- Philippa Roxby
- Health editor – BBC
Every woman goes through menopause, and symptoms associated with it usually begin in their mid-40s.
On the occasion of International Menopause Day, we show what happens in the period before menopause stops.
What is menopause?
Amenorrhea is the cessation of the menstrual cycle in women, and it usually occurs around the age of 51 years.
This is a sign of the end of the childbearing years, and the beginning of a new stage of life.
The period before this, which is usually characterized by irregular periods, is called perimenopause, and begins on average at the age of 46 years.
During this period, many women notice that it has become difficult to predict the date of their period, or that it has become more abundant, and they are exposed to feelings and physical problems that they did not face before.
When 12 months have passed since menopause, it means that the woman has gone through menopause.
Some women go through early menopause, either naturally or due to treatment following an illness.
What causes menopause?
The levels of hormones in a woman’s body change – particularly estrogen, which controls the menstrual cycle.
As women age, the ovaries produce fewer eggs, and estrogen levels fluctuate and gradually decrease, leading to menopausal symptoms.
However, that does not happen overnight.
It can take many years for this vital hormone to drop to low levels – and then stay there – causing changes in a woman’s body.
When the ovaries stop producing eggs completely, pregnancy is no longer possible and menopause occurs.
What are the symptoms?
Menopause and the years before it affect women in different ways.
The brain, menstrual cycle, skin, muscles, and emotions are all affected by low estrogen levels.
There are a large number of possible symptoms, and a woman may have some, all, or none at all, and over varying periods.
The most common symptoms are:
- Irregular or heavy periods
- sweat while sleeping
- low mood
- Bladder problems
Also, poor memory and lack of concentration, which is usually called brain fog, are symptoms that women usually suffer from at that stage, as well as joint pain and dry skin.
The majority of women — regarding 75 percent — have these symptoms.
A quarter of women who go through menopause describe their symptoms as severe.
These symptoms can last for an average of seven years, and a third of women have them for longer than that.
If a woman is taking birth control pills, it may be more difficult to tell if she has gone through menopause because the pills can affect the menstrual cycle in different ways.
What causes hot flashes?
Estrogen deficiency. This hormone plays a role in regulating body temperature.
The body usually adapts to changes in temperature, but when estrogen decreases, the part of the brain responsible for thermoregulation does not work as well, and the brain mistakenly thinks that the body temperature is excessively high.
Estrogen may also affect mood. It interacts with chemicals in the receptor and transmitter areas of the brain that control mood, and when hormone levels drop, it can cause feelings of anxiety and low mood.
Are other hormones related to menopause?
Yes, progesterone and testosterone – but they don’t have the same effect as low estrogen levels.
Progesterone helps prepare the body for pregnancy every month, and its level in the body decreases when ovulation stops and the cycle is interrupted.
Testosterone, which a woman’s body produces in high levels, is linked to sexual desire and energy levels.
This hormone decreases in a woman’s body from the twenties and beyond, and some women need to take medications to increase it.
Is there a hiatus test?w؟
There are tests sold and marketed as diagnosing whether a woman is going through menopause, but experts agree that these tests are not useful following the age of 45.
The best way is to see your doctor or nurse and talk to them regarding your menstrual cycle pattern and any symptoms you’re experiencing.
The tests measure levels of follicle-stimulating hormone (FSH). However, hormone levels go up and down in the body all the time, even during the day, so the test can’t tell exactly what’s going on.
It is possible for a woman to get pregnant even following her menstrual cycle becomes irregular, and experts advise using contraception until the age of 55.
Are there treatments available to relieve symptoms?
Hormone replacement therapy (HRT) increases levels of hormones such as estrogen, which begin to decline as menopause approaches, and helps relieve symptoms.
But it may not be suitable for some women who have a history of certain cancers, blood clots, and high blood pressure.
Women can improve their health by:
- Eat a balanced, low-fat, high-calcium diet to strengthen bones and protect the heart.
- Exercising regularly to reduce anxiety and prevent heart disease.
- Stop smoking to prevent heart disease and hot flashes.
- Avoid alcoholic beverages to reduce hot flashes.
Some research suggests that taking phytoestrogen – found in soybeans and red clover – can help relieve symptoms, and vitamin D tablets can improve bone health.
What happens following menopause?w؟
One year following the last menstrual period, post-menopause begins.
With estrogen production completely stopped, there are long-term effects on the bones and the heart. This is mostly considered an integral part of aging or old age.
With life expectancy rising, women now live more than a third of their life following menopause.
