What Is Menopause? – Age, Causes, Symptoms & Treatment

By (gynecologist), (embryologist), (embryologist) and (fertility counselor).
Last Update: 09/13/2023

Climacterium is a period that occurs between adulthood and old age amongst all women. It is during this time period when women go through a stage called menopause.

Menopause translates into the permanent ceasing of menstruation, monthly menses or period in women due to age. As a consequence, the woman experiences a series of menopausal symptoms as well as some health alterations that we will explain in the following sections.

Climacterium or menopause?

Climacterium is a phase of all woman's life in which they transition from their reproductive age into their non-reproductive. During this phase, the ovaries start to slow down the egg maturation process, which leads to the depletion of the egg count (ovarian reserve), and the subsequent decrease of estrogen levels.

Climacterium and menopause are commonly used interchangeably. However, the term menopause actually refers to the woman's last menses, something that occurs within the climacterium.

While climacterium is a transitory phase that can extend up to several years, menopause is an isolated event.

Typically, climacterium starts about 5 years before menopause, and can extend until up to age 70, when a phase known as senility starts.

Also, menopause is likely to appear between ages 45 and 55. At this moment, the ovaries of the woman stop working. On average, women go through menopause at age 51.

Phases of climacterium

Climacterium is a perfectly normal process in all women's lives.

Given that ovarian function diminishes slowly and progressively during the reproductive years, we can divide climacterium into three phases:

It begins around 2-3 years before menopause and finishes one year after the last menstrual period. You're likely to have alterations during your monthly periods and notice the first menopausal symptoms.
It is the total ceasing of menstruation after 12 months without experiencing menstrual bleeding. It is the end of childbearing age.
It's the longest period, with a duration of between 10 and 20 years. During this period, cardiovascular, endocrine, and certain pathologies such as osteoporosis may show up.

It should be noted that each woman's experiences in these climacteric phases may be different. Therefore, the duration, intensity and symptoms of the climacteric period may vary from one woman to another.

What symptoms does menopause cause?

There exist many symptoms that appear before menopause and during climacterium. The following are the most common ones:

Menstrual alterations
Bleeding irregularities due to increased FSH hormone levels, which is produced by the pituitary gland, and diminished estradiol and progesterone levels, produced by the ovary.
Hot flashes
A feeling of intense warmth that can last around 2-4 minutes. It's the most common symptom of menopause and it's due to the absence of estrogens, which affects the functioning of the natural regulation of body temperature.
Night sweats
Hot flashes that appear at night. As a consequence, the woman experiences associated symptoms like fatigue, irritability, brain fog, mood swings, etc.
Vaginal dryness and urogenital atrophy
Also due to insufficient levels of estrogens. Moreover, other symptoms like itching, pain during intercourse (dyspareunia), and urinary incontinence may appear. The risk of developing an UTI (urinary tract infection) is higher as well.
Mood swings
When a woman starts the menopausal period, she is likely to experience a mix of symptoms like sadness, depression, brain fog, etc.
Dry skin
The lack of collagens causes dryness in the skin and eczema. It loses the elasticity and youth appearance that used to have in the past.
Joint pain
Hormone imbalances cause the joints, tendons, ligaments, and muscles to suffer during menopause. Moreover, these symptoms are common throughout the entire climacterium stage.
Weight gain
Diminished levels of estrogen affect the woman's metabolism and the way in which fat is distributed through the body. The basal energy expenditure decreases, which makes it easier for the body to gain weight faster.
Migraine, hair loss, brittle nails, diminished sex drive, unwanted facial hair, palpitations, memory loss... are common symptoms.

It should be noted that not all women will experience the same premenopausal symptoms. In fact, 10% won't have any symptoms at all.

If you have recently noticed various menopausal symptoms, you should visit your gynecologist to undergo a routine examination. If necessary, he will prescribe a hormone replacement therapy that helps you deal with the symptoms during the upcoming years.

Health risks

Although menopause is not a disease or condition, it can cause certain health and/or mental complications due to hormonal imbalances.

