Menopause, also known as the climacteric, is the time in most women's
lives when menstrual periods stop permanently, and they are no longer
able to bear children.
Menopause typically occurs between 49 and
52 years of age. Medical professionals often define menopause as
having occurred when a woman has not had any vaginal bleeding for a
year. It may also be defined by a decrease in hormone production by
the ovaries. In those who have had surgery to remove their uterus
but still have ovaries, menopause may be viewed to have occurred at
the time of the surgery or when their hormone levels fell.
Following the removal of the uterus, symptoms typically occur earlier,
at an average of 45 years of age.
Before menopause, a woman's periods typically become irregular,
which means that periods may be longer or shorter in duration or be
lighter or heavier in the amount of flow. During this time, women
often experience hot flashes; these typically last from 30 seconds to
ten minutes and may be associated with shivering, sweating, and
reddening of the skin. Hot flashes often stop occurring after a
year or two. Other symptoms may include vaginal dryness, trouble
sleeping, and mood changes. The severity of symptoms varies
between women. While menopause is often thought to be linked to an
increase in heart disease, this primarily occurs due to increasing age
and does not have a direct relationship with menopause. In some
women, problems that were present like endometriosis or painful
periods will improve after menopause.
Menopause is usually a natural change. It can occur earlier in
those who smoke tobacco. Other causes include surgery that
removes both ovaries or some types of chemotherapy. At the
physiological level, menopause happens because of a decrease in the
ovaries' production of the hormones estrogen and progesterone.
While typically not needed, a diagnosis of menopause can be confirmed
by measuring hormone levels in the blood or urine.
the opposite of menarche, the time when a girl's periods start.
Specific treatment is not usually needed. Some symptoms, however,
may be improved with treatment. With respect to hot flashes,
avoiding smoking, caffeine, and alcohol is often recommended.
Sleeping in a cool room and using a fan may help. The following
medications may help: menopausal hormone therapy (MHT), clonidine,
gabapentin, or selective serotonin reuptake inhibitors. Exercise
may help with sleeping problems. While MHT was once routinely
prescribed, it is now only recommended in those with significant
symptoms, as there are concerns about side effects. High-quality
evidence for the effectiveness of alternative medicine has not been
found. There is tentative evidence for phytoestrogens.
1 Signs and symptoms
Vagina and uterus
1.2 Other physical
1.4 Long-term effects
2.2 Premature ovarian failure
2.3 Surgical menopause
3.1 Ovarian aging
Hormone replacement therapy
5.2 Selective estrogen receptor modulators
5.3 Other medication
5.4 Alternative medicine
5.5 Other therapies
6 Society and culture
7 Evolutionary rationale
7.1 Non-adaptive hypotheses
7.2 Adaptive hypotheses
7.2.1 "Survival of the fittest" hypothesis
7.2.2 Mother hypothesis
7.2.3 Grandmother hypothesis
8 Other animals
9 See also
11 External links
Signs and symptoms
Symptoms of menopause
During early menopause transition, the menstrual cycles remain regular
but the interval between cycles begins to lengthen.
begin to fluctuate.
Ovulation may not occur with each cycle.
The date of the final menstrual period is usually taken as the point
when menopause has occurred. During the menopausal transition and
after menopause, women can experience a wide range of symptoms.
Vagina and uterus
During the transition to menopause, menstrual patterns can show
shorter cycling (by 2–7 days); longer cycles remain
possible. There may be irregular bleeding (lighter, heavier,
Dysfunctional uterine bleeding is often experienced by
women approaching menopause due to the hormonal changes that accompany
the menopause transition. Spotting or bleeding may simply be related
to vaginal atrophy, a benign sore (polyp or lesion), or may be a
functional endometrial response. The European
Menopause and Andropause
Society has released guidelines for assessment of the endometrium,
which is usually the main source of spotting or bleeding.
In post-menopausal women, however, any genital bleeding is an alarming
symptom that requires an appropriate study to rule out the possibility
of malignant diseases.
