True menopause doesn’t actually occur until a year after a woman has her last menstrual period, and it can affect all women differently. Many women have minimal symptoms and embrace this stage of their life and their changing body. But for others the menopausal transition can be an extremely stressful and difficult time, as they try to cope with distressing mental and physical symptoms that greatly affect their quality of life.
There are three stages to menopause: perimenopause, menopause and postmenopause.
Perimenopause, also called the menopausal transition, is the years leading up to menopause when women experience changes in their menstrual cycle, and symptoms such as hot flushes and changes in mood and sleep. During this time the production of oestrogen and progesterone, the two hormones made by the ovaries, can vary greatly. Perimenopause begins around the age of 45 to 55, and it can last for around four years, depending on a woman’s overall health and other factors including what age their period began and whether they smoke.
Menopause is the stage when a women’s period stops permanently, which signals the end of their fertile reproductive years. Women are born with all their eggs, stored in the ovaries which stimulate the production of oestrogen and progesterone. Menopause happens when there are no more eggs left in a women’s ovaries, and as a result oestrogen levels naturally drop. Oestrogen has an effect on nearly every tissue in the body, so women can start experiencing a variety of menopausal symptoms associated with low oestrogen levels around this time.
After menopause, women go into postmenopause. This stage is when menopausal symptoms ease; however, health risks associated with loss of oestrogen increase as women get older. Supporting heart and bone health is particularly important for postmenopausal women.
What causes menopause?
When women are in their mid-30s their ovaries start producing less oestrogen and progesterone, and in turn their fertility starts to decline. During these reproductive years oestradiol is the major form of oestrogen produced by the ovaries. During menopause, the adrenal glands and women’s fat cells take over producing low levels of oestrogen called oestrone.
Menopause is caused by a change in hormones, including gonadotropin-releasing hormone (GnRH), luteinising hormone (LH), follicle-stimulating hormone (FSH), oestrogen (oestrone, oestradiol and oestriol), progesterone and testosterone. FSH and LH usually go up as you get close to menopause, and oestradiol, progesterone and testosterone levels go down.
As hormone levels drop, women can start experiencing a number of annoying and uncomfortable menopausal symptoms including hot flushes, moodiness, weight gain and issues with sleep. Symptoms can come and go, and their intensity and frequency can vary greatly from woman to woman. The body does eventually adjust to these new changes. Most women take around five years to make the transition through these stages; however, for some women it can take much longer. While a lot of women experience only mild symptoms, for others menopausal symptoms can be severe and can greatly affect their quality of life.