Climacterium increases the risk of developing the following health conditions:

Cardiovascular diseases
Increased cholesterol levels, arteriosclerosis, arterial hypertension, and obesity are risk factors that can trigger an ictus or a coronary heart disease.
Bone diseases
Osteoporisis is the deterioration and decrease of bone mass, which increases the risk of hip, spine, and wrist fracture.
Breast cancer
Especially in menopausal women with overweight. This is the reason why they should do a mammography every two years approximately as a prevention measure to ensure an early diagnosis.
Psychological alterations
Some women develop serious psychological issues when they go through menopause. The loss of sex-appeal, social stigmas as regards the dress style or behavior, or one's unwillingness to accept old age are some causes that lead the woman to develop depression symptoms.

To sum up, it's important that you attend your regular visits to the doctor and gynecologist after starting the climacterium period.


Depending on the symptoms and age at which menopause starts, your gynecologist may prescribe a hormone replacement therapy or not, as we have explained in the previous section.

This hormonal treatment involves the administration of estrogen and progesterone to try to relieve the symptoms associated with menopause. However, some specialists consider that HRT has a series of disadvantages, such as the risk of developing endometrial or breast cancer.

On the other hand, menopausal symptoms can be treated with certain natural remedies as well. For instance, following a balanced diet, including vitamin supplements containing isoflavones of soy and hop leaves can help.

Soy and hop leaves contain isoflavones, a type of phytoestrogens that have multiple benefits for menopausal women. They can help relieve symptoms like hot flashes, anxiety, insomnia, etc. Moreover, phytoestrogens are beneficial for bone health.

Tips to relieve the symptoms

Aside from what we have already explained above, there exist some tips or recommendations that can help you relieve the symptoms of menopause, and improve the everyday life of these women:

  • Do moderate exercise and be active, as it helps prevent depression symptoms and have strong muscles.
  • Wear various cloth layers to be able to take some of them off when hot flashes appear.
  • Keep room temperature cool and avoid hot drinks.
  • Maintain healthy sleep habits, such as waking up and going to be at the same time every day.
  • Avoid cigarette smoking and drinks that contain alcohol and caffeine.
  • Enjoy sex life and start using lubricants in case you experience vaginal dryness or dyspareunia (painful sex).
  • Reduce fat and sugar intake to prevent weight gain.
  • Avoid taking too much salt, as it increases blood pressure.
  • Add calcium to your diet in order to prevent osteoporosis. Dairy products and vitamin D enhance the calcium absorption process.
  • Seek support in other women who are in the same stage as you are. It is highly positive for your state of mind.

In addition to all the aforementioned recommendations, seeking support from other women who are at the same stage also helps to improve mood.

FAQs from users

What is hormone replacement therapy in menopausal women?

By Elisa Pérez Larrea M.D., M.Sc. (gynecologist).

Hormone replacement therapy consists of treatment with estrogens alone or with estrogens with progestogens in order to relieve the symptoms produced by the decrease of natural hormones in menopause.

The symptoms of menopause secondary to the drop in estrogens are very varied, from vaginal dryness or hot flushes to osteoporosis. In some cases, the symptoms can candition the quality of life, affecting and limiting the woman in her daily life. On other occasions, such as early menopause, the period of years in which a woman will have low levels of estrogen can be very long, thus increasing the risk of osteoporosis in the future. In these situations, hormone replacement therapy may be indicated for a variable time interval.

The FDA advises the use of hormone therapy for the shortest possible time and at the lowest possible dose to control the symptoms of menopause. The gynecologist will be responsible for deciding what medication to take and even when to take it, based on the patient's symptoms and characteristics.

When do women go through menopause?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

There is not a specific age when menopause should start. It is estimated that, on average, it begins when the woman is between 45 to 55 years old. Should it begin earlier than age 45, it is considered early menopause. Conversely, in case it you go through it later than age 55, it would be considered a case of late menopause.

The average age for menopause to show up is 51, with symptoms like hot flashes, alterations in the menstrual period, and mood swings.

Can you get pregnant while going through menopause?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Yes, although it is unlikely. During perimenopause, i.e. the period prior to menopause, you still ovulate and, subsequently, there are chances for you to get pregnant yet. Specialists recommend that women continue using birth control while on perimenopause until they have stopped having monthly menses for at least 12 months in a row.

Can you get pregnant with donor eggs after menopause?

By Rebeca Reus BSc, MSc (embryologist).