Symptoms that may appear during menopause and continue through
atrophic vaginitis – thinning of the membranes of the vulva, the
vagina, the cervix, and the outer urinary tract, along with
considerable shrinking and loss in elasticity of all of the outer and
inner genital areas.
Other physical symptoms of menopause include lack of energy, joint
soreness, stiffness, back pain, breast enlargement, breast
pain, heart palpitations, headache, dizziness, dry,
itchy skin, thinning, tingling skin, weight gain, urinary
incontinence, urinary urgency, interrupted sleeping
patterns, heavy night sweats, hot flashes.
Psychological symptoms include anxiety, poor memory, inability
to concentrate, depressive mood, irritability, mood
swings, less interest in sexual activity.
A possible but contentious increased risk of atherosclerosis. 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.
Increased risk of osteopenia, osteoporosis, and
accelerated lung function decline.
Women who experience menopause before 45 years of age have an
increased risk of heart disease, death, and impaired lung
Menopause typically occurs between 49 and 52 years of age. In India
and the Philippines, the median age of natural menopause is
considerably earlier, at 44 years.
In rare cases, a woman's ovaries stop working at a very early age,
ranging anywhere from the age of puberty to age 40. This is known as
premature ovarian failure and affects 1 to 2% of women by age 40.
Undiagnosed and untreated coeliac disease is a risk factor for early
Coeliac disease can present with several
non-gastrointestinal symptoms, in the absence of gastrointestinal
symptoms, and most cases escape timely recognition and go undiagnosed,
leading to a risk of long-term complications. A strict gluten-free
diet reduces the risk. Women with early diagnosis and treatment of
coeliac disease present a normal duration of fertile life
Women who have undergone hysterectomy with ovary conservation go
through menopause on average 3.7 years earlier than the expected age.
Other factors that can promote an earlier onset of menopause (usually
1 to 3 years early) are smoking cigarettes or being extremely
Premature ovarian failure
Premature ovarian failure (POF) is the cessation of the ovarian
function before the age of 40 years. It is diagnosed or
confirmed by high blood levels of follicle stimulating hormone (FSH)
and luteinizing hormone (LH) on at least three occasions at least four
Known causes of premature ovarian failure include autoimmune
disorders, thyroid disease, diabetes mellitus, chemotherapy, being a
carrier of the fragile X syndrome gene, and radiotherapy. However,
in about 50–80% of spontaneous cases of premature ovarian failure,
the cause is unknown, i.e., it is generally idiopathic.
Women who have a functional disorder affecting the reproductive system
(e.g., endometriosis, polycystic ovary syndrome, cancer of the
reproductive organs) can go into menopause at a younger age than the
normal timeframe. The functional disorders often significantly speed
up the menopausal process.
An early menopause can be related to cigarette smoking, higher body
mass index, racial and ethnic factors, illnesses, and the surgical
removal of the ovaries, with or without the removal of the uterus.
Rates of premature menopause have been found to be significantly
higher in fraternal and identical twins; approximately 5% of twins
reach menopause before the age of 40. The reasons for this are not
completely understood. Transplants of ovarian tissue between identical
twins have been successful in restoring fertility.
Menopause can be surgically induced by bilateral oophorectomy (removal
of ovaries), which is often, but not always, done in conjunction with
removal of the Fallopian tubes (salpingo-oophorectomy) and uterus
(hysterectomy). Cessation of menses as a result of removal of the
ovaries is called "surgical menopause". The sudden and complete drop
in hormone levels usually produces extreme withdrawal symptoms such as
hot flashes, etc.
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.
Bone loss due to menopause occurs due to changes in a woman's hormone
The menopausal transition, and postmenopause itself, is a natural
change, not usually a disease state or a disorder. The main cause of
this transition is the natural depletion and aging of the finite
amount of oocytes (ovarian reserve). This process is sometimes
accelerated by other conditions and is known to occur earlier after a
wide range of gynecologic procedures such as hysterectomy (with and
without ovariectomy), endometrial ablation and uterine artery
embolisation. The depletion of the ovarian reserve causes an increase
in circulating follicle-stimulating hormone (FSH) and luteinizing
hormone (LH) levels because there are fewer oocytes and follicles
responding to these hormones and producing estrogen.
