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Menopause, The Basics

Education on what menopause entails is usually limited to: “It’s when your periods stop”, but menopause is so much more than the absence of periods.

All women who survive to midlife years will go through menopause, some even younger due to illness, surgery, treatments etc., but all women reaching midlife will undergo the hormonal changes that indicate perimenopause and menopause. It is a completely natural process. The significant difference for women today is that, unlike a hundred years ago when we would have died in our late 50’s, we now live for 30-40 years post menopause. We therefore spend a third of our lives in a post-menopausal state.

The Basics:

What do the words perimenopause, menopause and post menopause mean?

  • Perimenopause: this word is used to indicate the stage of a woman’s life where she is moving towards menopause. It is during this stage that women can begin to experience changes, and these can be many and varied. For some this stage can be a challenging roller coaster of physical and emotional shifts. For others they will sail through without being aware of many symptoms of their changing hormones. This period can last for several years, as the hormone levels adjust, and fundamentally decline, slowly.

  • Menopause: is only a single day – the day you are one year post having a period. The average age at time of menopause is 51yrs.  Early menopause is <45yrs and Premature menopause (premature ovarian insufficiency) is <40yrs.

  • Post-Menopause: when a woman has not had a period for one year and one day, she is then post-menopausal; we remain post-menopausal for the rest of our lives.

The Hormones involved:

By and large, for most women, by the time we reach our mid to late 40s we begin to have noticed things changing, changes that are occurring due to shifts in our hormone levels. We move from our regular menstrual cycle, to perimenopause, menopause and finally post menopause, and our hormones are key to these stages, specifically oestrogen, progesterone and testosterone.

What do these hormones do and how does a declining level of these hormones impact our health and wellbeing?

  • Oestrogen:  we have oestrogen receptors throughout our body which means that changes in the level of oestrogens (there is more than one oestrogen) affect not only the breast and uterus, but also the brain, bone, liver, heart and other tissues. They control growth of the uterine lining during the first part of the menstrual cycle, cause changes in the breast during adolescence and pregnancy, maintain a lubricated and thick vaginal lining and regulate various other processes, including bone growth and cholesterol levels. Oestrogen is in fact the primary hormone regulator of the female brain. It influences maintenance of body temperature, sleep, and brain energy which results in some women experiencing brain fog, memory issues and mood swings during this time. Suffice to say “Oestrogen Matters” …as is the title of a book well worth a read by Avrum Bluming and Carol Tavris.

  • Progesterone: is often called the “pregnancy hormone” as it prepares the uterus for a possible pregnancy and impacts on the availability of breast milk. Raised progesterone is linked with PMS, bloating, mood swings, and breast tenderness, while reduced progesterone levels in perimenopause and menopause are linked with irregular periods, infertility, headaches or migraines, mood changes, including anxiety or depression, hot flushes, and weight gain.

  • Testosterone: along with oestrogen, helps with the growth, maintenance, and repair of a woman's reproductive tissues and bone mass, and has an impact on our emotions. An imbalance of testosterone can have damaging effects on a woman's health and libido. Raised testosterone is linked with acne, deep voice, excess hair on face and body, increased muscle mass, irregular periods etc., while reduced testosterone is linked with a reduction in general quality of life, tiredness, reduced melatonin, depression, headaches, cognitive problems, reduced libido, osteoporosis, and loss of muscle mass & strength.

Knowing this much is just the start. Keep learning.


If you are interested in learning more about the Menopause Maze education programme and coaching for Perimenopause and Menopause, please get in touch.

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