Stages of Menopause

Menopause is only one of several stages in the reproductive life of a woman. The whole menopause transition is divided into four main stages known as:

  1. Premenopause — refers to the entirety of a woman’s life from her first to her last regular menstrual period. It is best defined as a time of “normal” reproductive function in a woman.
  2. Perimenopause — means “around menopause” and is a transitional stage of two to ten years before complete cessation of the menstrual period and is usually experienced by women from 35 to 50 years of age. This stage of menopause is characterized by hormone fluctuations, which cause the typical menopause symptoms, such as hot flashes.
  3. Menopause — represents the end stage of a natural transition in a woman’s reproductive life. Menopause is the point at which estrogen and progesterone production decreases permanently to very low levels. The ovaries stop producing eggs and a woman is no longer able to get pregnant naturally.
  4. Postmenopause — refers to a woman’s time of life after menopause has occurred. It is generally believed that the postmenopausal phase begins when 12 full months have passed since the last menstrual period. From here a woman will be postmenopausal for the rest of her life.

Some women go through menopause before the age of 40. This is called premature menopause. It can happen naturally or as a result of certain medical treatments.

Source Women’s Health.gov

Is it Menopause?

We know menopause is a  change in a woman’s life when her period stops. Technically, a woman has reached menopause when she has not had a period for 12 months in a row. What is going on during menopause is the woman’s body is slowly makes less of the hormones estrogen and progesterone.

When does Menopause hit? Between the ages of 45 and 55 years old, according to experts. Some women may experience menopause at younger ages because of medical treatments such as surgery to remove the ovaries or a hysterectomy, family history (genes), or cancer treatments such as chemotherapy or radiation to the pelvic area. According to U.S. Census data from 2000, there are about 37.5 million women reaching or currently at menopause (ages 40 to 59).

What are the symptoms of Menopause?
Symptoms may include hot flashes (getting warm in the face, neck, or chest), night sweats or sleeping problems that led to feeling tired, stressed or tense, vaginal changes (the vagina may become dry and thin and sex may be painful) and thinning of bones, which may lead to loss of height and bone breaks. Every woman experience the symptoms in their own way.

So, what Is Menopause? Menopause is a normal part of life that can last for months or years .  It is caused by changing levels of estrogen and progesterone, which are two female hormones made in your ovaries. , It is the changing level that can   lead to the symptoms.

Perimenopause can begin several years before your last menstrual period. Perimenopause lasts for 1 year after your last period. After a full year without a period, you can say you have been “through menopause.” Postmenopause follows menopause and lasts the rest of your life.

According to experts, the average age of a woman having her last period, menopause, is 51. But, some women have their last period in their forties, and some have it later in their fifties.

What can affect Menopause? Smoking can lead to early menopause. So can some types of operations such as a hysterectomy which will make your periods stop . When your ovaries start to make less estrogen, menopause symptoms could start.

How do I know if I am going through Menopause?

You may notice first a change in your period. Your periods may no longer be regular. They may be shorter or last longer. You might bleed less than usual or more. These are all normal changes.

It is recommended that you see your doctor if:

Your periods come very close together
You have heavy bleeding
You have spotting
Your periods last more than a week
Hot flashes may be related to changing estrogen levels. A hot flash is a sudden feeling of heat in the upper part or all of your body. Your face and neck become flushed. Red blotches may appear on your chest, back, and arms. Heavy sweating and cold shivering can follow. Hot flashes may last a few years after menopause.   Flashes can be very mild or strong enough to wake you from your sleep (called night sweats).

Problems with your vagina and bladder. Changing estrogen levels can cause your genital area to get drier and thinner which could make sexual intercourse uncomfortable. Some women find it hard to hold their urine long enough to get to the bathroom. Sometimes urine leaks during exercise, sneezing, coughing, laughing, or running.

Sleep. Around midlife, some women start having trouble getting a good night’s sleep.

Sex. You may find that your feelings about sex are changing. You could be less interested. Or, you could feel freer and sexier after menopause.

