If you’re under 40, the menopause might seem like the least of your worries right now. But for some women, this transition can happen earlier than they might expect – even as early as their 30s, in rare cases. And you almost certainly know a family member, friend or colleague who’s going through menopause, or is likely to soon. After all, it affects around half the world’s population at some point.
But many women feel unprepared for what lies ahead. One survey found almost half of women feel completely uninformed about the menopause, and nearly 95% saying they were never taught about the menopause in school.
This means many women don’t have the knowledge they need to navigate this life transition or understand what’s happening to the people they know who are going through it. This is despite the fact it can last for many years, and can have a profound effect on almost every aspect of a woman’s life.
Here are five essential things to know about menopause that you probably weren’t taught in school.
Table of Contents
1. What exactly is the menopause?
Menopause marks the end of a woman’s reproductive years. This occurs when the ovaries stop releasing eggs and hormone levels decline. So the term “menopause” refers to when your periods stop for good. This is diagnosed retrospectively, after you’ve gone 12 months with no periods (in the absence of other influences, such as the pill).
The menopause typically happens between the ages of 45 and 55 – though this varies slightly by geographic region. For example, in the UK the average age of the menopause is 50. The reason for geographic variation isn’t completely understood, but might be due to differences in factors such as diet, lifestyle and health.
2. What is perimenopause – and how is it different from the menopause?
The menopause is sometimes referred to as the “menopausal transition” because it has three distinct stages: perimenopause, menopause and postmenopause. This transition reflects the gradual changes in hormone levels and reproductive function over time.
While “menopause” refers to your final menstruation, perimenopause is the period leading up to this event. Perimenopause often begins in a woman’s 40s – though it can happen earlier or later, with some women reporting perimenopause symptoms in their 30s.
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During perimenopause, hormones fluctuate and menstrual cycles start becoming irregular. Symptoms such as hot flushes and mood swings may also start. Perimenopause can last anywhere from a few months to over a decade. Many factors can affect the duration of perimenopause, including a woman’s BMI, ethnic background, and socioeconomic factors.
Once periods stop, a woman is considered to be in postmenopause. For many women, menopause symptoms will persist into this period.
3. What are the symptoms of menopause?
There’s huge variation in the menopause symptom experience. The most commonly experienced symptoms include hot flushes, night sweats, mood swings, vaginal dryness and fatigue.
Symptoms usually begin during the perimenopause. However, they can often persist after menopause occurs into the postmenopause period, lasting between two and eight years on average.
When symptoms start and how long they last varies hugely between women and is influenced by many factors – including genetics, ethnic background and lifestyle.
There are many ways to manage symptoms.
For many, lifestyle changes are helpful. Regular exercise, a balanced diet, avoiding smoking and alcohol, stress management and even cold water swimming are all shown to be useful in managing and reducing a range of symptoms.
Prescription treatments are also an option. The most popular is HRT (hormone replacement therapy), which restores oestrogen and progesterone to their “normal” pre-menopause levels. HRT is designed to treat a wide range of symptoms.
There are also medications for specific symptoms – including vaginal oestrogen to ease vaginal dryness, antidepressants to cope with mood swings and clonidine to treat hot flushes.
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4. How does the body change during the menopause?
Weight gain is a common concern for women going through the menopause. However, research shows that any weight gained after the menopause is probably a by-product of the normal ageing process – such as a slower metabolism or lifestyle habits – rather than menopause itself.
But one explanation for why women may feel like they’re gaining weight after the menopause is because hormonal changes influence how fat is distributed around the body. Before menopause, fat tends to be gained around the hips and thighs. After menopause, weight tends to be gained around the abdomen – giving the feeling of weight gain.
Staying active and making healthy choices can help with the natural weight gain associated with ageing.
HRT may be beneficial here too, as it can ease negative symptoms which may prevent us from making healthy lifestyle choices. It can also help redistribute the fat that accumulates around the abdomen since it mimics pre-menopause hormone levels.
5. What about how it affects you emotionally?
Menopause can bring significant physical and emotional changes, often accompanied by a profound shift in identity. Many women grapple with changes in how they see themselves. On the other hand, some women feel empowered by the transition to a new stage of life.
A strong support system can be invaluable during this time. Community initiatives such as Menopause Cafes can offer a space to share experiences and discuss how to manage symptoms. These conversations can also offer comfort and reduce isolation.
Prioritising self-care can also help women navigate the transition. Self-care can mean different things to different people – but staying active, getting enough rest, exploring mindfulness or relaxation techniques can all boost physical and emotional wellbeing.
The menopause may seem like a daunting life transition, but it doesn’t have to be. There are many proven, effective ways of managing symptoms and coping with the physical and psychological effects of the menopause – all of which will make this transition easier for you to navigate when it happens.
Megan Arnot has received funding from the ESRC and BBSRC.
