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==Overview==
==Overview==
Clinically, "Menopause does not happen all at once", but it passes through stages until it reaches the permanent cessation of the menstrual cycle.
[[Menopause]] is classified according to [[causes]] into three types including natural [[menopause]], [[Premature Menopause|premature menopause]]/[https://www.healthline.com/health/menopause/causes-early early menopause], and [https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/instant-help-for-induced-menopause induced menopause]. Natural    [[menopause]], does not happen suddenly, but it passes through 3 stages include [[perimenopause]], [[Perimenopause|premenopause]], and [[Menopause|postmenopause]]. [[Premature menopause]] because of [[premature ovarian failure]] and several medical [[diseases]]. [https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/instant-help-for-induced-menopause Induced menopause] because of bilateral [[oophorectomy]], [[salpingo-oophorectomy]], and [[hysterectomy]]. in addition to          [[Complication (medicine)|complication]] of [[chemotherapy]] and [[radiotherapy]].


It is classified to physiological menopause, Premature Menopause/Early menopause, and surgical menopause
<br />
==Classification of Menopause==
==Classification of Menopause==
[[Menopause]] is [[classified]] according to [[causes]] into three types :


====<big>'''Physiological Menopause'''</big>====
*Natural [[menopause]]
physiological menopause is amenorrhea without any pathological diseases and medical conditions. As women age, the production of estrogen and progesterone from the ovaries begins to decrease gradually, as these hormones play a major role in the occurrence of menstruation regularly, and as a result of the deficiency of these hormones occurs menopause.
*[[Premature Menopause]]/[https://www.healthline.com/health/menopause/causes-early Early menopause]
 
*[[Surgery|Surgical]]/[https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/instant-help-for-induced-menopause Induced Menopause]
* '''<big>Perimenopause or " menopause transition"</big>'''
 
Perimenopause means the menopause transition years, the years before and after the last period ever, when the majority of women find that they undergo at least some symptoms of hormonal change and fluctuation, such as hot flashes, mood changes, insomnia, fatigue, irregular menses, etc.
 
During perimenopause, the production of most of the reproductive hormones, including [[estrogen]]s and [[progestin]], diminishes and becomes more irregular, often with wide and unpredictable fluctuations in levels. During this period, fertility diminishes.
 
Symptoms of perimenopause can begin as early as age 35, although most women become aware of them about 10 years later than this. Perimenopause can last for a few years, or ten years or even longer. In this respect, it resembles puberty, a similar process that surrounds menarche. Menopause can usefully be compared to "[[puberty]] in reverse", and the psychological adjustments that take place over this period can be compared to [[adolescence]]. The actual duration and severity of perimenopause in any individual woman cannot be predicted in advance or during the process.
 
Not every woman suffers symptoms during perimenopause. Approximately one-third of all women get no noticeable symptoms other than their periods becoming erratic and then stopping. Another one-third of women have moderate symptoms. The remaining one-third of women have very strong symptoms which tend to have a longer duration. The tendency to have very strong perimenopause may be inherited in some cases.
 
One piece of recent research appears to show that [[melatonin]] supplementation in perimenopausal women can produce a highly significant improvement in thyroid function and gonadotropin levels, as well as restoring fertility and menstruation and preventing the depression associated with the menopause<ref name="Bellipanni_2005">Bellipanni G, DI Marzo F, Blasi F, et al. Effects of melatonin in perimenopausal and menopausal women: our personal experience. 2005. Ann N Y Acad Sci 1057:393-402. [[Digital_object_identifier|DOI]]: [http://dx.doi.org/10.1196/annals.1356.030 10.1196/annals.1356.030] '''PMID 16399909'''</ref>.
 
* <big>'''Premenopause'''</big>
 
Premenopause is a word used to describe the years leading up to the last period ever, when the levels of reproductive hormones are already becoming lower and more erratic, and symptoms of hormone withdrawal may be present. "Premenopause starts some time before the monthly cycles become noticeably irregular in timing".<ref>https://en.wikipedia.org/wiki/Menopause#:~:text=Menopause%20is%20usually%20a%20natural,the%20hormones%20estrogen%20and%20progesterone</ref>
 
* '''<big>Postmenopause</big>'''
 
Postmenopause is all of the time in a woman's life that takes place after her last period ever, or more accurately, all of the time that follows the point when her ovaries become inactive.


