Menopause is the final cessation of menstruation. Humans are the only primates to experience a menopause, and its origins and purpose remain unclear. The age of menopause has remained constant since Aristotle, although the age of menarche has fallen in the past 100 years. The incidence of natural premature ovarian failure before age 40 is 1%. The factors controlling the timing of the menopause are not well understood. The possession of two X chromosomes is essential for normal ovarian function. Genetic, reproductive and lifestyle factors, chemotherapy and radiation, pelvic surgery, infection, and autoimmunity have all been implicated. There is an association between age of menopause of mothers and daughters and greater concordance with identical than non-identical twins. However, with the exception of smoking which advances menopause by two years, these factors have failed to show a consistent influence on age at menopause.
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