Instruct: Given a question, retrieve relevant passages that answer the question.
Query: When does Menopause start?
The menopause transition typically begins between 40 and 50 years of age (average 47.5). The duration of perimenopause may be for up to eight years. Women will often, but not always, start these transitions (perimenopause and menopause) about the same time as their mother did.
The menstrual cycle is the regular natural change that occurs in the female reproductive system (specifically the uterus and ovaries) that makes pregnancy possible. The cycle is required for the production of oocytes, and for the preparation of the uterus for pregnancy. Up to 80% of women report having some symptoms during the one to two weeks prior to menstruation. Common symptoms include acne, tender breasts, bloating, feeling tired, irritability and mood changes. These symptoms interfere with normal life and therefore qualify as premenstrual syndrome in 20 to 30% of women. In 3 to 8%, they are severe.
The first period usually begins between twelve and fifteen years of age, a point in time known as menarche. They may occasionally start as early as eight, and this onset may still be normal. The average age of the first period is generally later in the developing world and earlier in developed world. The typical length of time between the first day of one period and the first day of the next is 21 to 45 days in young women and 21 to 35 days in adults (an average of 28 days). Menstruation stops occurring after menopause which usually occurs between 45 and 55 years of age. Bleeding usually lasts around 2 to 7 days.
The menstrual cycle is governed by hormonal changes. These changes can be altered by using hormonal birth control to prevent pregnancy. Each cycle can be divided into three phases based on events in the ovary (ovarian cycle) or in the uterus (uterine cycle). The ovarian cycle consists of the follicular phase, ovulation, and luteal phase whereas the uterine cycle is divided into menstruation, proliferative phase, and secretory phase.
Menopause, the natural or surgical cessation of the menstrual cycle, is due to an overall decrease in ovarian production of the hormones estradiol and progesterone. These hormonal changes are also associated with an increase in WHR independent of increases in body mass. Significantly, studies find that large premenopausal WHRs are associated with lower estradiol levels and variation in age of menopause onset. Circulating estrogen preferentially stores lipid deposits in the gluteofemoral region, including the buttocks and thighs, and evidence suggests that menopause-associated estrogen deficiency results in an accumulation of adipose deposits around the abdomen. These menopause-induced changes in body fat distribution can be counteracted with hormone replacement therapy. In contrast, aging males gradually accumulate abdominal fat, and hence increased WHR, in parallel with declining androgen levels.
A woman's fertility is affected by her age. The average age of a girl's first period (menarche) is 12-13 (12.5 years in the United States, 12.72 in Canada, 12.9 in the UK), but, in postmenarchal girls, about 80% of the cycles are anovulatory in the first year after menarche, 50% in the third and 10% in the sixth year. A woman's fertility peaks in the early and mid 20s, after which it starts to decline, with this decline being accelerated after age 35. However, the exact estimates of the chances of a woman to conceive after a certain age are not clear, with research giving differing results. The chances of a couple to successfully conceive at an advanced age depend on many factors, including the general health of a woman and the fertility of the male partner.
Menstruation is the most visible phase of the menstrual cycle and its beginning is used as the marker between cycles. The first day of menstrual bleeding is the date used for the last menstrual period (LMP). The typical length of time between the first day of one period and the first day of the next is 21 to 45 days in young women, and 21 to 31 days in adults (an average of 28 days).
Female fertility declines after age 30 and ends with the menopause. Female physical experiences vary depending on external forces such as diet, marriage patterns, culture, and other aspects. In Western nations menstruation begins to affect females at 13 and menopause starts around 51. In non-industrialized countries, on the other hand, most females begin menstruation at a later age. More lactation in the lifetime of non-western females inhibits ovulation and extends the number of fertile years. Pregnancy in the 40s or later has been correlated with increased risk of Down syndrome in the children. Males are capable of fathering children into old age. Paternal age effects in the children include multiple sclerosis, autism, breast cancer and schizophrenia, as well as reduced intelligence. Adriana Iliescu was reported as the world's oldest woman to give birth, at age 66. Her record stood until Maria del Carmen Bousada de Lara gave birth to twin sons at Sant Pau Hospital in Barcelona, Spain on December 29, 2006, at the age of 67. In both cases IVF was used. The oldest known father was former Australian miner Les Colley, who fathered a child at age 93.
The word menopause was invented by French doctors at the beginning of the nineteenth century. Some of them noted that peasant women had no complaints about the end of menses, while urban middle class women has 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.