The transition has a variable degree of effects.
The stages of the menopause transition have been classified according
to a woman's reported bleeding pattern, supported by changes in the
pituitary follicle-stimulating hormone (FSH) levels.
In younger women, during a normal menstrual cycle the ovaries produce
estradiol, testosterone and progesterone in a cyclical pattern under
the control of FSH and luteinising hormone (LH) which are both
produced by the pituitary gland. During perimenopause (approaching
menopause), estradiol levels and patterns of production remain
relatively unchanged or may increase compared to young women, but the
cycles become frequently shorter or irregular. The often observed
increase in estrogen is presumed to be in response to elevated FSH
levels that, in turn, is hypothesized to be caused by decreased
feedback by inhibin. Similarly, decreased inhibin feedback after
hysterectomy is hypothesized to contribute to increased ovarian
stimulation and earlier menopause.
The menopausal transition is characterized by marked, and often
dramatic, variations in FSH and estradiol levels. Because of this,
measurements of these hormones are not considered to be reliable
guides to a woman's exact menopausal status.
Menopause occurs because of the sharp decrease of estradiol and
progesterone production by the ovaries. After menopause, estrogen
continues to be produced mostly by aromatase in fat tissues and is
produced in small amounts in many other tissues such as ovaries, bone,
blood vessels, and the brain where it acts locally. The
substantial fall in circulating estradiol levels at menopause impacts
many tissues, from brain to skin.
In contrast to the sudden fall in estradiol during menopause, the
levels of total and free testosterone, as well as
dehydroepiandrosterone sulfate (DHEAS) and androstenedione appear to
decline more or less steadily with age. An effect of natural menopause
on circulating androgen levels has not been observed. Thus
specific tissue effects of natural menopause cannot be attributed to
loss of androgenic hormone production.
Hot flashes and other vasomotor symptoms accompany the menopausal
transition. While many sources continue to claim that hot flashes
during the menopausal transition are caused by low estrogen levels,
this assertion was shown incorrect in 1935 and, in most cases, hot
flashes are observed despite elevated estrogen levels. The exact cause
of these symptoms is not yet understood, possible factors considered
are higher and erratic variation of estradiol level during the cycle,
elevated FSH levels which may indicate hypothalamic dysregulation
perhaps caused by missing feedback by inhibin. It has been also
observed that the vasomotor symptoms differ during early perimenopause
and late menopausal transition and it is possible that they are caused
by a different mechanism.
Long-term effects of menopause may include osteoporosis, vaginal
atrophy as well as changed metabolic profile resulting in cardiac
Decreased inhibin feedback after hysterectomy is hypothesized to
contribute to increased ovarian stimulation and earlier menopause.
Hastened ovarian aging has been observed after endometrial ablation.
While it is difficult to prove that these surgeries are causative, it
has been hypothesized that the endometrium may be producing endocrine
factors contributing to the endocrine feedback and regulation of the
ovarian stimulation. Elimination of this factors contributes to faster
depletion of the ovarian reserve. Reduced blood supply to the ovaries
that may occur as a consequence of hysterectomy and uterine artery
embolisation has been hypothesized to contribute to this
Impaired DNA repair mechanisms may contribute to earlier depletion of
the ovarian reserve during aging. As women age, double-strand
breaks accumulate in the DNA of their primordial follicles. Primordial
follicles are immature primary oocytes surrounded by a single layer of
granulosa cells. An enzyme system is present in oocytes that
ordinarily accurately repairs DNA double-strand breaks. This repair
system is called "homologous recombinational repair", and it is
especially effective during meiosis.
Meiosis is the general process by
which germ cells are formed in all sexual eukaryotes; it appears to be
an adaptation for efficiently removing damages in germ line DNA.
