Menopause it the time of cessation of ovarian function resulting in permanent stoppage of menstruation.
Menopause normally occurs between the age of 45 and 50 years. The average is being 47 years. However, in some cases it may be beyond the age of 50.
Delayed menopause may be related to good nutrition and better health.
Premature menopause will set before  the age of 40 years.
Late menopause is also common in women suffering from uterine fibroids and those at high risk for endometrial cancer.
taking oral contraceptives etc.
Genetic disposition may be directly associated to menopause time.
Smoking induces premature menopause.
Climacteric is the phase of waning ovarian activity and may begin 2 to 3 years  before menopause and continue for 2 to 5 years after it.
 If menstruation is ceased for 12 months, then it is said to be under menopause. In some cases postmenopausal bleeding may occur after 6 month of last menstruation, but it needs initial investigations.
How Menstrual period ceased ?
Sudden cessation of menses.
Gradual diminution  in the amount of blood loss with each regular period until menstruation stops.
Gradual increase in the spacing of the periods until they cease for at least a period of one year.

Pathophysiology and Hormonal levels?
During climacteric , ovarian activity declines.  Initially, ovulation fails, no corpus luteum forms, and no progesterone is secreted by the ovary. Graafian follicles also fail to develop, oestrogenic activity is reduced. And endometrial atrophy leads to cessation of menses.  Cessation of ovarian activity and fall in the oestrogen level cause a rebound increase in the secretion of FSH by anterior pituitary gland.  And later a fall in FSH level occurs eventually. There is 50 percent reduction in androgen production and 66 percent reduction in oestrogen at menopause.

 Menopausal symptoms ?
Hot flushes and sweating.
Headache before hot flushes.
Palpitation and angina pain may be felt.
Sleep disturbances.
Depression and Irritability.
Lack of concentration.
Phobias and Fears of Pregnancy, Cancer etc.
Increased abdominal girth.
Weight gaining.
Sensation of pins and needles in the extremities.
Recurrent urinary infection
Urgency and incontinence of urine.
Loss of sex.
Increase of sex.
Vagina dry.
Vagina atrophic.
Due to chronic oestrogen deficiency, they may develop – Arthritis, Osteoporosis, Cardiovascular disorders,  Tachycardia, Bones and joints disorders, Skin changes, Tooth decay, Alzheimer disease etc.  

Anatomical Changes ?
The genital organs undergo atrophy and retrogression.
The ovaries shrink and their surfaces become grooved and furrowed.
The tunica albuginea thickens.
The plain muscle in the fallopian tube undergoes atrophy, cilia disappear from the tubal epithelium and the tubal plicae are no longer prominent.
The uterus becomes smaller.
The endometrium is changed and become very thin.
The cervix becomes smaller.
The vaginal fornices gradually disappear.
Vagina become narrow and atrophied and gets easily infected causing senile vaginitis.
The vulva atrophies and the vaginal orifice narrows and thic can cause dyspareunia.
The pubic hair is reduced and becomes grey.
The red patches seen around the urethra and introitus are caused by senile vulvitis.
Prolapse of genital organs.
Mammary glandular tissue atrophies, deposition of fat often makes the breasts more pendulous.
The  skin wrinkles and hair grow around the chin and lips.

Management of Menopause:
Periodical check up and investigations are needed to rule out multiple complications and maintenance of qualitative life. They need the required diet, medication, mineral and vitamin supplements, exercises, spiritual and yoga practices.

Why Homeopathy?
Homeopathy has very successful rate in  management of menopausal syndrome and symptoms. The associated problems will be well treated with  homeopathy. Just consult and get relief.