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Menopause is the ces­sa­tion of a wom­an’s repro­duc­tive abil­i­ty, the oppo­site of menar­che. Menopause is usu­al­ly a nat­ur­al change; it typ­i­cal­ly occurs in women in midlife, dur­ing their late 40s or ear­ly 50s, sig­nalling the end of the fer­tile phase of a wom­an’s life. Menopause is com­mon­ly defined by the state of the uterus and the absence of men­stru­al flow or “peri­ods”, but it can instead be more accu­rate­ly defined as the per­ma­nent ces­sa­tion of the pri­ma­ry func­tions of the ovaries. What ceas­es is the ripen­ing and release of ova and the release of hor­mones that cause both the build-up of the uter­ine lin­ing, and the sub­se­quent shed­ding of the uter­ine lin­ing (the menses or peri­od). The tran­si­tion from a poten­tial­ly repro­duc­tive to a non-repro­duc­tive state is nor­mal­ly not sud­den or abrupt, occurs over a num­ber of years, and is a con­se­quence of bio­log­i­cal aging. For some women, dur­ing the tran­si­tion years the accom­pa­ny­ing signs and effects (includ­ing lack of ener­gy, hot flash­es, and mood changes) can be pow­er­ful enough to sig­nif­i­cant­ly dis­rupt their dai­ly activ­i­ties and sense of well-being. In those cas­es var­i­ous dif­fer­ent treat­ments can be tried. Med­ical­ly speak­ing, the date of menopause (in a woman with an intact uterus) is the day after the final episode of men­stru­al flow fin­ish­es. “Per­i­menopause” is a term for the menopause tran­si­tion years, the time both before and after the last peri­od ever, while hor­mone lev­els are still fluc­tu­at­ing errat­i­cal­ly. “Pre­menopause” is a term for the years lead­ing up to menopause. “Post­menopause” is the part of a wom­an’s life that occurs after the date of menopause; once a woman with an intact uterus (who is not preg­nant or lac­tat­ing) has gone a year with no flow at all she is con­sid­ered to be one year into post menopause.