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Menopause marks the end of reproductive years in a womans life, when menstrual periods stop permanently. Menopause usually occurs naturally, as a result of declining levels of reproductive hormones, estrogen and progesterone, produced by the ovaries; but it may also happen prematurely after surgical removal of the ovaries, as a side effect of cancer treatments, or in a condition known as primary ovarian insufficiency, where the ovaries fail to produce hormones. Menopause is usually preceded by a transient period called perimenopause, when hormone levels start to drop. The last couple of years leading to menopause may bring symptoms such as hot or cold flashes, mood swings, insomnia, vaginal dryness, urinary urgency, and dry skin. Some women may also experience temporary heart racing, headaches and hair loss. The most telling sign that menopause is approaching is the irregularity of periods. Skipping a period or two is common. The cycles may also be shorter. Periods may be heavier or l
