The average age of menopause in the United States is 51.5 years. Menopause is defined as the absence of menses for one full year. The cause of menopause is the decline in ovarian function over time and thus the decline of the menstrual hormones. The most common symptoms experienced are hot flashes, night sweats, insomnia, mood swings, and vaginal dryness. These symptoms can occur as a woman's hormone levels change, sometimes years before the periods stop. There are no reliable tests available to predict the timing, onset, or severity of menopause. Typically, the patient is treated based on her symptoms and their severity. There are many different types of medications available, which can be tailored to the particular symptom. It is essential that a woman take an adequate amount of calcium with vitamin D when approaching the menopausal years. The highest rate of bone loss in women takes place during the first 5 years after menopause.