Heredity, living conditions, and childbearing all play a part in the menopause. Its arrival may be hastened by a bad environment and those who have never given birth. Early menopause may result from disease or the surgical removal of the ovaries.

This phase in a woman's life marks the end of her reproductive cycle. The monthly menstrual flow may stop suddenly or gradually. The first sign of menopause is irregular menstrual bleeding. Periods may be light one month and heavy the next until they eventually cease. Twelve months after the last period, a woman is no longer fertile.

Because of the change in hormone levels, a woman who has reached the menopause may experience other symptoms as well. These include hot flashes, a warm feeling in the chest moving to the face and neck followed by sweating which may last for 15 minutes.

Falling estrogen levels may cause itching, especially in the genitals, vaginal dryness, dizzy spells, headaches, insomnia, fatigue, lack of energy, abdominal bloatedness, digestive troubles, pain, flatulence, constipation, diarrhea, breathlessness and palpitations.

Estrogen also influences the growth of the breast, uterus, vagina, muscles, and skin. Lack of this hormone can make one susceptible to circulatory diseases and loss of calcium from the bones.

Without estrogen, the skin becomes wrinkled, breasts flatten and droop, the womb and ovaries shrink, and the vagina becomes prone to infections. The risk of a heart attack and arthritis also increases.

Not all women, however, suffer during the menopause. Although they may age noticeably, most remain physically, mentally, and sexually active after the change of life. Some, in fact, welcome the menopause because it is the ideal time to have sex without the burden of pregnancy.

Most of the above conditions can be remedied with a doctor's help. Estrogen replacement therapy may be prescribed to ease the pain and discomfort of menopause. But this is usually done for a short period of time since estrogen use in postmenopausal women may cause breast tenderness, gastric upset, swelling of the ankles, and breast and uterine cancer.

A healthy woman need not fear the arrival of the menopause. For her, it may be marked simply by the end of the menstrual flow. But if she experiences any of the above symptoms, she should see a doctor.

"Get at least 30 minutes of moderate-intensity physical activity on most days to protect against cardiovascular disease, diabetes, osteoporosis and other conditions associated with aging. More vigorous exercise for longer periods may provide further benefit and is particularly important if you are trying to lose weight. Exercise can also help reduce stress," according to the Mayo Clinic.

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