"The permanent cessation of menstruation resulting from loss of ovarian follicular activity" (World Health Organization definition). Ovaries decrease production of estradiol (the main estrogen in premenopausal women) but continue lower production of estrone (a weaker estrogen). Ovarian production of testosterone is stable, but overall body levels drop because of decreased production elsewhere. Perimenopause is the 2 -- 8 year period before menopause and the first year after last menstruation. Postmenopause is the time starting after last menstruation, thus overlapping slightly with perimenopause. In the United States, the average age at menopause is 52 years, so women spend up to one-third or more of their lives in postmenopause.

Why consider taking hormones at menopause?

• To reduce symptoms of menopause.


• To lower risk of spine and hip fractures.


• Possibly to lower risk of colon cancer.

Why NOT take hormones at menopause?

• Perimenopause symptoms are not always a problem.


• Unpleasant side effects.


• Health risks of medicines.


• Benefits of hormones reported in early studies are not always confirmed in later studies.

Decisions to treat menopause with medications are based on one's personal risk profile, including behavior, habits, family history, race, age and medical history.