ADULT SEXUALITY: THE MENOPAUSE

With aging, all women reach an end to their fertility. First, there is a gradual decline in female reproductive capacity from age thirty on, reflecting both a drop in fertility and a higher rate of miscarriages. In addition, abnormalities of the menstrual cycle become more frequent over thirty-five as the aging ovaries respond less efficiently to LH and FSH from the pituitary gland. After age forty, the frequency of ovulation generally begins to decrease, and around age forty-eight to fifty-two, menstrual flow stops entirely in a process called the menopause.* However, since deciding when the menopause has occurred can only be done retrospectively — by convention, after one year without further menstrual flow — women who are sexually active at this stage of their lives should continue to practice birth control until it is certain they cannot become pregnant.

The timing of the menopause and the symptoms that accompany it vary greatly from one woman to another. Although the ovaries stop producing all but a minute amount of estrogen, and ovarian progesterone production ceases entirely, small amounts of these hormones are still present because of continued activity of the adrenal glands. LH and FSH levels typically become elevated after menopause.

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