So, Exactly What Is Menopause?

So, Exactly What is Menopause? Don’t be embarrassed if you’re not exactly clear on how to answer that. I’m sure, like most women, you have at the very least a basic knowledge of menopause or maybe you’re really on your A-game and you know exactly what to expect and why these changes are happening to your body. I think many women, and you know what, I’m going to include men on this one too, would say that menopause is when a woman no longer gets her period and is plagued by dreaded hot flashes. And to a certain extent, that can be true. But, menopause is much more complicated and fascinating than that and I’m hoping that you’ll stick with me week after week to learn more about it.

One thing for sure, menopause isn’t a comfortable subject for a lot of women. And this was my starting point too. Luckily, it seems to becoming more “mainstream” now, which is great. But it makes me laugh too. How can half of the world’s population experience a natural part of life and yet feel like it needs to be talked about in whispers with your closest girlfriends? It’s like we’re going through puberty in reverse and we’re trying to find out what’s normal and what isn’t.  And we don’t know who to talk with to get some real answers. And what really shocks me is that menopause needs to be brought into the medical mainstream. Did you know that a Johns Hopkins led study found that fewer than one in five U.S. obstetrics and gynecology residents received formal training in menopause medicine?!? No wonder we don’t understand what’s happening to our bodies and minds!

So, exactly what is menopause? It seems like the word menopause is used as an umbrella term that covers all the stages of menopause. Yes, there are stages of menopause and some stages are a little more difficult or trying than others.

STAGE 1: PRE-MENOPAUSE

Simply put, this is the time in our life when we get a monthly (and hopefully regular) period. We’re in child bearing years and in general our hormones are like an orchestra and they’re playing a harmonious symphony that makes us feel pretty good and balanced.

STAGE 2: PERI-MENOPAUSE

Here is where the real fun starts and the party usually gets started in our 40s. Although, it can start as early as our 30s or as late as our 50s. It’s a pretty broad range. Peri-menopause also takes a broad stroke when it comes to the length of time we may experience it. Peri-menopause may last as little as 2 years or as many as 12 years. And true to form, peri-menopause does not hold the same experience or symptoms for each women. During peri-menopause our periods become irregular and we may start having various menopausal symptoms. What symptoms can you experience? There is actually a list of 34 official menopause symptoms. Some of the most common are hot flashes, brain fog, weight gain, insomnia and fatigue. And, the important thing to remember is even though your hormones are fluctuating and your body is getting older during peri-menopause, you can still get pregnant. So, make sure you’re using birth control until you’re in full blown post-menopause.

STAGE 3: MENOPAUSE

The term menopause seems to be the word that we use to cover all the stages. Yet, menopause itself is really just a one day event. Menopause is the one year anniversary from our last period. Yep, that’s it. Pretty uneventful. No cake, no balloons, no period. It starts and ends all in a 24 hour day. The average age to reach this point is 51. But, menopause can also happen more immediately with surgical removal of the ovaries or medically in the case of chemotherapy.  It can also happen with certain prescription drugs. When I was in my early 20s, I was diagnosed with a severe case of endometriosis. In order to save my uterus and my three-quarters of an ovary (I had 1 1/4 ovaries surgically removed) I was put on a strong medication, Lupron, that put me into a temporary state of menopause for a year.

STAGE 4: POST-MENOPAUSE

So, after reaching the one year milestone that marks menopause, you won’t have any more periods. But, your hormones are still in flux and mostly on the decline. This is when hot flashes start to really ramp up, and our vagina loses the ability to self lubricate which leads to dryness that can be more than just an inconvenience, it can be downright painful. I think the amazing thing about post-menopause is that we will live a third of our lives in this stage. A third! That’s around 30-50 years! I don’t know about you, but, I plan on crushing my next thirty years and not tossing in the towel.

SO WHAT STARTS THE MENOPAUSE PROCESS?

Natural menopause is a natural process of life…it’s not a disease or condition. It starts as our body begins to age and hormonal shifts of estrogen, progesterone and testosterone start to take place. In the early stages of peri-menopause progesterone starts to decline and this can result in estrogen dominance. Common symptoms during this time are PMS, breast tenderness, bloating and cramps and mood swings. 

As you continue in peri-menopause, estrogen also begins to decline. This is when hot flashes start. And because estrogen has over 400 different functions and almost every organ of our body has estrogen receptors, we also start to experience memory issues, migraine headaches, heart palpitations, cardiovascular disease, diabetes, osteoporosis, and vaginal dryness. As you edge toward the end of peri-menopause, estrogen and progesterone start to reach menopausal levels and a lot of the symptoms either reduce or completely end. Hot flashes tend to stick around and maybe this is why hot flashes are the one symptom everyone seems to know about when it comes to menopause. 

Interestingly, testosterone is the one sex hormone that declines due to aging and not menopause. In case you didn’t know it, women also have testosterone but in amounts about one tenth of what men have. Testosterone deficiency can show up as loss of sex drive, decrease in bone density, fatigue, depression, decrease in muscle mass and achy joints.

WHAT’S THE END GAME WITH MENOPAUSE?

Once we reach post-menopause our hormones seem to all level out again. But, this time they’re all at low levels. A lot of the symptoms that we may have experienced during peri-menopause may just become a distant memory. That’s great news but we still need to be vigilant about our health and how well we are taking care of ourselves. When our hormones were at our pre-menopausal levels they offered up all sort of protection to our bodies that is no longer there. Remember, how many functions estrogen has? Over 400. And how almost every one of our organs has estrogen receptors? Now that estrogen levels are at an all time low, a lot of those receptors are kind left hanging. This is the time when osteoporosis starts to build and cardiovascular disease becomes prevalent. Pop quiz here…what is the number one killer of post-menopausal women? Did you say breast cancer? Wrong. It’s heart attack. Welcome to the boy’s club. Post-menopausal, our risk for heart disease now equals that of men. But, our breast cancer risk also increases.

It is absolutely vital to maintain a healthy and happy lifestyle to best manage your way through and beyond menopause. You hold the power to make this 3rd act of life the absolute best it can be. And you deserve nothing less than the best!