A woman is considered in post-menopause after amenorrhea more than 12 months, not even any spotting. When she reaches that point, she is one year into post-menopause. The reason for this delay in declaring a woman post-menopausal is because periods become very erratic at this time of life, and therefore a reasonably long period is necessary to be sure that the cycling has ceased.
==='''Physiological Menopause'''===
[[Physiology|Physiological]] [[menopause]] is [[amenorrhea]], it passes gradually through 3 stages until it reaches the permanent cessation of the [[menstrual cycle]]


In women who have no uterus, and therefore have no periods, post-menopause can be determined by a blood test which can reveal the very high levels of [[Follicle-stimulating hormone|Follicle Stimulating Hormone]] (FSH) that are typical of post-menopausal women.
*[[Perimenopause|Premenopause]] is a word used to describe the years leading up to the last [[period]] ever when the levels of [https://www.cancer.gov/publications/dictionaries/cancer-terms/def/reproductive-hormone reproductive hormones] are already becoming lower and more erratic, and [[symptoms]] of [https://pubmed.ncbi.nlm.nih.gov/23421366/ hormone withdrawal] may be present.
*[[Perimenopause]] or "[[menopause]] transition"means the [[menopause]] transition years, the years before and after the last period ever, when the majority of [[women]] find that they undergo at least some [[symptoms]] of [[hormonal]] change and fluctuation, such as [[Hot flash|hot flashes]],  [[Mood disturbances|mood changes]], [[insomnia]], [[fatigue]], [https://my.clevelandclinic.org/health/diseases/14633-abnormal-menstruation-periods irregular menses]. During [[perimenopause]], the production of most of the [https://www.cancer.gov/publications/dictionaries/cancer-terms/def/reproductive-hormone reproductive hormones], including [[estrogen]]s and [[progestin]], diminishes and becomes more irregular, often with wide and unpredictable fluctuations in levels. During this [[period]], [[fertility]] diminishes.  [[Symptoms]] of [[perimenopause]] can begin as early as [[age]] 35, although most [[women]] become aware of them about 10 years later than this. [[Perimenopause]] can last for a few years, or ten years or even longer.
*[[Menopause|Postmenopause]], a [[Women|woman]] has considered in [[Menopause|post-menopause]] after [[amenorrhea]] more than 12 months, not even any spotting. When she reaches that point, she is one year into [[Menopause|post-menopause]]. The reason for this delay in declaring a woman [[Menopause|post-menopausal]] is because [[periods]] become very erratic at this time of life, and therefore a reasonably long period is necessary to be sure that the [[Menses|cycling]] has ceased. A woman's [https://www.cancer.gov/publications/dictionaries/cancer-terms/def/reproductive-hormone reproductive hormone] levels continue to drop and fluctuate for some time into post-[[menopause]], so any [https://pubmed.ncbi.nlm.nih.gov/23421366/ hormone withdrawal symptoms] that a woman may be experiencing do not necessarily stop right away but may take quite some time, even several years, to disappear completely.<ref name="pmid15345086">{{cite journal| author=Cheung AM, Chaudhry R, Kapral M, Jackevicius C, Robinson G| title=Perimenopausal and Postmenopausal Health. | journal=BMC Womens Health | year= 2004 | volume= 4 Suppl 1 | issue=  | pages= S23 | pmid=15345086 | doi=10.1186/1472-6874-4-S1-S23 | pmc=2096694 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15345086  }} </ref>


A woman's reproductive hormone levels continue to drop and fluctuate for some time into post-menopause, so any hormone withdrawal symptoms that a woman may be experiencing do not necessarily stop right away but may take quite some time, even several years, to disappear completely.
===Premature Menopause/Early menopause===


====<big>Premature Menopause and Early menopause</big>====
*[[Premature menopause]] is the permanent cessation of the [[menstrual cycle]] under 40 of [[age]] and [https://my.clevelandclinic.org/health/diseases/21138-premature-and-early-menopause early menopause] (between [[Age|ages]] 40 and 45 years).<ref name="pmid19733988">{{cite journal| author=Shuster LT, Rhodes DJ, Gostout BS, Grossardt BR, Rocca WA| title=Premature menopause or early menopause: long-term health consequences. | journal=Maturitas | year= 2010 | volume= 65 | issue= 2 | pages= 161-6 | pmid=19733988 | doi=10.1016/j.maturitas.2009.08.003 | pmc=2815011 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19733988  }} </ref>
Premature menopause is the permanent cessation of the menstrual cycle of the age of 40 because of premature ovarian failure" it is the permanent loss of ovarian function and this condition affects approximately 1% of women".  but early menopause is a cessation of the menstrual cycle between 40 and 45 of age.<ref>http://www.menopause.org/docs/default-source/2014/nams-recomm-for-clinical-care.pdf</ref>
*It is because of [[premature ovarian failure]] and several [[medical]] [[diseases]].<ref>{{cite journal| author=Okeke T, Anyaehie U, Ezenyeaku C| title=Premature menopause. | journal=Ann Med Health Sci Res | year= 2013 | volume= 3 | issue= 1 | pages= 90-5 | pmc=3634232 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23634337  }} </ref>


