Menopause is the gradual process involving the cessation of function of the ovaries. Natural menopause (menopause that is not surgically induced) can be divided into four stages. As early as her forties a woman may begin to experience premenopause. This first stage of menopause occurs when a woman's menstrual periods become erratic. By fifty, most women will begin perimenopause, which is signified by the continuation of irregular menstrual cycles accompanied by the onset of classic menopausal symptoms. These may include hot flashes, vaginal dryness, urogenital atrophy, mood disturbance, and insomnia. Menopause begins after a woman's final period and postmenopause is considered to occur after one full year without menstruation (Rosenthal,1999).
Processes that are directly associated with the ovaries become greatly disrupted during menopause. Primarily, ovulation ends resulting in infertility. As the ovaries become increasingly inactive and blood flow to them diminishes, hormone production is greatly affected. In particular, estrogen and progesterone are no longer produced. These hormones are responsible for many functions involving the female reproductive system. The decrease of estrogen and progesterone can cause adverse symptoms that are an annoyance to many perimenopausal and postmenopausal women. Also, depletion of these hormones places women at a higher risk of developing other more serious conditions such as cardiovascular disease, osteoporosis and Alzheimer's (Simon et al., 2001).
Hormone replacement therapy (HRT) administers natural or synthetically derived hormones to supplement a menopausal woman's own diminished supply. Currently there are several HRT's available, offering a range of doses of estrogen alone or in combination with progesterone delivered orally, transdermally or through injection (Simon et al, 2001). For healthy perimenopausal and postmenopausal women HRT is an excellent option for treatment of classic menopausal symptoms and prevention of more serious conditions.