Menopause literally means the "end of monthly cycles", from the Greek word pausis (cessation) and the root men- (month). Menopause is an event that typically (but not always) occurs in women in midlife, during their late 40s or early 50s, and it signals the end of the fertile phase of a woman's life. However, rather than being defined by the state of the uterus and the absence of menstrual flow, menopause is more accurately defined as the permanent cessation of the primary functions of the ovaries: the ripening and release of ova and the release of hormones that cause both the creation of the uterine lining, and the subsequent shedding of the uterine lining (a.k.a. the menses or the period). This transition from a potentially reproductive to a non-reproductive state is the result of a reduction in female hormonal production by the ovaries. This transition is normally not sudden or abrupt, tends to occur over a period of years, and is a consequence of biological aging. However, for some women, the accompanying signs and effects that can occur during the menopause transition years can significantly disrupt their daily activities and sense of well-being. In addition, women who have some sort of functional disorder affecting the reproductive system (e.g. , endometriosis, polycystic ovary syndrome, cancer of the reproductive organs) can go into menopause at a younger age than the normal timeframe. The functional disorders often significantly speed up the menopausal process and create more significant health problems, both physical and emotional, for the affected woman. The word "menopause" was coined specifically for human females, where the end of fertility is traditionally indicated by the permanent stopping of monthly menstruations. However, menopause also exists in some other animals, many of which do not have monthly menstruation; in this case, the term means a natural end to fertility that occurs before the end of the natural lifespan. The date of menopause in human females is formally medically defined as the time of the last menstrual period (or menstrual flow of any amount, however small), in those women who have not had a hysterectomy. Women who have their uterus removed but retain their ovaries do not immediately go into menopause, even though their periods cease. Adult women who have their ovaries removed however, go immediately into full surgical menopause, no matter how young they are. Menopause is an unavoidable change that every woman will experience, assuming she reaches middle age and beyond. It is helpful if women are able to learn what to expect and what options are available to assist the transition, if that becomes necessary. Menopause has a wide starting range, but can usually be expected in the age range of 42–58. An early menopause can be related to cigarette smoking, higher body mass index, racial and ethnic factors, illnesses, chemotherapy, radiation and the surgical removal of the ovaries, with or without the removal of the uterus. Menopause can be officially declared (in an adult woman who is not pregnant, is not lactating, and who has an intact uterus) when there has been amenorrhea (absence of any menstruation) for one complete year. However, there are many signs and effects that lead up to this point, many of which may extend well beyond the "official" declaration date of menopause. These include: irregular menses, vasomotor instability (hot flashes and night sweats), atrophy of genitourinary tissue, increased stress, breast tenderness, vaginal dryness, forgetfulness, mood changes, and in certain cases osteoporosis and/or heart disease. These effects are related to the hormonal changes a woman's body is going through, and they affect each woman to a different extent. The only sign or effect that all women universally have in common is that by the end of the menopause transition every woman will have a complete cessation of menses.
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