The menopause marks the end of a woman's reproductive period of life. It normally occurs between the ages of 45 and 54, and on average a woman will be about 51 when she goes through the menopause.
The menopause begins with a phase known as the Perimenopause. During this time the number of follicles left in the ovaries decreases, and the body produces less oestrogen and progesterone. The follicles no longer respond so well to the hormones FSH and LH (luteinising hormone) sent from the pituitary so the body starts make more of these. This is why FSH levels are sometimes used to check the ovarian reserve and assess how close a woman is to the menopause.
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As the FSH and then LH levels slowly rise and the body less oestrogen and progesterone, women may start to be aware of menopausal symptoms. These usually begin several years before the menopause itself, and include irregular periods, hot flushes, night sweats, sleep problems, dry skin, hair loss, headaches, mood changes and decreased sexual desire. About 70 per cent of women experience some kind of symptoms, whereas other fortunate types manage to get through the whole thing with no symptoms at all.
Eventually the ovaries give up trying to release mature eggs and the woman's periods stop completely. A woman reaches the menopause when a year has passed since her last period. Once this has happened, there is no longer any chance of pregnancy using her own eggs.
Premature menopause
Some women go through the menopause many years, even decades, before they would expect to, and this brings their fertility to an early end. It is known as premature menopause, or premature ovarian failure, and it can when women are still in their teens or twenties. The causes of premature ovarian failure are often unclear, but there are hereditary links, and if it happened to your mother, it is more likely to happen to you.
Women are often unaware of what is happening unless they are trying to have a child, as experiencing menopausal symptoms at an early age may be totally unexpected. Sometimes it is only during fertility investigations that the problem is discovered.
'When I asked my mum what age she'd gone through the menopause and she said she had completely finished by the age of 41 as three generations of my family had alarm bells went off. I went to the doctor and they said it was very likely that I would have a hereditary premature menopause as well.' Susan, 34
Pregnancy after the menopause
The eases of women giving birth in their late fifties and sixties that hit the headlines always involve the use of another woman's eggs. Egg donation was first developed in the 1980s as a way of treating women who had problems producing their own eggs, and it is not only used for those with premature ovarian failure or poor egg quality, but also for women who have a history of genetic disease, who have had to have their ovaries removed for medical reasons, who have not responded to previous fertility treatment, or who are just older.
It seems that although the biological clock stops us producing viable eggs as we get older, it doesn't affect our wombs in the same way. So women who have already been through the menopause and stopped producing their own eggs can successfully give birth if they use eggs from a younger donor. In theory, this means that women who are happy to use donated eggs can wait as long as they like to have a baby. In practice, most clinics set age limits for egg donation and will not treat women who are past their late forties or early fifties. There are few doctors in the world who are willing to offer headline making treatment to women in their sixties. To find out more, you can check out Infertility Egg Donation.