After 1 full year without a period, you can no longer become pregnant. But remember, you could still be at risk for sexually transmitted diseases (STDs), such as gonorrhea or even HIV/AIDS. You increase your risk for an STD if you are having sex with more than one person or with someone who is having sex with others. If so, make sure your partner uses a condom each time you have sex.

Mood changes. You might find yourself more moody or irritable around the time of menopause. Scientists don’t know why this happens. It’s possible that stress, family changes such as growing children or aging parents, a history of depression, or feeling tired could be causing these mood changes.

Your body seems different. Your waist could get larger. You could lose muscle and gain fat. Your skin could get thinner. You might have memory problems, and your joints and muscles could feel stiff and achy.

Other common health problems.

Osteoporosis. Day in and day out, your body is busy breaking down old bone and replacing it with new healthy bone. Estrogen helps control bone loss, and losing estrogen around the time of menopause causes women to lose more bone than is replaced. In time, bones can become weak and break easily. This condition is called osteoporosis. Talk to your doctor to see if you should have a bone density test to find out if you are at risk. Your doctor can also suggest ways to prevent or treat osteoporosis.

Heart disease. After menopause, women are more likely to have heart disease. Changes in estrogen levels may be part of the cause. B  Be sure to have your blood pressure and levels of triglycerides, fasting blood glucose, and LDL, HDL, and total cholesterol checked regularly. Talk to your health care provider to find out what you should do to protect your heart.

Stay Healthy After Menopause

  • Don’t smoke.
  • Eat a healthy diet, low in fat, high in fiber, with plenty of fruits, vegetables, and whole-grain foods, as well as all the important vitamins and minerals.
  • Make sure you get enough calcium and vitamin D—in your diet or with vitamin/mineral supplements.
  • Learn what your healthy weight is, and try to stay there.
  • Do weight-bearing exercise, such as walking, jogging, or dancing, at least 3 days each week for healthy bones. But try to be physically active in other ways for your general health.

The National Institute on Aging (NIA) has publications on many of these topics.

Menopause is not a disease that has to be treated. But you might need help if symptoms like hot flashes bother you. Here are some ideas that have helped some women:

  • Try to keep track of when hot flashes happen—a diary can help. You might be able to use this information to find out what triggers your flashes and then avoid those triggers.
  • When a hot flash starts, try to go somewhere cool.
  • If night sweats wake you, sleep in a cool room or with a fan on.
  • Dress in layers that you can take off if you get too warm.
  • Use sheets and clothing that let your skin “breathe.”
  • Have a cold drink (water or juice) when a flash is starting.
  • You could also talk to your doctor about whether there are any medicines to manage hot flashes. A few drugs that are approved for other uses, for example, certain anti-depressants, seem to be helpful to some women.

If you are bothered by symptoms like hot flashes, night sweats, or vaginal dryness, your doctor might suggest taking estrogen (as well as progesterone, if you still have a uterus). This is known as menopausal hormone therapy (MHT). Some people still call it hormone replacement therapy or HRT. Taking these hormones will probably help with menopause symptoms. It also can prevent the bone loss that can happen at menopause.

For More Information

Here are some helpful Federal and non-Federal resources:

American College of Obstetricians and Gynecologists
409 12th Street, SW
Box 96920
Washington, DC 20090
202-638-5577
www.acog.org

National Institutes of Health
Menopausal Hormone Therapy Information
www.nih.gov/PHTindex.htm

National Library of Medicine
MedlinePlus
www.medlineplus.gov

North American Menopause Society
Box 94527
Cleveland, OH 44101
440-442-7550
www.menopause.org

For more information on osteoporosis, exercise, nutrition, urinary incontinence, sexuality, menopausal hormone therapy, and other resources on health and aging, contact:

National Institute on Aging Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
800-222-2225 (toll-free)
800-222-4225 (TTY/toll-free)
www.nia.nih.gov
www.nia.nih.gov/Espanol

To sign up for regular email alerts about new publications and other information from the NIA, go to www.nia.nih.gov/HealthInformation.

Visit NIHSeniorHealth (www.nihseniorhealth.gov), a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website has health information for older adults. Special features make it simple to use. For example, you can click on a button to have the text read out loud or to make the type larger.

National Institute on Aging
National Institutes of Health
U.S. Department of Health and Human Services

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