Menopause is a natural physical transition that every woman experiences as she ages. It is often loosely defined as the final cessation of menstruation in a woman's life. This implies an abrupt and complete transition, although the actual process is typically quite gradual.

While most women undergo this change between the ages of 48 and 52, some women stop menstruating as young as their late thirties or early forties, and others continue to menstruate into their mid-fifties.

The process leading up to menopause begins with a slow-down in the function of the ovaries, generally about five years before the last menstrual period, and additional physical and emotional changes continue for several years after the last period.

What Happens During Menopause

During this time, there is a change in the hormonal balance, with a decrease in the amount of estrogen produced by the ovaries. Finally, there is such a low level of estrogen production that periods become irregular, eventually stopping altogether.

As the menstrual cycles cease, the level of progesterone also decreases. Together, these hormones influence and regulate a number of physical and emotional functions, and with changing levels of both, many women experience more than just the cessation of menstruation.

Menopause sets in motion a number of physiological changes that may impact a woman's sexual functioning. The decreased levels of estrogen and progesterone during and after menopause cause the lining of the vaginal walls to thin and become more rigid. In addition, the production of vaginal lubrication drops off, contributing to discomfort during intercourse.

Estrogen-replacement Therapy for Menopause

Helping to counter these changes for many women is estrogen-replacement therpay. But its risks may outweigh the benefits for women with cardiovascular disease, breast cancer, or uterine cancer in their histories. Estrogen suppositories or creams, which contain much lower doses of estrogen and are used over much shorter periods of time, are another option for maintaining the viability of the vagina.

For women who cannot, or prefer not to use estrogen treatments, water-based vaginal lubricants effectively alleviate vaginal dryness at the time of intercourse.

Menopause need not signal the end of a woman's sexual interest or activity, as was assumed to be true in the past. It is not the loss of estrogen, but the beliefs and attitudes about sex and menopause, or aging, that seem to be important to sexual desire and activity.

In recent years it has become clear that not only does interest in and capacity for sex continue well beyond menopause, but that many women report an increased enjoyment of sex because worries about unwanted pregnancy are no longer a concern.

Some women experience this as a smooth transition with little physical discomfort, while others experience many uncomfortable accompanying symptoms such as hot flashes, night sweats, mood swings, irregular heavy bleeding, osteoporosis, and vaginal dryness (which may lead to painful sexual intercourse).