What is Menopause?

Technically it is simply one day, one year, after not having any periods.
However, how we use this term in society differs! Many people describe going through menopause as a time of life of irregular periods and symptoms such as hot flushes that can start years before menopause.
The average age of menopause in Australia is 51, though it is considered ‘normal’ from age 45 onwards.
Perimenopause is the time leading up to menopause and this is usually the hardest time for women. On average it lasts 5 years, however, it can last as long as 10 in some women.
Postmenopause is simply any time after that last period anniversary! Unfortunately, the symptoms of menopause frequently continue long after that last period.
What are the symptoms of perimenopause?
- changes in cycle length
- changes in the heaviness of your period – can be less or more
- hot flushes, or sometimes just running hotter than usual
- unexplained mood swings
- low libido
- headaches
- disturbed sleep
- sore breasts
- weight gain, especially in the abdominal region
- vaginal dryness
- tiredness
- difficulty with concentration and memory, foggy brain (nouns usually go first)
- itchy or dry skin
- hair loss
- sore muscles and joints
What is happening to my body?
We are all born with a finite number of eggs in our ovaries. As the number starts to decline, so does the ovaries’ ability to produce oestrogen and progesterone. It is the mismatch of these hormones and eventual decrease, that causes the symptoms listed above.
Your body loves oestrogen so it does try to correct this loss by doing things like keeping your abdominal fat. Why? Because oestrogen can also be made in fat cells. Not much but enough for the body to try!
Most research on those pesky hot flushes suggest that they occur when decreased oestrogen levels cause your body’s thermostat, the hypothalamus, to become more sensitive to slight changes in body temperature, espacially when we are asleep.
When the hypothalamus thinks your body is too warm, it starts a chain of events, culminating in a hot flush, to cool you down. Really your body is trying to help you, it has just slightly overdone itself.
I love the graph below showing the mismatch of hormones over the perimenopausal period. Stereotypical regular cycles, followed by anything goes and then more of a flat line. It really shows why we have those mood swings, and the hot flushes.
Above is a more stylised version and is probably how I describe oestrogen levels to people whilst wildly waving my hands around.
What can I do about these symptoms?
Symptoms will ease if you:
- eat a healthy diet
- do regular exercise
- get enough sleep (this is a massive problem for many of us)
reduce stress, super important - lose weight, (if you are overweight)
- consider this a time of change for something new, not a loss of youth. (In other words, change our thought patterns.)
Hot flushes are often relieved by:
- cutting back on caffeine – tea, coffee and other drinks
- avoiding alcohol
- for sensitive people, avoiding spicy foods
- eating foods that contain phytoestrogens, such as tofu, whole grains, beans and lentils – that healthy diet thing, yet again
In reality, these can all be tricky to do and may not totally alleviate symptoms. However, without changing up your life, even a little, you are likely to continue suffering.
You can use HRT, it does help. It is not magic, merely a fabulous tool in our toolbox. It is also not suitable for everyone.
Can I start HRT while I still have my period?
Absolutely. It is probably the time that most women struggle with symptoms.
And don’t forget you can also stop them anytime you wish to, though many women never wish to do so!
I’m terrified this is me, not my hormones.
Don’t stress it!
We will do blood work, discuss options and see what is really going on in your life. Optimal health helps all of us cope with life better. Even if you don’t have the flushes, you can still be experiencing all or even just some of the other symptoms, which can be incredibly confronting. There is plenty that can be done. It will take time however I believe everyone, even those not in perimenopause will feel better understanding what is going on. Take a breath, write your concerns down, and let’s address them.
I will leave you with a quote from Oprah Winfrey that I think beautifully sums up menopause as an opportunity and a transition, not a loss.
“So many women I’ve talked to see menopause as an ending. But I’ve discovered this is your moment to reinvent yourself after years of focusing on the needs of everyone else. It’s your opportunity to get clear about what matters to you and then to pursue that with all of your energy, time, and talent.”