About 5% of women have early menopause both of them happen because of several medical diseases ( Autoimmune disease, thyroid disease, metabolic disorder, diabetes mellitus,  chemotherapy, and radiotherapy for treatment of cancer.<ref>womenshealth.gov/menopause/early-or-premature-menopause/#2</ref>
===Surgical/Induced Menopause===


====<big>Surgical menopause</big>====
*[https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/instant-help-for-induced-menopause Induced menopause] is the permanent cessation of the [[menstrual cycle]] because of [[Complication (medicine)|complication]] of [[medical treatment]] such as [[chemotherapy]], and [[radiotherapy]] for [[treatment]] of [[cancer]] and  [[Surgery operation|surgery]] such as bilateral [[oophorectomy]], [[salpingo-oophorectomy]], and [[hysterectomy]].
Surgical menopause is the permanent cessation of the menstrual cycle because of surgically such as Bilateral oophorectomy that means remove ovaries which are sometimes done with removal of the Fallopian tubes (salpingo-oophorectomy) so remove ovaries with or without tubes is called surgical menopause, in these case, the menopause symptoms may be more severe because of " the sudden and complete drop in hormone levels". Hysterectomy means remove uterus that causes menopause indirectly due to a decrease in the mechanism of feedback via the inhibin, although ovaries are still producing hormones.<ref>https://en.wikipedia.org/wiki/Menopause#:~:text=Menopause%20is%20usually%20a%20natural,the%20hormones%20estrogen%20and%20progesterone</ref>
*The [[causes]] of  [[menopause]] after these [[surgery]] are the sudden quickly drop in [[Hormone|hormone levels]] after [[oophorectomy]]  and decrease in the [[Mechanism (biology)|mechanism]] of [[feedback]]  after [[Hysterectomy]] although [[ovarian hormones]] are still produced .The surgical [https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397 menopausal symptoms] may be more severe like [[hot flushes]].<ref name="pmid31416275">{{cite journal| author=Secoșan C, Balint O, Pirtea L, Grigoraș D, Bălulescu L, Ilina R| title=Surgically Induced Menopause-A Practical Review of Literature. | journal=Medicina (Kaunas) | year= 2019 | volume= 55 | issue= 8 | pages=  | pmid=31416275 | doi=10.3390/medicina55080482 | pmc=6722518 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31416275  }} </ref>


<br />
==References==
== References ==
{{reflist|2}}
{{reflist|2}}



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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Rahmah Al-Edresi, M.D.[2]

Overview

Menopause is classified according to causes into three types including natural menopause, premature menopause/early menopause, and induced menopause. Natural menopause, does not happen suddenly, but it passes through 3 stages include perimenopause, premenopause, and postmenopause. Premature menopause because of premature ovarian failure and several medical diseases. Induced menopause because of bilateral oophorectomy, salpingo-oophorectomy, and hysterectomy. in addition to complication of chemotherapy and radiotherapy.

Classification of Menopause

Menopause is classified according to causes into three types :

Physiological Menopause

Physiological menopause is amenorrhea, it passes gradually through 3 stages until it reaches the permanent cessation of the menstrual cycle

Premature Menopause/Early menopause

Surgical/Induced Menopause

References

  1. Cheung AM, Chaudhry R, Kapral M, Jackevicius C, Robinson G (2004). "Perimenopausal and Postmenopausal Health". BMC Womens Health. 4 Suppl 1: S23. doi:10.1186/1472-6874-4-S1-S23. PMC 2096694. PMID 15345086.
  2. Shuster LT, Rhodes DJ, Gostout BS, Grossardt BR, Rocca WA (2010). "Premature menopause or early menopause: long-term health consequences". Maturitas. 65 (2): 161–6. doi:10.1016/j.maturitas.2009.08.003. PMC 2815011. PMID 19733988.
  3. Okeke T, Anyaehie U, Ezenyeaku C (2013). "Premature menopause". Ann Med Health Sci Res. 3 (1): 90–5. PMC 3634232.
  4. Secoșan C, Balint O, Pirtea L, Grigoraș D, Bălulescu L, Ilina R (2019). "Surgically Induced Menopause-A Practical Review of Literature". Medicina (Kaunas). 55 (8). doi:10.3390/medicina55080482. PMC 6722518 Check |pmc= value (help). PMID 31416275.


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