What Is Menopause?

Menopause is a significant transition from a person’s reproductive to a non-reproductive stage.

Many people go through this change in their 40s or earlier (see Premature & Early Menopause section), while others experience it later in life.

Those born with ovaries are born with all of their eggs—around two-four million of them. These eggs start to deplete from puberty onwards through menstrual cycles. Once the eggs are depleted, the hormonal feedback loop of the menstrual cycle is disrupted until it eventually ceases. Usually, by the time we reach adulthood and are thinking about fertility, there are only around 4% of egg cells left. Hence why babies are called little miracles.

Perimenopause, Menopause, and Post-menopause

The complete cessation of the menstrual cycle can take a considerable amount of time, often up to 15 years. The term peri-menopause or perimenopausal is used to describe the transitional phase leading up to the event when periods finally stop.

Menopause is officially recognized after 12 consecutive months without bleeding. Subsequently, it is referred to as post-menopause for the remainder of a person’s life.

It’s important to note that people of diverse gender identities, including transgender men and non-binary individuals, may also experience menopause.

Perimenopause—the phase when individuals still experience periods—is the most symptomatic stage of the menopausal cycle.

Why Do We Experience Symptoms?

Our body chemistry is like a jigsaw puzzle with specific pieces fitting together. When the dimensions aren’t right, the picture becomes disorganized.

The presence or absence of symptoms, their duration, and the most suitable treatments vary among individuals. There are unique gaps and overlaps for each person.

Some individuals may experience few or no symptoms, while others may suffer for many years. However, even those who are symptom-free need to consider long-term postmenopausal health concerns.

The average duration of perimenopause is 3-4 years, but it’s important to note that this is an average and not universally applicable. Many individuals experience symptoms for a longer duration but may not recognize them as perimenopause due to the relatively recent introduction of the term.

The menopause is a completely normal and natural part of a woman’s life. It’s a time when our hormones are changing, and our bodies are shifting towards the end of fertility. It’s a period of our lives to take stock and look after ourselves so that we can live our best lives and thrive going forward.

Let’s start with a short summary of what’s going on in our bodies before the menopause begins.

When we start to run out of eggs, our ovaries begin to produce fewer hormones, particularly oestrogen, and the levels can fluctuate wildly. Our brains make more FSH to try to balance things out when oestrogen levels are low. The changing levels of hormones from the ovaries give many of us symptoms – some of which are well known (hot flushes) and some less so (joint pains). This stage of the menopause transition is known as the perimenopause.

The menopause occurs when your ovaries permanently stop producing eggs. Your oestrogen levels are now always low, and your FSH levels are permanently high. If you have a blood test to see if you’ve reached menopause, your doctor will check the FSH and, sometimes, oestrogen levels.