Natural menopause is often contrasted to induced or surgical menopause. In the latter, certain treatments such as chemotherapy or removal of the ovaries causes cessation of monthly menstruation or periods. In the former, menopause occurs as a result of the natural decline in hormone production that tends to happen in women’s late forties or early fifties. Once a woman has had no menstrual activity for a year, she is considered to have undergone natural menopause and is post-menopausal. Note that this is not the same as cessation of monthly periods during pregnancy and breastfeeding, and women who have been through a pregnancy can usually expect the menstrual cycle to return.
There are many definitions that might be used to describe the time leading up to natural menopause. Fluctuating hormones can lead to a number of changes in menstrual cycle long before periods fully cease. This stage is usually called perimenopause, and the medical community differs on how long it typically last. Some women may experience the first signs of perimenopause in their early thirties and begin to note changes in lengths of or distances between periods.
As perimenopause progresses, other symptoms of the closeness of natural menopause may become evident. Even before periods cease, some women note increase in things like vaginal dryness, period irregularity, hot flashes, mood changes, and night sweats. These may intensify once periods begin to cease and a woman is truly in natural menopause.
Some women may choose to alleviate some of the effects of natural menopause by using hormone replacement therapy (HRT). Many women routinely used this until recently, when concerns were raised about the safety of treatment. It is true that HRT elevates risk for certain cancers, and fewer women may now use it. Some have suggested using creams with natural plant based estrogens instead, but it is not clear that these are safer.
Others adopt an approach of treating potential risk factors that may occur with menopause, including greater risk for heart disease and osteoporosis. Many women take drugs that may help increase bone density. They also might require additional cardiac screenings, and it makes sense to pursue a heart healthy lifestyle, including sensible diet and cardiovascular exercise to reduce risk.
In certain circumstances, the term natural menopause refers to allowing the process of menopause to proceed without minimal drug or medical intervention. A number of women argue that this is the process of female aging and medical science has interfered with that process too long. Even with this view, it still makes sense to use certain interventions such as lubricating gels for intercourse or pursuing good diet and exercise. These may be useful in reducing discomfort or in protecting health.
