Overview Menopause signals end of menstrual cycles and reproductive function in females progressive loss of ovarian follicle units (atresia) throughout reproductive life causes a decrease in ovarian production of estrogen and reduces negative feedback to anterior pituitary, leading to an increase in FSH and LH levels typically preceded by several years of abnormal menstrual cycles e.g., anovulatory cycles diagnostic findings include ↓ estrogen, ↑↑ FSH, ↑ LH, ↑ GnRH in post-menopausal women, source of estrogen includes ovary and adrenal cortex via peripheral aromatization of androgens adrenal cortex (major) and ovary (minor) are sources of androstenedione ↑ androgens result in a male pattern hair growth (mainly on the face) average age of menopause is 50 years onset early in smokers early menopause may indicate premature ovarian failure Menopause symptoms symptoms are caused by loss of ovarian source of estrogen male-pattern hair growth in women via ↑ androgens hot flashes (vascular instability) atrophy of vagina (thinning of vaginal epithelium) ↓ vaginal secretions osteoporosis coronary artery disease