Menopause, strictly speaking, is defined as when a woman has had no periods for two years. The beginning of that process may be called pre or perimenopause and there is a wide age range at which it can begin.
On average women can experience symptoms from one to five years and for some women even longer, indeed post menopause women are still reporting hot flushes for example.
When it starts is just as individual, but on average it is from 48-55 and it seems that 51 is the most common age. If it occurs before the age of 4o that is a premature menopause and women who have had a hysterectomy, for example, will go straight into a surgical menopause which in some ways can be harder as there is no gradual transition.
Changing hormone levels
Menopause may start around 51, but it is actually from the 40s onwards that hormonal changes start to occur. Perimenopause is marked by falling hormone levels: both oestrogen and progesterone start to decline anywhere from 4 to 8 years before your last period.
Women need balanced levels of both hormones: oestrogen helps with the dryness that is inevitable at this time and progesterone is essential to help protect against breast cancer, heart disease, strokes and osteoporosis.
It is the word balance that is key here, as any excess oestrogen is linked to hormonal health risks and women are designed so that these two equally hormones remain in the right ratio to each other.
Unfortunately women are exposed to increased oestrogen environmentally, through the food chain, and from drugs such as HRT so ensuring the right hormone balance protects their health.
Women are often told that oestrogen is the only hormone they need at menopause to help with their symptoms, but the role of progesterone is to help build bones and protect from hormone related risks throughout their lives, not just during menopause.
Its essential role is recognised in the fact that HRT preparations contain both oestrogen and a synthetic progestin.This clearly establishes the importance of having both hormones, but the synthetic progestin is exactly that, synthetic, and does not have the same protective qualities as natural progesterone itself.
In fact such progestins run directly counter to the protective elements of the natural hormone. Progestins can sometimes cause some unwanted effects such as blood clots, heart attacks, and strokes, or problems of the liver and eyes.
What symptoms can you expect?
It may surprise you but your pre menopause diet will make a great deal of difference to your symptoms.
Women on higher-fat diets have measurably more oestrogen activity than do those on low-fat diets. This means that there is then a violent drop in oestrogen levels (similar to that experienced by women coming off HRT).
If you have been vegan for instance, then you are less likely to have high body fat levels, and vegetarians also seem to experience fewer or less severe symptoms.
Another factor that will definitely impact your symptoms is how stressed you are, and menopause can be a time of great change and challenge.
In the months or years leading up to menopause (perimenopause) you might experience these signs and symptoms:
- Irregular periods.
- Heavy periods
- Vaginal dryness.
- Hot flushes.
- Night sweats.
- Sleep problems.
- Mood changes.
- Weight gain and slowed metabolism
- Vaginal dryness
So we can see women need both oestrogen, which helps most with symptoms like severe hot flushes and vaginal dryness and progesterone to protect against hormonal cancers, heart disease and bone loss (osteoporosis).
If you are not sure if your symptoms do relate to menopause you can ask your doctor for a blood follicle-stimulating hormone (FSH) blood test or you may just want to rely on your symptoms as a guide.
Menopause-related health issues
At, or after, menopause a number of things can occur that will impact your health. Some will definitely be hormone related but others are a consequence of age, but it can be hard to tell the difference as the outcome is the same.
• Heart disease
• Poor bladder and bowel function
• Poor brain function (increased risk of Alzheimer’s disease)
• Poor skin elasticity and dryness
• Poor muscle power and tone
• Some deterioration in vision, such as from cataracts and macular degeneration
There is no doubt that menopause is a time of change, however it does not have to be the end of life as you know it. Staying fit and healthy, having a well balanced diet and moderate exercise will all ensure a healthy menopause and older age.
Staying balanced with your hormones is also essential, whether you need oestrogen and progesterone in a combined form, or just progesterone alone, having that balance will ensure a happier, healthier menopause.
Common symptoms such as hot flushes, sleeplessness, brain fog and mood swings/depression don’t have to be suffered, there is help available.