In women the climacteric at one time referred to seven year cycles throughout life, puberal climacteric, menopausal climacteric, and at the age of 63 the grand climacteric. Nowadays when we mention the climacteric we mean the period of a woman’s life in which the function of child bearing ceases; the menopause, which is an incident in this change, is the result of hormonal readjustments and genital atrophy which result. The whole process is normal and physiological and is not a disease.
In general the menopause is considered a mark of the climacteric, although climacteric symptoms frequently precede the cessation of menstruation by months and sometimes by years, and although it is rare, typical symptoms may make their appearance as late as ten years after the menstrual flow disappears. Rarely the climacteric occurs before the age of 20, and it may occur before the menarche, as in a case which I recently reported1 in which typical hormonal changes, headaches and hot flashes were present at the age of 16 years, before the menses appeared. On the other hand menstrual periods occasionally remain regular until the age of 65. The average age for cessation of menstrual periods is 47 years, and race or the age of onset of menstruation have not been shown to have a distinct bearing on the time of the menopause.
The Physiology of the Female Climacteric
The primary change is probably in the ovary, which gradually fails to respond to stimulation from the pituitary. Failure to ovulate regularly. . .