Human primary oocytes are present at an intermediate stage of meiosis,
termed prophase I (see Oogenesis). Expression of four key DNA repair
genes that are necessary for homologous recombinational repair during
meiosis (BRCA1, MRE11, Rad51, and ATM) decline with age in
oocytes. This age-related decline in ability to repair DNA
double-strand damages can account for the accumulation of these
damages, that then likely contributes to the depletion of the ovarian
One way of assessing the impact on women of some of these menopause
effects are the Greene climacteric scale questionnaire, the
Cervantes scale and the
Menopause rating scale.
Premenopause is a term used to mean the years leading up to the last
period, when the levels of reproductive hormones are becoming more
variable and lower, and the effects of hormone withdrawal are
present. Premenopause starts some time before the monthly cycles
become noticeably irregular in timing.
The term "perimenopause", which literally means "around the
menopause", refers to the menopause transition years, a time before
and after the date of the final episode of flow. According to the
Menopause Society, this transition can last for four to
eight years. The Centre for Menstrual Cycle and
describes it as a six- to ten-year phase ending 12 months after the
last menstrual period.
During perimenopause, estrogen levels average about 20–30% higher
than during premenopause, often with wide fluctuations. These
fluctuations cause many of the physical changes during perimenopause
as well as menopause. Some of these changes are hot flashes, night
sweats, difficulty sleeping, vaginal dryness or atrophy, incontinence,
osteoporosis, and heart disease. During this period, fertility
diminishes but is not considered to reach zero until the official date
of menopause. The official date is determined retroactively, once 12
months have passed after the last appearance of menstrual blood.
The menopause transition typically begins between 40 and 50 years of
age (average 47.5). The duration of perimenopause may be for
up to eight years. Women will often, but not always, start these
transitions (perimenopause and menopause) about the same time as their
In some women, menopause may bring about a sense of loss related to
the end of fertility. In addition, this change often occurs when other
stressors may be present in a woman's life:
Caring for, and/or the death of, elderly parents
Empty nest syndrome
Empty nest syndrome when children leave home
The birth of grandchildren, which places people of "middle age" into a
new category of "older people" (especially in cultures where being
older is a state that is looked down on)
Some research appears to show that melatonin supplementation in
perimenopausal women can improve thyroid function and gonadotropin
levels, as well as restoring fertility and menstruation and preventing
depression associated with menopause.
The term "postmenopausal" describes women who have not experienced any
menstrual flow for a minimum of 12 months, assuming that they have a
uterus and are not pregnant or lactating. In women without a
uterus, menopause or postmenopause can be identified by a blood test
showing a very high FSH level. Thus postmenopause is the time in a
woman's life that takes place after her last period or, more
accurately, after the point when her ovaries become inactive.
The reason for this delay in declaring postmenopause is because
periods are usually erratic at this time of life. Therefore, a
reasonably long stretch of time is necessary to be sure that the
cycling has ceased. At this point a woman is considered infertile;
however, the possibility of becoming pregnant has usually been very
low (but not quite zero) for a number of years before this point is
A woman's reproductive hormone levels continue to drop and fluctuate
for some time into post-menopause, so hormone withdrawal effects such
as hot flashes may take several years to disappear.
A period-like flow during postmenopause, even spotting, may be a sign
of endometrial cancer.
Perimenopause is a natural stage of life. It is not a disease or a
disorder. Therefore, it does not automatically require any kind of
medical treatment. However, in those cases where the physical, mental,
and emotional effects of perimenopause are strong enough that they
significantly disrupt the life of the woman experiencing them,
palliative medical therapy may sometimes be appropriate.
Hormone replacement therapy
Hormone replacement therapy (menopause)
In the context of the menopause, hormone replacement therapy (HRT) is
the use of estrogen in women without a uterus and estrogen plus
progestin in women who have an intact uterus.
HRT may be reasonable for the treatment of menopausal symptoms, such
as hot flashes. It is the most effective treatment option,
especially when delivered as a skin patch. Its use, however,
appears to increase the risk of strokes and blood clots. When used
for menopausal symptoms some recommend it be used for the shortest
time possible and at the lowest dose possible. Evidence to support
long term use however is poor.
It also appears effective for preventing bone loss and osteoporotic
fracture, but it is generally recommended only for women at
significant risk for whom other therapies are unsuitable.
