Natural menopause 

Natural menopause occurs when the ovaries stop releasing eggs and, as a result, the levels of sex steroid hormones (estrogen, progesterone, and testosterone) fall. The average age of natural menopause is 51 years of age, but any time after 45 is considered 'normal'. The years during the menopausal transition are called perimenopause, and this stage can last 5-10 years. Periods often become heavier and more sporadic during this time, and menopausal symptoms (for example, night sweats, hot flashes, or vaginal dryness) begin to appear. If you are going through menopause naturally, you will be considered postmenopausal a year to the day of your last period.

If menopause occurs between the ages of 40 and 45, this is referred to as early menopause. One in a hundred women will experience menopause below the age of 40 – this is referred to as premature menopause or premature ovarian insufficiency (POI).

Surgical menopause

In those who undergo bilateral oophorectomy (removal of both ovaries), the transition into menopause is immediate and known as surgical menopause. The symptoms can be sudden and may be more intense than those experienced in natural menopause, especially in younger individuals. Following surgery to remove your ovaries, you will become postmenopausal instantly. 

Sudden symptoms of menopause often occur quickly following surgery and can be unpleasant or distressing, so it is important to work with an experienced health care provider to look after both your short term and long term health during this rapid transition.

Accreditation: SMAC

Visit www.iapmd.org/surgery for lots of evidence-based information and resources for those considering, going through or recovering from surgery for PMDD/PME.