Menopause is the ‘pause’ of your menses, to put it simply. Most women understand that when they stop having a regular menstrual cycle, they are considered menopausal. A patient is not formally diagnosed as menopausal until they cease having a period for 12 full months (1 year.) There is a large decline in hormone production (primarily estrogen, progesterone and testosterone) starting around age 40 and when it finally declines to a certain point, your hormone production is not enough to maintain a menstrual cycle and you are likely no longer fertile. This can be confusing for many because it’s not as linear of a process as you might think. Many women have irregular periods for years prior to their final menstrual cycle. This phase, starting around age 40, is considered perimenopause. More on that in another post … The average age of full-blown menopause is around age 53 for women in the United States. Once the period is gone for an entire twelve months in a ‘naturally cycling woman,’ she is considered menopausal. There are also important blood tests (mostly FSH) that hormone doctors hone in on to determine a woman’s estrogen producing capacity as she ages, since estrogen levels vary a lot throughout the month and can be an unreliable test by itself in the perimenopausal phase. You may be thrilled to say goodbye to your monthly period, but I imagine you are not so thrilled about the symptoms you are starting to suffer from: • Hot flashes  • Night sweats • Insomnia  • Anxiety • Depression • Mood swings • Vaginal dryness  • Low libido • Sexual dysfunction • Fatigue • Weight gain • Dry skin/hair • Hair loss • Muscle loss • Foggy thinking • Memory loss • Muscle/joint pain