Within the United States, social location affects the way women perceive menopause and its related biological effects. Research indicates that whether a woman views menopause as a medical issue or an expected life change is correlated with her socio-economic status. 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.
Most female mammals have an estrous cycle, yet only ten primates species, four bats species, the elephant shrew, and the spiny mouse have a menstrual cycle. The relatedness of these groups suggests that four distinct evolutionary events have caused menstruation to arise.
In support of the above mentioned conclusions many studies have been performed. Doctors Lindamer, Lohr, Harris, and Jeste conducted a study to determine age of onset of schizophrenia in which they examined gender differences in 194 patients ranging in age from 35 to 97. They found that the mean age for onset in men was 30, while in women it was 39. (It is important to note that this is just one study, and overall averages come from a combination of different studies). About 37% of the women developed schizophrenia at the age of 45, while only 16% of men reported the same. Thus, more women than men experience late onset schizophrenia. This indicates that there is indeed another peak for women at the age of 45 and women do develop schizophrenia later in life.
"Eumenorrhea" denotes normal, regular menstruation that lasts for a few days (usually 3 to 5 days, but anywhere from 2 to 7 days is considered normal). The average blood loss during menstruation is 35 milliliters with 10–80 ml considered normal. Women who experience Menorrhagia are more susceptible to iron deficiency than the average person. An enzyme called plasmin inhibits clotting in the menstrual fluid.
Menstruation in mammals is the shedding of the uterine lining (endometrium). It occurs on a regular basis in uninseminated sexually reproductive-age females of certain mammal species.
Strassmann argued menstrual synchrony defined as menstruation overlap should be quite common. For example, the expected difference by chance between two women with 28-day cycles—which is approximately the average length of menstrual cycles of women at the age —is 7 days. Considering that the mean duration of menses is 5 days and the range is 2 to 7 days, the probability of menstruation overlap by chance should be high.
In some women, menstrual spotting between periods occurs as a normal and harmless part of ovulation. Some women experience acute mid-cycle abdominal pain around the time of ovulation (sometimes referred to by the German term for this phenomenon, "mittelschmerz"). This may also occur at the same time as menstrual spotting. The term breakthrough bleeding or breakthrough spotting is usually used for women using hormonal contraceptives, such as IUDs or oral contraceptives, in which it refers to bleeding or spotting between any expected withdrawal bleedings, or bleeding or spotting at any time if none is expected. If spotting continues beyond the first three cycles of oral contraceptive use, a woman should have her prescription changed to a pill containing either more estrogen or more progesterone.
The North American Menopause Society (NAMS), founded in 1989, is a nonprofit, multidisciplinary organization with the mission of promoting the health and quality of life of women during midlife and beyond through an understanding of menopause and healthy aging. Based in Cleveland, Ohio, NAMS has more than 2,000 members from 51 countries, with 88% of its members from North America.Its membership includes experts from many disciplines such as medicine, nursing, sociology, psychology, nutrition, anthropology, epidemiology, pharmacy, and education.
While the normal menstrual cycle in the human typically lasts 4 weeks (28 days, range 24–35 days) and consists of a follicular phase, ovulation, and a luteal phase, followed by either menstruation or pregnancy, the anovulatory cycle has cycle
lengths of varying degrees. In many circumstances, menstrual intervals are prolonged exceeding 35 days leading to oligomenorrhea (cycle >35 – 180 days interval), or even longer, amenorrhea. In other cases, menstruation may be fairly regular (eumenorrhea), or more frequent (intervals < 21 days), or there may be a loss of menstrual pattern (menorrhagia, dysfunctional uterine bleeding).
The number of children born to one woman can vary dependent on her window from menarche to menopause. The average window of fertility is from 13.53 to 49.24. Taking into consideration lactational amenorrhea and the period between conception and birth, the average woman is capable of experiencing around 20 births. However, if the duration of lactation is cut short due to use of a formula substitute or the woman has multiple births, the number of offspring could exceed 20.
Middle class women oftentimes delay motherhood until after the peak of their fertility at age 29–30, a delay that has become more common in the last two decades. Motherhood is delayed because of the higher educational and career aspirations middle class women oftentimes make—the career incentives are too great to pass up. While middle class women on average have children at age 29, lower class women typically have children much earlier in their lives because of the lack of incentives to delay childbirth. According to Edin and Kefalas, lower class women do not make the same delay because they are oftentimes lacking the career and educational incentives that middle class women have.