Yes, it is possible to have a baby after menopause, a phenomenon known as postmenopausal pregnancy. Menopause is defined as the cessation of menstruation, which means the loss of ovarian activity. However, this does not affect the uterus, which is still functional, and able to carry a pregnancy. This is perfectly possible with either donor eggs from a young girl, the woman's own previously frozen eggs, or the couple's frozen embryos, if any.

Do you run out of eggs at menopause?

By Andrea Rodrigo B.Sc., M.Sc. (embryologist).

Yes, in fact, that is the definition of menopause. When a woman hits this stage in her reproductive life, it literally means that her ovaries have run out of oocytes.

What is the male version of menopause?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Yes, though it is not so noticeable as in the case of women. Experts have named it male climacterium, andropause, low T or male menopause. It involves a gradual decline in testicular function, with the subsequent decrease in testosterone levels, hence the name low T.

Andropause usually comes hand in hand with a series of symptoms, including a decrease in testicular size, increased prostate volume, altered erectile function, increased body fat, drop in testosterone levels, etc.

Read more: What Is Andropause or “Male Menopause”?

What AMH level indicates menopause?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Anti-Müllerian hormone (AMH) allows us to predict ovarian reserve in women directly. Since menopause marks the end of ovarian function in women and the depletion of the ovarian follicle count, AMH levels at this moment are low, close to zero.

However, women who wish to have a child at an advanced maternal age, that is, an age that is close to menopause, can use donor eggs to get pregnant. Click here to learn more: What’s Being an Egg Donor Recipient Like? – Preparation & Process.

Imagen: amh-in-menopause

Is it normal to have ovarian pain during menopause?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

No, actually is not a common symptom during menopause, given that the ovaries stop working during this stage. However, the presence of bacterial infections during menopause may cause the ovaries to swell, causing pain.

Suggested for you

As explained throughout this post, perimenopause is one stage of climacterium, particularly the one leading up to menopause per se. Would you like to read more about it? If so, do not miss this: What Is Perimenopause?

Throughout the reproductive years of females, sex hormones are responsible for the proper regulation of the menstrual cycle in order to trigger ovulation on a monthly basis. To learn more about this, read: The Different Phases of the Menstrual Cycle.

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FAQs from users: 'What is hormone replacement therapy in menopausal women?', 'When do women go through menopause?', 'Can you get pregnant while going through menopause?', 'Can you get pregnant with donor eggs after menopause?', 'Do you run out of eggs at menopause?', 'What is the male version of menopause?', 'What AMH level indicates menopause?' and 'Is it normal to have ovarian pain during menopause?'.

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Authors and contributors

 Elisa Pérez Larrea
Elisa Pérez Larrea
M.D., M.Sc.
Dr. Elisa Pérez Larrea is a graduate in Medicine and Surgery from the University of Zaragoza and a specialist in Obstetrics and Gynecology from the University of Oviedo. She also has a Master's degree in Human Reproduction from the Complutense University of Madrid. More information about Elisa Pérez Larrea
Licence number: 203311163
 Rebeca Reus
Rebeca Reus
BSc, MSc
Degree in Human Biology (Biochemistry) from the Pompeu Fabra University (UPF). Official Master's Degree in Clinical Analysis Laboratory from the UPF and Master’s Degree about the Theoretical Basis and Laboratory Procedures in Assisted Reproduction from the University of Valencia (UV). More information about Rebeca Reus
 Zaira Salvador
Zaira Salvador
B.Sc., M.Sc.
Bachelor's Degree in Biotechnology from the Technical University of Valencia (UPV). Biotechnology Degree from the National University of Ireland en Galway (NUIG) and embryologist specializing in Assisted Reproduction, with a Master's Degree in Biotechnology of Human Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI) More information about Zaira Salvador
License: 3185-CV
Adapted into english by:
 Sandra Fernández
Sandra Fernández
B.A., M.A.
Fertility Counselor
Bachelor of Arts in Translation and Interpreting (English, Spanish, Catalan, German) from the University of Valencia (UV) and Heriot-Watt University, Riccarton Campus (Edinburgh, UK). Postgraduate Course in Legal Translation from the University of Valencia. Specialist in Medical Translation, with several years of experience in the field of Assisted Reproduction. More information about Sandra Fernández

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