cycle" title="Template:Menstrual cycle"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Menstrual_cycle" title="Template talk:Menstrual cycle"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Menstrual_cycle" title="Special:EditPage/Template:Menstrual cycle"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Menstrual_cycle245" style="font-size:114%;margin:0 4em"><a href="/wiki/Menstrual_cycle" title="Menstrual cycle">Menstrual cycle</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Events and phases</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Menstruation" title="Menstruation">Menstruation</a></li> <li><a href="/wiki/Follicular_phase" title="Follicular phase">Follicular phase</a></li> <li><a href="/wiki/Ovulation" title="Ovulation">Ovulation</a></li> <li><a href="/wiki/Luteal_phase" title="Luteal phase">Luteal phase</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Life stages</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Menarche" title="Menarche">Menarche</a></li> <li><a class="mw-selflink selflink">Menopause</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Tracking</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Signs</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Basal_body_temperature" title="Basal body temperature">Basal body temperature</a></li> <li><a href="/wiki/Cervix#Cervical_mucus" title="Cervix">Cervical mucus</a></li> <li><a href="/wiki/Mittelschmerz" title="Mittelschmerz">Mittelschmerz</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Systems</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Fertility_awareness" title="Fertility awareness">Fertility awareness</a></li> <li><a href="/wiki/Calendar-based_contraceptive_methods" title="Calendar-based contraceptive methods">Calendar-based methods</a></li> <li><a href="/wiki/Billings_ovulation_method" title="Billings ovulation method">Billings Ovulation Method</a></li> <li><a href="/wiki/Creighton_Model_FertilityCare_System" title="Creighton Model FertilityCare System">Creighton Model</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Menstrual_suppression" title="Menstrual suppression">Suppression</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Extended_cycle_combined_hormonal_contraceptive" title="Extended cycle combined hormonal contraceptive">Extended cycle combined hormonal contraceptive</a></li> <li><a href="/wiki/Lactational_amenorrhea" title="Lactational amenorrhea">Lactational amenorrhea</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Menstrual_disorder" title="Menstrual disorder">Disorders</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Amenorrhea" title="Amenorrhea">Amenorrhea</a></li> <li><a href="/wiki/Anovulation" title="Anovulation">Anovulation</a></li> <li><a href="/wiki/Cryptomenorrhea" title="Cryptomenorrhea">Cryptomenorrhea</a></li> <li><a href="/wiki/Dysmenorrhea" title="Dysmenorrhea">Dysmenorrhea</a></li> <li><a href="/wiki/Hypomenorrhea" title="Hypomenorrhea">Hypomenorrhea</a></li> <li><a href="/wiki/Irregular_menstruation" title="Irregular menstruation">Irregular menstruation</a></li> <li><a href="/wiki/Menometrorrhagia" title="Menometrorrhagia">Menometrorrhagia</a></li> <li><a href="/wiki/Menorrhagia" class="mw-redirect" title="Menorrhagia">Menorrhagia (hypermenorrhea)</a></li> <li><a href="/wiki/Metropathia_haemorrhagica" title="Metropathia haemorrhagica">Metropathia haemorrhagica</a></li> <li><a href="/wiki/Metrorrhagia" class="mw-redirect" title="Metrorrhagia">Metrorrhagia</a></li> <li><a href="/wiki/Oligoamenorrhea" title="Oligoamenorrhea">Oligoamenorrhea</a></li> <li><a href="/wiki/Oligomenorrhea" title="Oligomenorrhea">Oligomenorrhea</a></li> <li><a href="/wiki/Oligoovulation" class="mw-redirect" title="Oligoovulation">Oligoovulation</a></li> <li><a href="/wiki/Polymenorrhagia" title="Polymenorrhagia">Polymenorrhagia</a></li> <li><a href="/wiki/Polymenorrhea" title="Polymenorrhea">Polymenorrhea (epimenorrhea)</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related events</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Folliculogenesis" title="Folliculogenesis">Folliculogenesis</a></li> <li><a