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Introduction
Menopause is a natural process in a woman's life that can be defined as an irreversible loss of menstruation for at least 12 months due to the cessation of ovarian activity (Casper, 2015; Harlow et al., 2012). In the late reproductive stage, which is the last stage before the onset of the menopausal transition, menstrual cycles are ovulatory, but the follicular phase begins to shorten. During this stage, women have difficulty conceiving. Although not definite, the age this period begins is in the 40s when cycles begin to shorten. The perimenopausal (menopause transition) stage occurs, on average, at 47 years of age and after the reproductive years. During this time, endocrinal changes, several menopausal symptoms, and irregular menstrual cycles are seen before menopause. Perimenopause begins, on average, 4 years before the last menstrual period. Hot flashes are the most common symptom, however, depression, vaginal dryness, and sleep disturbances are also common. Women experience a permanent cessation of menstruation after the menstrual irregularity; postmenopause then begins following 12 months of amenorrhea (Casper, 2015; Harlow et al., 2012).
Menopausal stages can be classified as premenopausal, perimenopausal,...