Understanding the Stages of Menopause

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Have you stumbled into menopause oblivious of what is happening to your body and mind as you experience the symptomatic changes that come hand in hand with this transition period?


It’s a word we all know, yet 'menopause' is misused as an easy catch-all that fails to separate the different stages all women go through. Knowing these stages will help women to take the steps needed to in the build up to their own ‘menopause’

Gynaecologist and Obstetrican, Dr Karen Morton clarifies the stages of menopause with Hot Flush:

What are the Stages leading up to and beyond the Menopause?

  1. Premature menopause or Premature Ovarian Insufficiency

  2. Peri-menopause

  3. Menopause itself

  4. Post- menopause


What is a premature menopause?

More correctly termed Premature Ovarian Insufficiency (POI), it’s the loss of ovarian function that causes your body to stop producing normal levels of oestrogen, stop producing eggs and ends periods before the age of 45. POI leaves your body without hormone support for an unhealthily long period.

To help work out if you’re having an early menopause and how to treat it, your doctor may ask if you're having symptoms such as hot flushes, irregular periods or sleep problems. Blood tests will establish if you’re in early menopause by measuring your oestrogen levels and more importantly, the ‘driving hormones’, which come from the pituitary gland or ‘Master gland’, that drives several of the body’s important hormone systems. The test may need to be repeated as hormone levels can fluctuate wildly. Testing will also clarify whether you are still able to get pregnant.

Early menopause can make you more susceptible to health problems such as heart disease and osteoporosis. Talk to your doctor to discuss ways to protect your health. Hormone replacement therapy (HRT) may well be recommended. 

What support is there for premature menopause

The Daisy Network charity provides information and support for young women diagnosed with premature menopause, or POI. Understanding how isolating, and confusing, a diagnosis of POI can be. They provide guidance and information as well as the latest research on all aspects of POI alongside support for you, your family and partners.

Watch our Hot Flush vlog Premature Menopause - Annabel’s Story.

What is peri-menopause?

Some women will start to feel below par in their early forties, they’re still having regular periods but their ovaries aren’t producing the same quantities of oestrogen that they previously took for granted. While women are going about their daily toil, a silent change is taking place as their body prepares for the inevitable transition of menopause.

There is a whole length of time during which women may get symptoms of declining ovary function, usually called the peri-menopause, or sometimes the climacteric. It’s difficult to know when you’ve entered peri-menopause but irregular periods, with cycles and flow becoming more erratic, heavier or lighter are one of the first signs.

Your fluctuating hormone levels may mean you’ll experience a variety of peri-menopausal symptoms. These symptoms are very real physical and emotional conditions. It’s called the ‘change’ for a reason. It’s easy to fail to spot that you’re in peri-menopause as it’s not something many of us are familiar with or are, prepared for. You may put changes in mood and increased anxiety, down to dealing with the stressful situations happening around you, concerning work, family or partners.

A survey by The British Menopause Society found that women reported experiencing on average seven symptoms in the various stages of menopause. 8 out 10 women experience symptoms for between 4 to 12 years, so it’s worth knowing more about the signs Symptoms  and treatment options to help you to keep on top of the side-effects of depleting hormones. In our Symptoms section we tell you why symptoms occur and give up-to-date tips and advice on the various ways you can deal with them to take control of your menopause.

What is the menopause?

The menopause happens to every woman when their predetermined number of ovarian follicles are finally exhausted. As a result, oestrogen and progesterone hormone levels fall, periods become erratic and eventually stop.

Clinically speaking, a woman has gone through menopause when it’s been twelve months since the date of her last period. ‘Menopause’ is retrospective in marking an event in the past.

With the arrival of menopause, fertility comes to an end. Women have different feelings about this. Some may experience sadness at the finality, and the fact that they no longer have a choice about getting pregnant. For others, loss of fertility can be a welcome relief from the hassle of birth control, tampons and towels.  And for many, it’s the start of a liberating and positive period of life!

What is post-menopause?

What does post-menopause mean?

Essentially, you’re post-menopausal 12 months after your last period and well, for the rest of your life! Many women will have renewed energy and feel like their old selves but others may experience long-term flushes and sweats.

Post-menopausal bleeding (PMB) may occur as the ovaries have a last burst of activity. It’s not usually a cause for concern but, if you notice any type of bleeding more than a year after your last period, even if it is only light spotting, check this out with your doctor straight away, to rule out anything more serious.

Post-menopause health awareness

This is no time to take your foot off the gas. When women lose the protective effects of oestrogen, we’re more susceptible to certain health issues including; osteoporosis, heart disease and diabetes. Lifestyle changes may prevent the onset of these conditions. We all have unique risk factors, speak to your doctor about where yours lie, and how you can manage them.

Have a healthy and happy post-menopause

Menopause happens to all women, whether naturally occurring or surgically induced. The postmenopausal period should see those acute symptoms of declining ovarian function gradually settle, although you may find that symptoms continue well into the postmenopausal timeframe, and for some, remain indefinitely! Looking on the bright side you won’t be ruled by the mood changes and physical management of a monthly menstrual cycle.  Maybe time to take stock and see what brings you joy?

Check out our Symptoms section where we've got plenty of Hot Help on how you can take charge of your menopause and make lifestyle choices and changes to manage this inevitable phase in your life.

If you'd like to speak to a doctor in confidence about menopause related issues, you can get expert medical advice from Dr Karen Morton’s Medical Helpline https://www.drmortons.co.uk/services/index.php, or speak to your own doctor.

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