Menopause is a physiologic cessation of menses due to a decrease in ovarian function. Menopause is established when menses has been absent for 1 year. The average age of menopause is 51 years old.

Signs and symptoms:

Changes in the menstrual cycle usually begin during a woman’s 40s, with variation in cycle length. Persistent changes of ≥ 7 days defines early perimenopause. Skipping an entire month (ie, cycle length of 60 days) defines late perimenopause.

The marked fluctuations in estrogen levels may contribute to other perimenopausal symptoms and signs (eg, breast tenderness, changes in menstrual flow, moodiness, exacerbation of menstrual migraines). Symptoms can last from 6 mo to > 10 yr and range from nonexistent to severe.


  • Clinical evaluation- 1 year without menstruation
  • Rarely FSH levels