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What is Menopause?
Menopause is the stage in a woman’s life when her menstrual cycle stops and she can no longer reproduce naturally.
This natural part of the aging process usually happens between the ages of 45 and 55, although it can happen earlier or later. The average age of menopause is about 51 years. (1)
Menopause does not usually happen overnight, there is a transitional period which can last for several years before a woman has her last period.
Symptoms
A woman is deemed to have reached menopause when she has had no bleeding or spotting for a continuous period of 12 months.
The majority of women will experience some symptoms of menopause. They can start a few years before final menstruation and continue for, on average 4 years, afterwards. (2)
The period leading up to the last instance of vaginal bleeding is called perimenopause.
Symptoms can begin gradually or appear suddenly; they can be mild or severe. These include:
Irregular Vaginal Bleeding
The pattern of vaginal bleeding can vary from woman to woman. Some might experience minimal issues while others could have prolonged heavy bleeding. In either case, periods will generally become unpredictable.
The gap between menstrual bleeding might shorten, with periods becoming more frequent. Alternatively, it can lengthen, meaning they are less frequent. Sometimes a woman might go for some months without experiencing any bleeding, only for it to start again.
There is no set timescale for irregular bleeding patterns, they can last for several years before finally stopping. During this period, a woman remains fertile and can still become pregnant. (3)
Hot Flashes
Hot flashes are experienced as feelings of heat which spread throughout the body. Most commonly affecting the face, chest and neck, these happen suddenly without warning. They cause a woman to perspire and go red in the face.
Some women will experience only occasional hot flashes which don’t cause much discomfort. Others will have them frequently, sometimes many times a day. When this happens, the flashes can be uncomfortable and embarrassing. They can disrupt a woman’s daily life.
The onset of hot flashes can happen within a few months before periods stop, and continue for a few years afterwards. (4)
Night Sweats
Night sweats are hot flashes which occur at night. It is normal to sweat at night if sleeping in a hot room or using bedding which is thick and heavy.
Night sweats will make a woman sweat profusely, even when the room they are sleeping in is cool. This can result in night clothes and bedding being left soaking wet. (5)
Sleeping Issues
Some women may find they have difficulty falling asleep, or staying asleep. It can leave a person feeling tired, restless and irritable during the day. (6)
Reduced Libido
During menopause, the levels of hormones, estrogen and testosterone, which control a woman’s sex drive, become lower. As a result, a loss of interest in sex can occur. (7)
Vaginal Dryness
Decreasing levels of estrogen during menopause can lead to vaginal dryness. A woman might experience irritation, itching, discomfort or a burning sensation in the vagina.
Sex can become uncomfortable, and arousal and reaching orgasm may be difficult. Frequent urination can also accompany a dry vagina. (8)
Headaches and Migraines
Headaches, or even migraines, are another symptom of menopause. They can last for as little as 30 minutes, or go on for hours. (9)
Mood Changes
Mood swings during menopause are common. A woman might find herself feeling sad, anxious, worried or irritable for no apparent reason. (10)
Palpitations
The hormonal changes which happen during menopause can cause heart palpitations. A woman might notice a sudden change in heartbeat, from a mild fluttering to feeling like the heart is pounding. These sensations can also be felt in the neck and chest. (11)
Memory
A woman might find she becomes forgetful and her levels of concentration will not be as sharp as she is used to. (12)
Urinary Infections
Women may experience more frequent urinary tract infections, such as cystitis. Indications of this type of infection are: a need to urinate more frequently, burning sensation when urinating, or urine which is cloudy or smells. Pain might also be felt in the lower abdomen. (13)
Stages
The stages of reproduction workshop has set out 10 stages of female reproduction, including menopause. These are based primarily around the menstrual cycle and supported by the amount of certain hormones in the body. They are also supported by the amount of eggs in the ovaries (antral follicle count).
The hormones concerned are responsible for the release of eggs (follicles) from the ovaries.
The stages are numbered from minus five to plus two, with zero being the time a woman has her final menstruation.
Stage – 5
Classed as the early reproductive stage in women, this indicates the onset of menstruation. Periods (menses) will be regular or variable.