HRT may be unsuitable for some women, including those at increased
risk of cardiovascular disease, increased risk of thromboembolic
disease (such as those with obesity or a history of venous thrombosis)
or increased risk of some types of cancer. There is some concern
that this treatment increases the risk of breast cancer.
Adding testosterone to hormone therapy has a positive effect on sexual
function in postmenopausal women, although it may be accompanied by
hair growth, acne and a reduction in high-density lipoprotein (HDL)
cholesterol. These side effects diverge depending on the doses and
methods of using testosterone.
Selective estrogen receptor modulators
SERMs are a category of drugs, either synthetically produced or
derived from a botanical source, that act selectively as agonists or
antagonists on the estrogen receptors throughout the body. The most
commonly prescribed SERMs are raloxifene and tamoxifen. Raloxifene
exhibits oestrogen agonist activity on bone and lipids, and antagonist
activity on breast and the endometrium.
Tamoxifen is in widespread
use for treatment of hormone sensitive breast cancer. Raloxifene
prevents vertebral fractures in postmenopausal, osteoporotic women and
reduces the risk of invasive breast cancer.
Some of the
SNRIs appear to provide some relief. Low dose
paroxetine has been FDA-approved for hot moderate-to-severe vasomotor
symptoms associated with menopause. They may, however, be
associated with sleeping problems.
Gabapentin or clonidine may help but does not work as well as hormone
Clonidine may be associated with constipation and sleeping
There is no evidence of consistent benefit of alternative therapies
for menopausal symptoms despite their popularity. The effect of
soy isoflavones on menopausal symptoms is promising for reduction of
hot flashes and vaginal dryness. Evidence does not support a
benefit from phytoestrogens such as coumestrol, femarelle, or
the non-phytoestrogen black cohosh. There is no evidence to
support the efficacy of acupuncture as a management for menopausal
symptoms. As of 2011 there is no support for herbal or dietary
supplements in the prevention or treatment of the mental changes that
occur around menopause. A 2016
Cochrane review found not enough
evidence to show a difference between Chinese herbal medicine and
placebo for the vasomotor symptoms.
Lack of lubrication is a common problem during and after
perimenopause. Vaginal moisturizers can help women with overall
dryness, and lubricants can help with lubrication difficulties that
may be present during intercourse. It is worth pointing out that
moisturizers and lubricants are different products for different
issues: some women complain that their genitalia are uncomfortably dry
all the time, and they may do better with moisturizers. Those who need
only lubricants do well using them only during intercourse.
Low-dose prescription vaginal estrogen products such as estrogen
creams are generally a safe way to use estrogen topically, to help
vaginal thinning and dryness problems (see vaginal atrophy) while only
minimally increasing the levels of estrogen in the bloodstream.
In terms of managing hot flashes, lifestyle measures such as drinking
cold liquids, staying in cool rooms, using fans, removing excess
clothing, and avoiding hot flash triggers such as hot drinks, spicy
foods, etc., may partially supplement (or even obviate) the use of
medications for some women.
Individual counseling or support groups can sometimes be helpful to
handle sad, depressed, anxious or confused feelings women may be
having as they pass through what can be for some a very challenging
Osteoporosis can be minimized by smoking cessation, adequate vitamin D
intake and regular weight-bearing exercise. The bisphosphate drug
alendronate may decrease the risk of a fracture, in women that have
both bone loss and a previous fracture and less so for those with just
Society and culture
The cultural context within which a woman lives can have a significant
impact on the way she experiences the menopausal transition. Menopause
has been described as a subjective experience, with social and
cultural factors playing a prominent role in the way menopause is
experienced and perceived.
Within the United States, social location affects the way women
perceive menopause and its related biological effects. Research
indicates that whether a woman views menopause as a medical issue or
an expected life change is correlated with her socio-economic
status. The paradigm within which a woman considers menopause
influences the way she views it: Women who understand menopause as a
medical condition rate it significantly more negatively than those who
view it as a life transition or a symbol of aging.
Ethnicity and geography play roles in the experience of menopause.
