Menopause 101

Getting to grips with menopause starts with a fundamental understanding of what we’re actually talking about when we use the term ‘menopause’. 

From a medical perspective, menopause is a biological event in a woman’s life (occurring naturally or brought on medically) when there’s a decline in the hormone levels that regulate the reproductive function, that is the production of eggs in a menstrual cycle. 

On an experiential level, menopause is a complicated and multifaceted episode lasting anything from a few months to many years. Impacting women physically, biologically, psychologically and socially, it has common characteristics across all women but is an entirely personal experience.  

The stages of menopause

The disparate nature of the experience means it’s not uncommon to wonder if you’ve actually reached menopause. Something of a catch-all phrase, there are three distinct phases of menopause.

Perimenopause: 

An ill-defined length of time in a woman’s life when periods become irregular and changes in hormone levels lead to menopause symptoms.

Menopause:

The time when a woman hasn’t had a period for 12 months. 

Postmenopause:

The time after a woman hasn’t had a period for a year. 

 

There’s a lot to unpack here but we’ll start with what’s happening to your body.

 

What’s going on with your body?

When you’re in perimenopause your estrogen, progesterone and testosterone levels are going up and down, no longer balanced in a stable monthly cycle. Because estrogen and progesterone are the hormones that regulate your menstrual cycle and egg production, your periods are yo-yoing as your ovaries stop producing eggs. During perimenopause your periods will at some stage become irregular and vary in duration and flow.   

These unbalanced hormones are also what’s leading to other menopause symptoms as well as irregular periods. Some of the most common symptoms include hot flushes, night sweats, mood changes, weight gain and changes in skin, hair and nails and sex drive, but there are a huge range of symptoms that vary from woman to woman.

The symptoms of perimenopause and menopause can last anything from a few months to several years and may vary during that time. Eventually your periods will stop although for some women symptoms may continue in this postmenopause time.  

 

When does perimenopause happen?

Menopause literally means ‘the end of the monthly cycles’ from the Greek words pausis (‘pause’) and men (‘month’).

While the ancients may have given us the word, they were as hazy on when it happens as we are today. Aristotle said way back in 322 BC it was between the ages of 40 to 50.

Today the average age for the menopause is 51 with perimenopausal symptoms starting around 45 years old. However, this can vary from woman to woman. Early menopause is classed as happening before 45 with a menopause under the age of 40 classed as Premature (or Primary) Ovarian Insufficiency. Early menopause can run in the family and a woman’s menopausal age can correlate with the age her mother went through menopause. 

Early perimenopause changes may be subtle with women not recognising early indicators, which contributes to the indeterminate question of when menopause happens.

 

Surgical, medical or induced menopause

Some women will go through menopause earlier than they would have naturally because of treatment for a medical condition. This ‘cold turkey’ menopause can cause sudden shifts within the body’s hormone levels within days and weeks, rather than years. 

This can happen if:

• You have your ovaries removed or have a hysterectomy 
• You have treatments such as radiotherapy, chemotherapy or drugs to treat cancer
• You have treatment for endometriosis or premenstrual syndrome
• You have genetic or autoimmune factors that contribute

 

How long does menopause last?

Again, it’s difficult to give an exact time frame, but averages suggest menopausal changes can take place for between four to eight years. It’s very common for women to experience symptoms well after their periods have stopped so the menopause doesn’t signal the end of changes for every woman.

 

Diagnosing menopause

In most cases menopause is self-diagnosed. Factors based on age, symptoms and frequency of periods can help you gauge what stage you’re in. If symptoms are affecting your day-to-day life, you should see your GP or if one symptom seems more prevalent, visit your GP to rule anything else out.

You can use an app to track your symptoms and periods which might help predict when you’re likely to experience particular symptoms and help you keep a log of your last period. 

If you’re younger than 45 you might be asked to have a blood test to measure your hormone levels. This will be repeated about six weeks later to take account of fluctuating hormones. 

 

How to treat menopause

Women have found relief from menopause symptoms in a wide variety of ways. If symotoms are getting you down its worth talking to your healthcare professional about the pros and cons of medications. 

Exercise can help improve mood and manage weight, as can a healthy diet, reducing alcohol and cutting out smoking. 

Talking about your experience, either with a professional counsellor or good friend, can help you feel you’re not alone. Relaxation in the form of a favourite pastime, or mindfulness exercises have helped some women. Alternative medicine and quality targeted supplements can also help reduce the severity of symptoms.

There’s no right way or wrong way for menopause, just the way that works best for you.  

 

This article has been reviewed by our expert advisory team.