Menopause – what is it and when does it begin?


What is menopause?

Menopause is often defined as the end of the menstrual cycles and the end of the reproductive period of a woman’s life. Most women go through menopause at the age of 45-55, but did you know that about 1% of women go through menopause before the age of 40? This is called premature menopause – obviously! Menopause normally lasts about 1-2 years, but it varies. For some, it lasts for just a couple of months, while for others it can last up to 10 years.

This huge change takes place in the ovaries, which are hormone producing organs. Starting when a woman enters puberty in her adolescence, and until menopause, oestrogen and progesterone are produced in the ovaries in regular cycles that last for about four weeks. The ovaries predominantly make oestrogen during the first two weeks and progesterone during the last two.

A woman is born with all of her eggs in the ovaries, meaning no new eggs are produced during her lifetime. An unfertilised egg is ejected at each menstruation and the eggs naturally weakens as you get older. When the number of remaining eggs in the ovaries get close to zero, that’s when the bodily changes start to occur.

The body’s oestrogen levels follow your menstrual cycle and when you have fewer eggs, the ovaries’ make less oestrogen, which often leads to irregular periods.

One of the reasons that reduced oestrogen production affects the body in many different ways is that one has oestrogen receptors located throughout the body’s tissues and organs. The reduced oestrogen levels affect the receptors and thereby the bodily processes that previously have been initiated by this interrelation. This can cause major physiological changes. Not all women experience the same level of discomfort; about 3 out of 4 experience actual disorders, whereof some get away with just slight discomfort while others have to seek medical care due to severe discomfort.

The four stages of menopause:

  1. Premenopause: This stage occurs several years before the periods stop. You may experience irregular periods with both heavier and reduced bleeding. You can also experience both hot flashes and reduced sex drive. In this stage you are approaching menopause, meaning the body produces less oestrogen and progesterone. For some, this hormonal imbalance can start 2-5 years before the final period, and for others 5-10 years before. If your period stops before the age of 45, it is considered early.
  2. Perimenopause: At this stage, women may experience symptoms such as night sweats, hot flashes, difficulty sleeping, mood swings, needing to pee more often, loss of libido (reduced sex drive) and difficulty concentrating. Hot flashes are often described as a sudden feeling of warmth that spreads over the body and can occur completely regardless of the situation you are in. Sleeping disturbances are often noticed by difficulty to fall asleep due to hot flashes, which sometimes are combined with severe sweating leaving your bedlinen drenched and in need of a change.
  1. Menopause: This is the stage when it has been about 12 months since your last period. The bleeding stops because the ovaries release very little oestrogen and progesterone, making the menstrual cycle stop. Some women may notice changes to their body and head with depression, mood swings, fatigue, headache, memory issues and irritability as common symptoms. Other symptoms can include thinner and dryer skin, vision disturbance, thinner hair, bleeding gums, reduced muscle mass, unwanted facial hair growth, low tolerance for caffeine, refined carbohydrates and alcohol, and some also suffer from vaginal dryness.
  2. Postmenopause: In the last stage, many of the difficult symptoms from the earlier stages will gradually ease. You know you are in postmenopause when a full year, i.e. 12 months, has passed since you had your last period. You should slowly and steadily regain your energy levels and life should return to normal – minus the periods.

To prepare for menopause

As different individuals have such different experiences of menopause, you may want to talk to someone in your immediate family, such as your mother or sister, and ask them about their experiences. The age of the menopause onset, as well as the symptoms can be hereditary. Remember to also be aware of other hereditary diseases, such as cardiovascular diseases and diabetes, that often occur after menopause.

Here are some useful tips on how to best prepare yourself for the four stages of menopause:

  • Strengthen your bones with regular exercise, such as 30-minute powerwalks 3-4 times weekly, or strength training with weights and resistance band.
  • Make sure to get a sufficient intake of calcium to keep your bones strong and reduce the risk of osteoporosis. Aim for about 1,500 mg calcium daily through e.g. dairy products.
  • Vitamin D is particularly important for women in early menopause. It supports optimal absorption of calcium and helps maintain normal skeletal function.
  • 5 serves of fruit and vegetables a day – eat a healthy and balanced diet.
  • Dress in layers, so you can peel off a layer when the hot flashes hit you.
  • Avoid stress. Find time to relax and get enough sleep.
  • Drink enough of water daily.
  • Avoid or reduce the intake of hot spicy food, caffeine, tobacco and alcohol.
  • Maintain a healthy weight.
  • Maintain a regular bedtime schedule.