American women of different ethnicities report significantly different
types of menopausal effects. One major study found Caucasian women
most likely to report what are sometimes described as psychosomatic
symptoms, while African-American women were more likely to report
It seems that Japanese women experience menopause effects, or konenki,
in a different way from American women. Japanese women report
lower rates of hot flashes and night sweats; this can be attributed to
a variety of factors, both biological and social. Historically,
konenki was associated with wealthy middle-class housewives in Japan,
i.e., it was a "luxury disease" that women from traditional,
inter-generational rural households did not report.
Menopause in Japan
was viewed as a symptom of the inevitable process of aging, rather
than a "revolutionary transition", or a "deficiency disease" in need
In Japanese culture, reporting of vasomotor symptoms has been on the
increase, with research conducted by Melissa Melby in 2005 finding
that of 140 Japanese participants, hot flashes were prevalent in
22.1%. This was almost double that of 20 years prior. Whilst
the exact cause for this is unknown, possible contributing factors
include significant dietary changes, increased medicalisation of
middle-aged women and increased media attention on the subject.
However, reporting of vasomotor symptoms is still significantly lower
than North America.
Additionally, while most women in the United States apparently have a
negative view of menopause as a time of deterioration or decline, some
studies seem to indicate that women from some Asian cultures have an
understanding of menopause that focuses on a sense of liberation and
celebrates the freedom from the risk of pregnancy. Postmenopausal
Indian women can enter
Hindu temples and participate in rituals,
marking it as a celebration for reaching an age of wisdom and
Diverging from these conclusions, one study appeared to show that many
American women "experience this time as one of liberation and
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.
The medicalization of menopause within biomedical practice began in
the early 19th century and has affected the way menopause is viewed
within society. By the 1930s in North America and Europe, biomedicine
practitioners began to think of menopause as a disease-like state.
This idea coincided with the concept of the "standardization of the
body". The bodies of young premenopausal women began to be considered
the "normal", against which all female bodies were compared.
Menopause literally means the "end of monthly cycles" (the end of
monthly periods or menstruation), from the Greek word pausis ("pause")
and mēn ("month"). This is a medical calque; the Greek word for
menses is actually different. In Ancient Greek, the menses were
described in the plural, ta emmēnia, ("the monthlies"), and its
modern descendant has been clipped to ta emmēna. The Modern Greek
medical term is emmenopausis in
Katharevousa or emmenopausi in Demotic
The word "menopause" was coined specifically for human females, where
the end of fertility is traditionally indicated by the permanent
stopping of monthly menstruations. However, menopause exists in some
other animals, many of which do not have monthly menstruation; in
this case, the term means a natural end to fertility that occurs
before the end of the natural lifespan.
Main article: Disposable soma theory of aging
Various theories have been suggested that attempt to suggest
evolutionary benefits to the human species stemming from the cessation
of women's reproductive capability before the end of their natural
lifespan. Explanations can be categorized as adaptive and
The high cost of female investment in offspring may lead to
physiological deteriorations that amplify susceptibility to becoming
infertile. This hypothesis suggests the reproductive lifespan in
humans has been optimized, but it has proven more difficult in females
and thus their reproductive span is shorter. If this hypothesis were
true, however, age at menopause should be negatively correlated with
reproductive effort and the available data do not support
A recent increase in female longevity due to improvements in the
standard of living and social care has also been suggested. It is
difficult for selection, however, to favour aid to offspring from
parents and grandparents. Irrespective of living standards,
adaptive responses are limited by physiological mechanisms. In other
words, senescence is programmed and regulated by specific genes.
