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The Three Stages of Menopause

1. Perimenopause (sometimes called premenopause)

Perimenopause, which means ‘around the end of menstruation’, is basically the start of the menopause journey and usually the transition into the middle of life. During this time, the ovaries start producing less of the sex hormones oestrogen, progesterone and testosterone. It’s unfortunately not a steady and linear decline as sometimes hormone levels fluctuate and cause those pesky irregular periods, which seem to catch us out at the most inconvenient of times. (If you suddenly experience heavy periods and flooding, and that is generally unusual for you, you should get it checked out with your doctor, just to be on the safe side.)


The hot flushes, insomnia, night sweats,  and brain fog are at their mightiest. The tissues of the vagina and urinary tract may become dry and atrophied, possibly making sex uncomfortable and maybe even painful, and making urinary-tract infections more common.  Some women also experience skin problems, inflammation, food sensitivities, allergies and terrible mood swings.


DO NOT FORGET! It is still possible for a woman to become pregnant during this phase!!!  I so often hear ladies say that they didn’t realise this.  


To determine whether you are entering perimenopause, there are blood tests that can be done by your doctor, but they are not absolutely conclusive.  However, should your blood test show consistently high levels of follicle stimulating hormone (FSH) and low levels of estradiol (the most common form of oestrogen), combined with some of the symptoms above, that’s a pretty good indication.


Many doctors at this stage will offer HRT or a low-dose birth control pill.  As a Homeopath and Nutritional Therapist, it’s not something that I’d personally recommend.  Part of learning how to take control of your hormones and your body is by monitoring and getting a feel for how yours is reacting and functioning.  By dropping hormones in which aren’t natural, you are masking what’s going on in your body and it’s more difficult to take control of.


However, many women experience great relief from their symptoms by using HRT.  And conversely many women do not. Much like all therapies, it works for some and not for others.  (For alternatives to HRT, click here...)


The average age of menopause is still considered to be 51  However, it is not uncommon at all these days to see ladies in their 30s starting to experience perimenopausal symptoms, much as it is not unusual to see young girls as young as 10 getting their periods.  The ages are shifting backwards over the decades, but on average, perimenopause begins at the age of 47 and lasts anywhere from 2 to 12 years. There are occasionally cases of it lasting longer, but there is usually an underlying cause which is perpetuating the symptoms and not allowing the body to move naturally through. Contrary to popular belief, there is no relationship between the age at which a woman started menstruating and the age at which she enters menopause.


Chances are, you’ll go through menopause at about the same age as your mother and grandmother did. Women who smoke typically enter menopause two to three years earlier than those who don’t.


2.  Menopause

In literal terms, menopause is a single, isolated event in a woman’s life: her last period. Of course, you can’t know when your last period took place until no others follow, so this is a retrospective determination. Doctors consider menopause has occurred once there have been 12 consecutive months without a period.


3. Postmenopause 

The period from menopause through the rest of a woman’s life is called postmenopause (‘after the end of menstruation’). 


Back in the days of questionable hygiene practices and a lower standard of living, this was really the beginning of the end.  Life expectancy was low, the woman had often had several children and when in her early 50s, was already considered old. I remember my own grandmother when she was still in her late 50s and she always looked ancient.  Times have changed SO MUCH since then (which was only the late 70s/early 80s, with the average life expectancy in the UK now lying at almost 81 for women. (YAY) That means that after you are free of periods, which for most are at their best a necessary and mild inconvenience, and at their worst, almost life destroying, you may have 30 plus years ahead of you to be enjoyed.


Due to lifestyle factors, women face an increased risk of heart disease, stroke and osteoporosis during the postmenopause years. For this reason, some doctors recommend hormone replacement therapy following menopause and encourage women to engage in lifestyle behaviours that reduce their risks. These include supplementing with calcium, magnesium and vitamin D; eating a nutritious, low-fat diet; and regular, moderately intense exercise.


The key phrase here is life-styles changes, and not hormone replacement therapy.  The importance of healthy living is still very much played down by the mainstream medical world today because there is a pill for everything, which let’s face it, IS easier than making the necessary changes to maintain a healthy life well into your 80s.  But if you make those changes, your body and mind will reward you. (For alternatives to HRT, click here...)


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