Stage – 4
This is a woman’s peak reproductive stage and periods will be regular.
Stage -3b
At this late reproductive stage, a woman’s periods are still regular but levels of some hormones begin to fall. The number of eggs in the ovaries is also less.
Stage – 3a
Menstruation now presents with subtle changes, such as a change in the amount of bleeding and duration of the period. Hormone levels are variable and egg count is low.
Stage -2
Classed as early menopausal transition or perimenopause, there are no time scales for this stage. Menstruation will be marked by a more variable extended length of menstrual cycles. The gap between menstruation will increase.
These gaps will be present consecutively for about 10 cycles in a row. Some hormones will be variable and others low, the egg count in the ovaries will be low.
Stage -1
Menopausal transition or perimenopause can last between one and three years. A woman will find that she can go 60 days or more without experiencing a period.
There will be fluctuations in hormone levels, from high to low. Hot flashes and night sweats (vasomotor symptoms) are likely to be experienced.
Stage 0
This is the time menopause begins, when a woman has her final menstrual period (FMP).
Stage +1a
The first 12 months following the final menstrual period. Classed as early post-menopause, it marks the time when perimenopause ends. Vasomotor symptoms are most likely to be experienced during this stage and the next.
Hormone levels change rapidly and level of eggs in the ovaries is low.
Stage +1b
The second stage of early post-menopause begins 12 months after a woman’s last period and lasts for about a year.
Again, hormone levels are rapidly changing and egg levels remain low. Hot flashes and night sweats are very likely to happen.
Stage +1c
The last stage of early post-menopause is characterized by a stabilization of hormone levels. This stage generally lasts between three and six years.
Stage +2
This is the final late phase of menopause. It continues for the remainder of a woman’s lifetime. During this time, she can experience an increase in vaginal dryness and other symptoms associated with the urogenital area. These include vaginal irritation, an increased frequency of urination, and possible urinary infections. (14)
Treatment
Treatments are available to help a woman manage the symptoms associated with menopause. These include lifestyle changes, medication and therapy.
Lifestyle Changes
Staying fit and keeping weight at a healthy level can help reduce the symptoms of menopause. It is important to maintain a healthy diet and exercise regime.
Wearing light clothing, keeping a room cool at night and taking cool showers can help reduce hot flashes. Any potential triggers, such as alcohol, smoking, spicy foods or caffeine, should be avoided.
Keeping stress levels low, getting plenty of rest and partaking in relaxing activities, such as yoga, might help mood swings.
Medication
Hormone replacement therapy (HRT) can be prescribed to replace lowering hormone levels. These medicines are available as tablets, patches, gels and implants.
There are also medications which might be prescribed to deal with vaginal dryness and other symptoms of menopause.
Side effects are often associated with HRT; if you are affected, a doctor can recommend suitable alternatives.
Therapy
Some women will experience low moods and anxiety. A type of talking therapy called cognitive behavior therapy (CBT) can help with these symptoms. (15)
FAQ
What is menopause? Menopause is the stage in a woman’s life when her menstrual cycle stops and she can no longer reproduce naturally.
What are the signs of menopause? The signs include changes in a woman’s menstrual cycle, leading to it finally stopping. Hot flashes, headaches, mood swings, loss of libido, vaginal dryness and palpitations can also be experienced.
How do you develop menopause? For most women, menopause begins between the ages of 45 and 55. It is part of the natural reproductive cycle.
How are you diagnosed for menopause? Age and symptoms generally indicate whether a women has begun menopause. A blood test might be carried out to confirm this.
What is the best treatment for menopause? Treatments include lifestyle changes, medication and therapy.
What are the long term complications of menopause? Lower estrogen levels in the body can lead to a weakness in the bones (osteoporosis). (16)
Is menopause considered a disability? Menopause occurs naturally in all women and is not considered a disability.
Is there a cure for menopause? There are treatments available to help women with the symptoms associated with menopause.
Is menopause life threatening? Menopause Is not considered life threatening.
Summary
Menopause is a natural part of aging in women, defined by the cessation of menstrual bleeding.
The symptoms associated with this unavoidable condition can be mild or severe.
However, many treatments are available which relieve the symptoms and help a woman through this time in her life.