Perimenopause. Menopause. Post menopause. Premenopause. Menopause transition. Natural menopause. Surgically-induced menopause. Early menopause.
Are you confused?
These are all terms that are being thrown around to describe a woman around her midlife and the time when she might be experiencing a range of not-so pleasant symptoms and when she will stop her monthly period (that is if it hasn’t already been modified or stopped by a oral contraceptive pill or other internal device).
But do you know what they all are?
Do you know whether you are in menopause or perhaps in perimenopause?
In this article, I’m going to help you understand the differences in the terminology and help you understand which one might be most appropriate for you.
Let’s start with MENOPAUSE.
Menopause is a normal, natural point in a woman’s life. It’s the time when your ovaries stop releasing eggs, your periods end and you can no longer fall pregnant. It is officially determined as the time that is 12 months from your last period. When you reach menopause, the production of hormones like progesterone and oestrogen are significantly reduced compared to during your reproductive years and hence your monthly menstrual cycle stops and you no longer have a monthly bleed. In Australia, the average age for women to reach menopause is 51 years. It can be tricky to know if you have reached menopause if you are on some form of medication or intrauterine device (IUD), like a contraceptive pill, that may be modifying your natural hormones and menstrual cycle. Blood tests can be used to determine the levels of various hormones to see if you have reached menopause.
The term POST MENOPAUSE is often used to describe the years after MENOPAUSE has been reached. Once you have reached menopause you will be in post menopause for the rest of your life. Often the challenging symptoms associated with menopause and perimenopause (see below) gradually improve and settle down over the first few years following menopause.
Now, let’s go to PRE- MENOPAUSE which refers to the time before menopause is reached. It is commonly called PERIMENOPAUSE. The word ‘peri’ means around so in this case it’s around menopause. It’s the natural transition phase leading up to menopause. Rather like the start of your reproductive years, in your teens, you didn’t suddenly change overnight, your body went through a gradual transition both externally and internally as you went through puberty. In some ways perimenopause is a bit like a second puberty. It’s the transitional phase as your hormones and your body begin to change and adapt to a new normal as your body prepares to be ‘reproductive’. Just as puberty can go on for a number of years, and the journey is different, with different challenges for each teen, so is perimenopause. It can take up to 12 years to pass through this phase in your life. If you are in your 40s, it is probable that you are in perimenopause even if you are symptom free.
There are four phases of a NATURAL PERIMENOPAUSE:
Very early:
Regular cycles (may shorten to 21-26 days)
Progesterone is reducing but oestrogen may increase
Hormone imbalance/high oestrogen is common
Common Symptoms: heavy periods, increased period pain, migraines, sleep disturbance
May last 2-5 years
Early menopause transition:
Onset of irregular periods
Low progesterone and high, fluctuating oestrogen but when oestrogen drops, it goes really low
Common symptoms: Hot flushes, night sweats
May last 2-3 years
Late menopause transition:
When your cycle becomes more than 60 days
Common Symptoms: Easing breast pain, intensifying hot flush/night sweats, lighter bleeding generally with occasional heavy period
May last 4 years
Late perimenopause:
The final twelve months before menopause is determined
Much lower oestrogen levels
Common Symptoms: hot flushes may continue for 1-2 more years, less migraines, mood swings and other symptoms begin to ease.
These four stages form the basis of most women’s perimenopausal journey and a natural menopause, however, some women will have an early or surgically-induced menopause which affects the speed of their journey and their progression through these stages.
EARLY MENOPAUSE may occur due a dysfunction of the ovaries leading to primary ovarian insufficiency or premature menopause (ie before 40 years). It is quite a sudden transition and so often all 4 phases are not experienced.
SURGICALLY-INDUCED MENOPAUSE is when a woman has a full or partial hysterectomy. In a full hysterectomy where the ovaries are also removed, the transition is rapid too. As this is not a natural menopause, the associated transitional symptoms may be stronger and the 4 phases of perimenopause may be skipped. Women with a partial hysterectomy are more likely to go through the four natural stages but owing to the removal of the uterus some of the symptoms like heavy or irregular bleeding will not occur. They can however experience mood swings, breast fullness, migraines and hot flushes quite severely.
Perimenopause, menopause and post menopause are all natural stages in a woman’s life. Often it is treated as a condition or an illness but would you treat puberty as an illness? It’s also not about ageing; it is not caused by getting old and your body organs deteriorating. It is simply a stage in our life. Our body’s are designed to go through perimenopause and to reach menopause, to switch off our reproductive function.
I like to see it as closing one door as a new one opens, even if the doors are a bit stuck and are challenging to close and take time to open and operate with ease.
If you are being challenged by your perimenopause symptoms, like weight gain, why not download my FREE ‘Why Losing Weight is a Struggle in your 40s’ ebook to feel empowered and know what steps to take to move forwards.