Menopause: The Definition

Menopause Matters… this new columns intention is to give you, the reader, factual information about changes in health and wellness after a woman’s FMP (final menstrual period). I want to share factual scientific information endorsed by the North American Menopause Society-NAMS (, which is the professional medical society devoted exclusively to menopausal health in North American women.

A little about me may be helpful so you can trust that my opinions are unbiased and always have your improved health at heart. I am board certified by the American Board Ob/Gyn (ABOG) and a certified menopausal practitioner (NCMP/NAMS). What this means is that every year I have to read over 50 journal articles and pass written examinations to demonstrate ongoing competence in Ob/Gyn and menopausal medicine. I attend professional society meetings and regularly read my societies professional journals. I have been practicing Ob/Gyn at John Muir Medical Center’s (Walnut Creek and Concord) for 17 years and am currently the medical director of Ob/Gyn at the Walnut Creek campus.

If you are going to understand why menopause matters … some overview of menopause definitions, demographics, and quality of life are in order.  Menopause represents the permanent cessation of menses resulting from the loss of ovarian function. Menopause is a normal, physiologic event, defined as a woman’s final menstrual period (FMP). There is no blood test that can tell you when your menopause will occur. There are some blood tests used in fertility assesments that when abnormal might predict the onset of menopause within the next 5 years, but nothing more accurate. Menopause has different stages (pre/post/transition to be defined in future columns) and is most often a naturally occurring event (spontaneously) such that by 52 years old, about 50% of women have not had a period for 12 months.  Menopause can also be induced thru a medical intervention (surgery, chemotherapy, pelvic radiation therapy). Women have experienced menopause for thousands of years.

Accurate information about physiologic changes, management of menopause symptoms, and reducing disease risk is essential to midlife.  Menopause affects every woman, if she is fortunate enough to survive to middle adulthood. Today most women live far beyond their menopause, which was not always the case.  Approximately 6000 US women reach menopause every day and in 2010 it was estimated that there were ~45 million women over 52 years old and by 2020 there will be well over 50 million. Canadian demographers reported that in 1920 a 50-year-old woman lived to be 75 years old and today a woman that same age is expected to live until her mid 80’s. A woman’s life expectancy in the Western world is estimated at 80.8 years, so women can expect to spend approximately a third of their lives living without any ovarian function as reflected my no menstrual function. My goal is to help you live without ovarian function while maintaining a high quality of life (QOL).

All women experience menopause, but each one does so in a unique way. Some may view the end of fertility as liberation from the possibility of pregnancy, while others may grieve for the children they never had. The level of menopausal symptoms will also have an influence on how a woman perceives her “unique” menopause. Diverse social and cultural differences can affect a woman’s experience of menopause and her view of menopause treatments, as well as her overall health and well being. In one study 80% of women experiencing menopause reported no decrease in quality of life (QOL); 75% of women denied experiencing any loss in their attractiveness. Most (62%) women reported positive attitudes toward menopause itself. Only about 10% of perimenopausal and postmenopausal women participating in community-based studies reported feelings of despair, irritability, or fatigue during the menopause transition.

Fortunately, today menopause is better understood and more openly discussed then ever before. Collaboration between a woman and her healthcare professional (family practice, internal medicine, ob/gyn), characterized by mutual respect and trust, is the goal of menopausal counseling. Menopause counseling can facilitate informed decision-making and validate a woman’s confidence in her decisions and in her ability to carry them out or modify them over time. As I mentioned above NAMS can help patients around the country find a doctor who is a certified menopausal practitioner. NAMS website ( has a link “FOR WOMEN” and below The Menopause Guidebook there is a link to Find a Menopause Practitioner. This certification (NCMP) is only given to physicians who have taken the time to extensive reading regarding menopause and then pass a written competency exam with >85% correct responses.

I hope that you find this monthly column scientifically factual and informative in maximizing your health and wellness for a time that many women spend more then a third of their life in, that is why menopause matters. Future columns will explore timing of important health screens, midlife body changes, clinical issues like hot flashes/night sweats (can happen during the day), changes in vaginal health. I plan to share the best we know about complimentary and alternative medicines, non-prescription and prescription therapies for the various clinical diagnoses that can affect women in menopause. Visit my website at for links to resources and our Facebook page Timothy Leach MD for more information.

Dr. Timothy Leach

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