href="/wiki/Menstrual_synchrony" title="Menstrual synchrony">Menstrual synchrony</a></li> <li><a href="/wiki/Premenstrual_water_retention" title="Premenstrual water retention">Premenstrual water retention</a></li> <li><a href="/wiki/Sexual_activity_during_menstruation" class="mw-redirect" title="Sexual activity during menstruation">Sexual activity</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Menstruation_and_mental_health" title="Menstruation and mental health">Mental health</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Premenstrual_syndrome" title="Premenstrual syndrome">Premenstrual syndrome</a></li> <li><a href="/wiki/Premenstrual_dysphoric_disorder" title="Premenstrual dysphoric disorder">Premenstrual dysphoric disorder</a></li> <li><a href="/wiki/Menstrual_psychosis" class="mw-redirect" title="Menstrual psychosis">Menstrual psychosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Hygiene</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Menstrual_hygiene_management" title="Menstrual hygiene management">Menstrual hygiene management</a></li> <li><a href="/wiki/Feminine_hygiene" title="Feminine hygiene">Feminine hygiene</a> <ul><li><a href="/wiki/Menstrual_pad" title="Menstrual pad">Menstrual pad</a></li> <li><a href="/wiki/Cloth_menstrual_pad" title="Cloth menstrual pad">Cloth menstrual pad</a></li> <li><a href="/wiki/Tampon" title="Tampon">Tampon</a></li> <li><a href="/wiki/Menstrual_cup" title="Menstrual cup">Menstrual cup</a></li> <li><a href="/wiki/Menstrual_pad" title="Menstrual pad">Menstrual pad</a></li> <li><a href="/wiki/Period_underwear" title="Period underwear">Period underwear</a></li></ul></li> <li><a href="/wiki/Menstrual_Hygiene_Day" title="Menstrual Hygiene Day">Menstrual Hygiene Day</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Culture_and_menstruation" title="Culture and menstruation">In culture and religion</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Chhaupadi" title="Chhaupadi">Chhaupadi</a></li> <li><a href="/wiki/Menstruation_in_Islam" title="Menstruation in Islam">In Islam</a></li> <li><a href="/wiki/Menstrual_leave" title="Menstrual leave">Menstrual leave</a></li> <li><a href="/wiki/Menstrual_stigma" title="Menstrual stigma">Menstrual stigma</a></li> <li><a href="/wiki/Menstrual_suppression" title="Menstrual suppression">Menstrual suppression</a></li> <li><a href="/wiki/Menstrual_taboo" class="mw-redirect" title="Menstrual taboo">Menstrual taboo</a></li> <li><a href="/wiki/Menstruation_celebration" title="Menstruation celebration">Menstruation celebration</a></li> <li><a href="/wiki/Menstruation_hut" title="Menstruation hut">Menstruation hut</a></li> <li><a href="/wiki/Niddah" title="Niddah">Niddah</a></li> <li><a href="/wiki/Period_poverty" title="Period poverty">Period poverty</a></li> <li><a href="/wiki/Sustainable_menstruation" title="Sustainable menstruation">Sustainable menstruation</a></li> <li><a href="/wiki/Tampon_tax" title="Tampon tax">Tampon tax</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235" /><style data-mw-deduplicate="TemplateStyles:r1038841319">.mw-parser-output .tooltip-dotted{border-bottom:1px dotted;cursor:help}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319" /></div><div role="navigation" class="navbox authority-control" aria-labelledby="Authority_control_databases_frameless&#124;text-top&#124;10px&#124;alt=Edit_this_at_Wikidata&#124;link=https&#58;//www.wikidata.org/wiki/Q177708#identifiers&#124;class=noprint&#124;Edit_this_at_Wikidata1993" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Authority_control_databases_frameless&#124;text-top&#124;10px&#124;alt=Edit_this_at_Wikidata&#124;link=https&#58;//www.wikidata.org/wiki/Q177708#identifiers&#124;class=noprint&#124;Edit_this_at_Wikidata1993" style="font-size:114%;margin:0 4em"><a href="/wiki/Help:Authority_control" title="Help:Authority control">Authority control databases</a> <a href="https://www.wikidata.org/wiki/Q177708#identifiers" 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