Even as menstrual cycles (setting on of female puberty) are the first rushes of hormonal effulgence in women, the end of the fertility road or menopause is the big one, which is where science has tuned its telescopic interests intensely in modern day research. Acutely symptomatic, visibly emotional and psychological in mood swings, menopause has become the great escape/excuse/generalizations for explaining away many ‘inexplicable’ responses of middle-aged women.

The moody mother of teenage progeny, depressed, wants to be left alone, starts to cry, gets angry at the drop of a hat; the aunt with the receding hairline and ever present scowl on her face constantly screams at the kids playing in front of her house; the spinster/divorcee living next door is not liked because she is grouchy and does not talk much to her neighbours. The harridan female type? Largely people brush her off as the crotchety woman, some nod them off as symptoms of ‘aging’ and then those others who smirk about ‘sexual frustration’.

Sociologists would in turn mutter about residues of cultural obssession with the reproductive role of the female. Any female who is no longer or who does not (like the spinster) fulfill the reproductive role must be an ‘abberation’. Sociological studies of cultures, have often pointed out the association made between women without children, unmarried women, older women and widows with witches and old hags.

However, thank God for the modern world, with more and more women spending about one third of their lives in the non-reproductive phase, it has become important for us to address this as a biological truth, the rites of passage of women, buffeted through the vagaries of fertility cycles.

Though T (testosterone) has always won hands down in research interest (therefore funding) recently medical science has finally begun to look at the non-reproductive phase of a woman’s life-cycle and its impact. Menopause is finally being acknowledged as a medical condition, with sweeping emotional/biological/sexual changes in a woman’s life. The word menopause comes from the Greek and Latin words for "moon" and "stop" and refers to the ending of a woman's menstrual cycle.

There are three phases to menopause-Perimenopause, Menopause and Postmenopause. Perimenopause is the period of gradual changes that lead into menopause. It can start as early as 35 and is a stop-start process that may take months or years before the actual menopause occurs. Some clinicians maintain that perimenopause can last for as long as 5 to 15 years, while others refer to perimenopause as that period which is a 3 to 4 year span just before menopause. Women reach menopause at different times. The timing is not however related to race, class, pregnancy, breastfeeding, fertility patterns, the birth control pill, height, age of menarche (first period), or age at last pregnancy. Even though all these factors including genetics and nutrition levels all contribute, many more complex emotional/ life style issues finally decide when and how a woman approaches Menopause. The average age for menopause is broadly around 51.

What causes menopause and how does it affect the lives of women? Both menstruation and menopause are linked to the secretions of the female hormone Estrogen. Estrogen is a hormone primarily responsible for female traits. In order to understand what causes menopause we must first understand estrogen’s role during the menstrual cycle. For a proper rotation of menstrual cycle (every 28 days) what is required is the hormonal balance among estrogen, progesterone, follicle stimulating hormone (FSH) and luteinizing hormone (LH). Dip in estrogen levels sends signals to the brain to increase the secretion of FSH. FSH aids in the development of the follicles in the ovary, which contains the ovum (during a single menstrual cycle only one follicle, out of the thousands, ruptures to release an egg). A single follicle responds to this and becomes dominant. As it does so it begins to secrete large amounts of estrogen. The estrogen suppresses the further secretion of FSH; it helps stimulate a large and sudden release of LH which is accompanied by a transient rise in body temperature indicating that ovulation is about to happen; the LH surge ruptures the follicle and expels the egg into the fallopian tube. As the follicle ruptures it turns into corpus luteum and starts secreting progesterone which helps thicken the endometrial lining of the uterus to become thicker and enriched so that it can receive the fertilized egg if necessary. If the egg does not get fertilized the corpus luteum starts to "crumble", causing the levels of estrogen and progesterone to drop. Without these hormones to support it, the uterus soon sheds its lining, and menstruation begins. In addition, with no estrogen to suppress it, FSH levels again start to rise. Thus, one cycle ends and another begins.

As women age the egg producing follicles in the ovaries become less sensitive and the ovaries ability to produce estrogen also declines. When a follicle fails to develop it secretes less estrogen. If estrogen levels are sufficiently low, they may fail to trigger the LH surge supposed to rupture the follicle, and the egg isn't released, the corpus luteum does not form and progesterone cannot be released at the appropriate time. Low estrogen levels might lead the uterus to shed its endometrial lining prematurely leading to shorter cycles. Lower levels of estrogen means higher levels of FSH. However the less sensitive follicles may not respond completely to FSH and the follicles may not develop fully or follicles may develop after longer intervals. This leads to irregular menstruations and finally to menopause.

With estrogen levels fluctuating the female body goes through a phase of hormonal imbalances and turmoils. After leaving the ovaries, estrogen travels to special receiving points, found in different type of tissues all over the body. Many of these receptors are found in female anatomy, such as the breast, uterus, labia, and vulva. But you can also find them in bone, skin, the brain, muscles, heart, and blood vessels. The lack of normal amounts of estrogen therefore affect functions related to these organs. Some of the most common symptoms of perimenopause and menopause are:

· Hot flashes
· Temporary and minor decrease in the ability to concentrate or recall
· Changes in sexual desire
· Extreme sweating
· Headaches
· Frequent urination
· Early wakening
· Vaginal dryness
· Mood changes
· Insomnia
· Night sweats
· Osteoporosis
· Heart disease
· Sagging breasts, loosening of skin
· Migraine
· Higher risk of breast cancer

If menopause is reached unnaturally (due to premature ovarian failure) or surgically (hysterectomy) before the age of 40, it is called early or premature menopause. Menopause also occurs in women who are undergoing anticancer treatment. Chemotherapy and anticancer drugs can damage the ovaries and reduce the amount of hormones they produce.

A very interesting thing that occurs during menopause is a slight rise in the secretion of testosterone. Though high levels of testosterone, as Jasjit illustrated in her article, does not affect women in the same way as it does in the men, the slight rise of this hormone in women in relation to fall in estrogen levels causes certain physical as well as behavioral changes. Receding hairline, facial hair growth, heavy masculine voice are some of the physical changes. Behavioral changes can be best illustrated through the powerful and domineering role that older matriarchs are seen to play in households. Similarly in men ageing decreases the testosterone levels and leads to a rise in estrogen levels. This change in ratio of estrogen and testosterone in both men and women, makes the sexes more similar as they age. Interestingly it harmonizes their hormonal levels to make them ‘more similar’ than at any other point in their lives.

Hormones, as we all know, are the life giving force that animate us not only physically but mentally and emotionally also. The E and T play some moving roles in tandem with the body clock bringing man and woman into another phase of complementarity, albeit with gentle but unequivocal role reversals. The quieter, calmer gentler man, ready to grandfather his grandchildren with bedtime stories and hugs and cuddles. The retired go-getter, settling in as man-about-the –house willing to help his aging wife with peeling potatoes and hanging out the washing. However the lower levels of E and rising T leave women with far more complex needs, desires and options and therein lies the tale of why menopause for women can be an intense, nearly traumatic experience.