Symptoms of<unk>  During early<unk>  transition, the menstrual cycles remain regular but the interval between cycles begins to lengthen. Hormone levels begin to fluctuate. Ovulation may not occur with each cycle. The term<unk>  refers to a point in time that follows one year after the last menstruation. During the<unk> l transition and after<unk> , women can experience a wide range of symptoms. Vagina and uterus Size of the vaginal canal before and after<unk> , demonstrating vaginal atrophy. During the transition to<unk> , menstrual patterns can show shorter cycling (by 2–7 days); longer cycles remain possible. There may be irregular bleeding (lighter, heavier, spotting). Dysfunctional uterine bleeding is often experienced by women approaching<unk>  due to the hormonal changes that accompany the<unk>  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<unk>  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<unk>  and continue through postmenopause include: *painful intercourse *vaginal dryness * 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 Bone mineral density, especially of the vertebrae, decreases with<unk>  Other physical symptoms of<unk>  include lack of energy, joint soreness, stiffness, back pain, breast enlargement, breast pain, heart palpitations, headache, dizziness, dry, itchy skin, thinning, tingling skin, rosacea, weight gain, urinary incontinence, urinary urgency, interrupted sleeping patterns, heavy night sweats, and hot flashes. Mood and memory effects Psychological symptoms include anxiety, poor memory, inability to concentrate, depressive mood, irritability, mood swings, and less interest in sexual activity.<unk> -related cognitive impairment can be confused with the mild cognitive impairment that precedes dementia. Tentative evidence has found that forgetfulness affects about half of<unk> l women and is probably caused by the effects of declining estrogen levels on the brain, or perhaps by reduced blood flow to the brain during hot flashes. Long-term effects<unk>  confers: *A possible but contentious increased risk of atherosclerosis. The risk of acute myocardial infarction and other cardiovascular diseases rises sharply after<unk> , 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<unk>  before 45 years of age have an increased risk of heart disease, death, and impaired lung function.
Menopause
Somatopause
Adrenopause
Menstruation
Premenstrual syndrome
Lactational amenorrhea
Menarche
Pregnancy