A study of a population of French women from 1670 and 1789 shows that those who married at age 20–24 had 7.0 children on average and 3.7% remained childless. Women who married at age 25–29 years had a mean of 5.7 children and 5.0% remained childless. Women who married at 30–34 years had a mean of 4.0 children and 8.2% remained childless. The average age at last birth in natural fertility populations that have been studied is around 40.
Many have questioned the evolution of overt menstruation in humans and related species, speculating on what advantage there could be to losing blood associated with dismantling the endometrium rather than absorbing it, as most mammals do.
The female will ovulate spontaneously and be receptive to the male to be bred (express estrus) at regular biologically defined intervals. The female is receptive to males only while experiencing estrus.
There is criticism of the claim that menopause and somewhat earlier age-related declines in female fertility could coevolve with a long term dependency on monogamous male providers who preferred fertile females. This criticism argues that the longer the time the child needed parental investment relative to the lifespans of the species, the higher the percentage of children born would still need parental care when the female was no longer fertile or dramatically reduced in her fertility. These critics argue that unless male preference for fertile females and ability to switch to a new female was annulled, any need for a male provider would have selected against menopause to use her fertility to keep the provider male attracted to her, and that the theory of monogamous fathers providing for their families therefore cannot explain why menopause evolved in humans.
Females of most mammal species advertise fertility to males with visual behavioral cues, pheromones, or both. This period of advertised fertility is known as "oestrus", "estrus" or "heat". In species that experience estrus, females are generally only receptive to copulation while they are in heat (dolphins are an exception). In the estrous cycles of most placental mammals, if no fertilization takes place, the uterus reabsorbs the endometrium. This breakdown of the endometrium without vaginal discharge is sometimes called "covert menstruation". Overt menstruation (where there is blood flow from the vagina) occurs primarily in humans and close evolutionary relatives such as chimpanzees. Some species, such as domestic dogs, experience small amounts of vaginal bleeding while approaching heat; this discharge has a different physiologic cause than menstruation.
"World Menopause Day / Month". IMS has designated October 18 as World Menopause Day. In observation of the Day, the IMS and the member national societies of CAMS distribute materials and organize activities to inform women about menopause, its management and the impact of estrogen loss. Since it is not always possible for local societies to arrange activities for this specific day, the IMS has now designated October as World Menopause Month. Local societies can also collaborate with other organizations working in the field of adult women's health, such as societies for osteoporosis and breast cancer, to organize joint events. World Menopause Month can also be a call to implement policies that support research and treatment in the area of menopausal health.
Written by Jeanie Linders, Menopause The Musical debuted March 28, 2001 in Orlando, Florida. The original cast members were Shelly Browne as the Power (later Professional) Woman, Patti McGuire as the Iowa Housewife, Pammie O'Bannon as the Earth Mother and Wesley Williams as the Soap Star. The musical follows four women shopping for lingerie at a Bloomingdale's sale sing 25 songs about chocolate cravings, hot flashes, loss of memory, nocturnal sweats, and sexual predicaments. The lyrics parody popular music from the baby boomer era, and includes the numbers "Stayin' Awake" and "Puff, My God I'm Draggin'."
The musical started previews in July 2017 and officially opened Off-Broadway in August 2017 at Westside Theatre.The New York Times's Anita Gates gave a review to the Broadway production as she writes, "I wish I had Bobby Goldman’s faith that New York is filled with attractive, charming, emotionally stable older men looking for relationships." In a review by Suzanna Bowling from Times Square Chronicles, Bowling proclaims, "Nancy Opel, pulls a tour de force, as she embodies the Curvy Widow upstairs at the Westside Theatre. This musical is sure to beat Menopause, as the most popular and highest grossing show in town. Critics were not in love when they saw Menopause, but the authors laugh all the way to the bank. Well move over, because Curvy Widow is bound to surpass that fad."
The Society's official journal, "Climacteric", the Journal of Adult Women's Health and Medicine, was founded in 1998 and is listed in Index Medicus/MEDLINE. The editors-in-Chief are Anna Fenton (New Zealand), and Nick Panay (United Kingdom). It publishes international, original, peer-reviewed research on all aspects of aging in men and women, especially during the menopause and climacteric. The content of the journal covers the whole range of subject areas relevant to climacteric studies and adult women’s health and medicine, including underlying endocrinological changes, treatment of the symptoms of the menopause and other age-related changes, hormone replacement therapies, alternative therapies, effective life-style modifications, non-hormonal midlife changes, and the counselling and education of perimenopausal and postmenopausal patients.