What Is Menopause And When Does It Happen?
By Nadia Khan
Updated December 12, 2018
Reviewer Martha Furman, LPC, CAC
Women go through a lot of different stages in their lives. As teenagers, we've all experienced the joy (and subsequent frustration) of a first period followed swiftly by the anguish of realizing we've got another 40 years of that to go through. We wish it would end, and one day it does. When menstruation ceases, a woman enters menopause. The term means that a woman's menstrual cycle stops and that the natural hormone process that has allowed oocytes or eggs to age and is released for possible fertilization will no longer happen. This is the final stage in a woman's reproductive life cycle, and it is something most women dread because of the abysmal symptoms that start to show as menopause approaches.
The first stage of menopause is unrelated to how early a woman gets her first period. The perimenopause period is a transitioning time that starts in a woman's 30s when her body starts having changes in her hormone levels that cause secondary changes in her body. While actual perimenopause only lasts 1-2 years a woman can enter the menopausal state any time from her 30s until her 60s since this differs from woman to woman. The signs of perimenopause may start as slightly irregular periods, extra moodiness around that time, and fatigue.
Actual menopause does not happen until a woman has not experienced 12 months. It is not strictly a medical term but is commonly used by most practitioners for this transition time. At this point, a woman may still be able to carry a child and become pregnant, but it will be much harder, and as the point of menopause inches closer, it will become even harder or impossible. At the end of perimenopause, the vaginal tissue and pelvic muscle structure simply aren't strong enough anymore to support a child as it grows within the womb.
During menopause, a woman no longer experiences periods but will have many of the same symptoms such as moodiness, vaginal bleeding, hot flashes, and weight gain. The normal aging process for women means that menopause should occur sometime between 40-55. If it occurs before age 40, it is considered to be early menopause, and while this can be natural, it is more likely to be medically triggered by chemotherapy damage to the ovaries, or a hysterectomy.
In natural menopause the ovaries no longer release eggs, and the production of estrogen falls sharply and may even drop off completely. The health risks that lower estrogen brings will start to increase, for example, heart disease and osteoporosis. There are a variety of different medications and supplements used to treat menopausal side effects, but as the symptoms vary between women, this is usually something that must be discussed with a doctor.
Most women will experience menopause at the same as that their mothers went through it. Unlike perimenopause and postmenopause menopause is not a "stage" but a point marked by that magic 12-month number. There is simply a before/after, and symptoms of menopause may start years before actual menopause occurs. This is a common misunderstanding as most women call themselves "in menopause" once the symptoms start even though they may still be experiencing irregular menstruation.
Most menopausal symptoms will eventually drop off within a couple of years. Women will have some changes after menopause, especially in the vaginal area which can become dry and the tissue delicate. This means for many women postmenopausal sex becomes painful, but there are also medications which can help with this. The muscles in the vaginal area will also start to atrophy which is why Kegel exercises and tools like Ben Wa balls become so important. There is also a decrease in skin elasticity all over the body from the loss of estrogen which causes wrinkling and a loss of muscle tissue in the rest of the pelvic region which can cause incontinence. In post-menopause women will no longer experience hot flashes and their moods will stabilize. This is usually gradual as with perimenopause.
Once a woman goes through menopause, she is at a much greater risk for other diseases linked to low estrogen-like heart disease. Because estrogen is linked to keeping your arteries flexible, your blood flow can be impeded as your arteries harden. Women who are post-menopausal are at a much greater risk for heart disease even if they have not changed anything about their lifestyle from before menopause.
Menopausal Symptoms Timing
While the age you start menopause is debatable when you get the symptoms associated with it tends to follow a standard timeline. Early menopause can happen for some reasons, but the average age that women will experience it is 51. This doesn't mean the start of symptoms though. The average woman starts to experience symptoms of menopause approximately ten years before the event occurs.
These are usually the first signs of menopause beginning. First, you may put on some weight or find it harder to lose weight. You may find yourself bloated and hold water which can cause your ankles and legs to swell. However, bloating is also a normal symptom of your period which makes perimenopause so hard to pin down. As weight gain is also hard to determine, when you first notice perimenopause, may be after your body has also started to exhibit other symptoms. The most noticeable body symptom is hot flashes or flushes, and these will start as soon as your estrogen levels begin to drop. Approximately 75% of women experiencing perimenopause get hot flushes which makes them the most common symptom, and they can occur at any time. Some women do experience these with periods because of the estrogen fluctuations, but when they start occurring more regularly, and without a period it is likely, you have entered perimenopause.
The most obvious of all body symptoms is the loss of menstruation. This is usually a gradual thing and may start as an occasional skipped or light period with long periods of regular menstruation. Since a skipped period can happen for other reasons, this is often just dismissed despite being a clear sign of the beginning of menopause. As menstruation becomes, less frequent, other symptoms will become more pronounced. This is also the final symptom as a counter of 12 months with no periods marks the actual moment of menopause.
Most women will experience emotional and mental symptoms, but they will get more pronounced as they get closer to menopause. The most noticed of these are memory problems, fatigue, and rapid mood swings. These can be very difficult to handle and are so common that most women know they are experiencing menopause when these happen. This can be extremely stressful which compounds the problem and can even make the symptoms worse. Many of these symptoms can be no different than PMD or PMS which makes it harder to determine if the cause is just normal menstrual hormones or menopause related.
While there is no cure for menopause (it simply has to be endured and will eventually be over), dealing with these mood issues and cognitive issues can be handled with the help of medications and coping methods. As most mood swings are hormonal, it's hard to create a plan to deal with them, and each has to be handled itself. Ideally, you'll have coping mechanisms to deal with them in place from dealing with PMS over the past few decades, however, because these are often worse and more drastic some women need extra help. A psychologist or psychiatrist may be a good choice if the emotional changes are impacting your ability to have a fulfilling life. Sites like BetterHealth can help you find one.
Dealing With Post Menopause Symptoms
Once you've reached that magic 12-month mark, your symptoms will not simply vanish. Just as they gradually appeared, they will gradually subside, but some things will also change. These are not necessarily symptoms but changes that occur from the loss of estrogen production. Many women start taking hormone replacements and supplements to alleviate the symptoms of menopause. Soy is a common dietary choice because some compounds found naturally in soy, mimic soy estrogen within the body and will act as a substitute.
Postmenopause refers to the time immediately after that 12-month mark. The symptoms of menopause will gradually subside and the only change in symptoms marking menopause may simply be that they are lessening. The rate at which the symptoms subside is different for each woman and can vary based on age, diet, and medications as well as the reason behind menopause.
Unfortunately, all women have to go through this eventually. It's part of the inevitable aging process, and there's no way of stopping it, but some treatments can make the experience easier to bare. Ideally, you should seek help if any of your symptoms become damaging to your daily life or mental health as there are solutions out there.