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Biology of Menopause From the age of 20, the menstrual interval gradually shortens and becomes increasingly regular until the perimenopause. This is related to a shortening of the follicular rather than the luteal phase of the cycle. Serum FSH concentration is elevated during the follicular phase in older women who are still menstruating regularly, while serum inhibin levels are decreased in both the follicular and luteal phases.(2) Menopause is defined biomedically as the last menstrual period followed by 12 months of amenorrhea, therefore it is identified retroactively. (1) According to a 1997 survey women are split on their views on menopause, some believing it to be a medical condition and some believing it to be a natural part of aging. (3) 1 Leidy, L. (1994). Biological Aspects of Menopause: Across the Lifespan. Annual Review of Anthropology, 23(1), 231-253. Retrieved February 28, 2016. 2 Richardson, S. J. (1993). 1 The biological basis of the menopause. Baillière's Clinical Endocrinology and Metabolism, 7(1), 1-16. 3 Kaufert, P., Boggs, P. P., Ettinger, B., Woods, N. F., & Utian, W. H. (1998). Women and Menopause. Menopause, 5(4). Additions to Surgical Menopause From Wiki: Removal of the uterus without removal of the ovaries does not directly cause menopause, although pelvic surgery of this type can often precipitate a somewhat earlier menopause, perhaps because of a compromised blood supply to the ovaries.[citation needed] Symptoms of menopause may be more severe following hysterectomy and could lead to reduced sexual pleasure in some cases. Observational studies indicate growing evidence that surgical menopause may impact negatively on future cardiovascular, psychosexual, cognitive and mental health.However removal of ovaries could possibly reduce incidences of ovarian cancer so the leaving of ovaries in hysterectomy is an individual choice. 4 Hickey, M., M. Ambekar, and I. Hammond. "Should the Ovaries Be Removed or Retained at the Time of Hysterectomy for Benign Disease?" Human Reproduction Update 16.2 (2009): 131-41. Web. 29 Feb. 2016. 5 Nichols, H. B., K. Visvanathan, P. A. Newcomb, J. M. Hampton, K. M. Egan, L. Titus-Ernstoff, and A. Trentham-Dietz. "Bilateral Oophorectomy in Relation to Risk of Postmenopausal Breast Cancer: Confounding by Nonmalignant Indications for Surgery?" American Journal of Epidemiology 173.10 (2011): 1111-120. Web. From Wiki: Long term effects[edit]Menopause confers:A possible but contentious increased risk of atherosclerosis[20] The risk of acute myocardial infarction and other cardiovascular diseases rises sharply after menopause, but the risk can be reduced by managing risk factors, such as tobacco smoking, hypertension, increased blood lipids and body weight.[21][22] Increased risk of osteopenia and osteoporosis[citation needed] There are multiple risk factors of osteoporosis including genetic factors, low body mass index. It is triggered by a dramatic increase in cytokines involved in bone remodeling with net increase in bone reabsorption. As adequate calcium intake may be vital for maintaining peak bone mass theses changes may be reversed by estrogen therapy. 6 Saied, Mary Naim Ayad, Nevine Fouad EL-Hefnawi, and Mamdouh Sheiba. "Osteoporosis and menopause." (2001).

From Wiki:Generally speaking, women raised in the Western world or developed countries in Asia live long enough so that a third of their life is spent in post-menopause. For some women, the menopausal transition represents a major life change, similar to menarche in the magnitude of its social and psychological significance. Although the significance of the changes that surround menarche is fairly well recognized, in countries such as the United States, the social and psychological ramifications of the menopause transition are frequently ignored or underestimated.[citation needed] Utian, Wulf H., and Pamela P. Boggs. "The North American Menopause Society 1998 Menopause Survey. Part I." Menopause 6.2 (1999). Web.