"Survival of the fittest" hypothesis
This hypothesis suggests that younger mothers and offspring under
their care will fare better in a difficult and predatory environment
because a younger mother will be stronger and more agile in providing
protection and sustenance for herself and a nursing baby. The various
biological factors associated with menopause had the effect of male
members of the species investing their effort with the most viable of
potential female mates.[page needed] One problem with this
hypothesis is that we would expect to see menopause exhibited in the
The mother hypothesis suggests that menopause was selected for humans
because of the extended development period of human offspring and high
costs of reproduction so that mothers gain an advantage in
reproductive fitness by redirecting their effort from new offspring
with a low survival chance to existing children with a higher survival
The grandmother hypothesis suggests that menopause was selected for
humans because it promotes the survival of grandchildren. According to
this hypothesis, post-reproductive women feed and care for children,
adult nursing daughters, and grandchildren whose mothers have weaned
them. Human babies require large and steady supplies of glucose to
feed the growing brain. In infants in the first year of life, the
brain consumes 60% of all calories, so both babies and their mothers
require a dependable food supply. Some evidence suggests that hunters
contribute less than half the total food budget of most
hunter-gatherer societies, and often much less than half, so that
foraging grandmothers can contribute substantially to the survival of
grandchildren at times when mothers and fathers are unable to gather
enough food for all of their children. In general, selection operates
most powerfully during times of famine or other privation. So although
grandmothers might not be necessary during good times, many
grandchildren cannot survive without them during times of famine.
Arguably, however, there is no firm consensus on the supposed
evolutionary advantages (or simply neutrality) of menopause to the
survival of the species in the evolutionary past.
Indeed, analysis of historical data found that the length of a
female's post-reproductive lifespan was reflected in the reproductive
success of her offspring and the survival of her grandchildren.
Interestingly, another study found comparative effects but only in the
maternal grandmother—paternal grandmothers had a detrimental effect
on infant mortality (probably due to paternity uncertainty).
Differing assistance strategies for maternal and paternal grandmothers
have also been demonstrated. Maternal grandmothers concentrate on
offspring survival, whereas paternal grandmothers increase birth
Some believe a problem concerning the grandmother hypothesis is that
it requires a history of female philopatry while in the present day
the majority of hunter-gatherer societies are patriarchal.
However, there is disagreement split along ideological lines about
whether patrilineality would have existed before modern times.
Some believe variations on the mother, or grandmother effect fail to
explain longevity with continued spermatogenesis in males (oldest
verified paternity is 94 years, 35 years beyond the oldest documented
birth attributed to females). Notably, the survival time past
menopause is roughly the same as the maturation time for a human
child. That a mother's presence could aid in the survival of a
developing child, while an unidentified father's absence might not
have affected survival, could explain the paternal fertility near the
end of the father's lifespan. A man with no certainty of which
children are his may merely attempt to father additional children,
with support of existing children present but small. Note the
existence of partible paternity supporting this. Some argue that
the mother and grandmother hypotheses fail to explain the detrimental
effects of losing ovarian follicular activity, such as osteoporosis,
Alzheimer's disease and coronary artery disease.
The theories discussed above assume that evolution directly selected
for menopause. Another theory states that menopause is the byproduct
of the evolutionary selection for follicular atresia, a factor that
Menopause results from having too few ovarian
follicles to produce enough estrogen to maintain the
ovarian-pituitary-hypothalamic loop, which results in the cessation of
menses and the beginning of menopause. Human females are born with
approximately a million oocytes, and approximately 400 oocytes are
lost to ovulation throughout life.
Menopause in the animal kingdom appears to be uncommon, but the
presence of this phenomenon in different species has not been
thoroughly researched. Life histories show a varying degree of
senescence; rapid senescing organisms (e.g.,
Pacific salmon and annual
plants) do not have a post-reproductive life-stage. Gradual senescence
is exhibited by all placental mammalian life histories.
Menopause has been observed in several species of nonhuman
primates, including rhesus monkeys and chimpanzees.
Menopause also has been reported in a variety of other vertebrate
species including elephants, short-finned pilot whales,
killer whales and other cetaceans, the guppy, the
platyfish, the budgerigar, the laboratory rat and mouse, and the
opossum. However, with the exception of the short-finned pilot whale,
such examples tend to be from captive individuals, and thus they are
not necessarily representative of what happens in natural populations
in the wild.
Dogs do not experience menopause; the canine estrus cycle simply
becomes irregular and infrequent. Although older female dogs are not
considered good candidates for breeding, offspring have been produced
by older animals. Similar observations have been made in
Pregnancy over age 50
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