Menopause is a natural biological process that affects the production of female hormones, resulting in changes to a woman’s body and fertility. All women experience menopause, usually during midlife, with various symptoms manifesting across the three main stages of menopause, known as perimenopause, menopause, and postmenopause.
This comprehensive guide details the scientific mechanisms involved in the different stages of menopause and provides definitive answers to common questions such as how to manage menopause symptoms, which menopause treatments could be best for you, and what signs to watch out for that may indicate menopause is coming to an end.
What is 'the menopause'?
‘The menopause’, simply referred to as menopause, is a natural biological process that marks the end of menstrual periods in women due to lower oestrogen levels, typically occurring between the ages of 45 and 55.
Menopause is medically diagnosed when a woman stops menstruating for a period of at least twelve months, signifying the end of fertility and resulting in various physiological changes associated with fluctuations in the body’s hormone levels. In particular, menopause results in a decrease in the production of oestrogen and progesterone, the hormones responsible for regulating the menstrual cycle.
What are the stages of menopause?
There are three key stages of menopause, each of which produces a different set of symptoms and requires different approaches to managing the condition. These stages are known as perimenopause, menopause, and postmenopause.
Perimenopause
Perimenopause, the initial phase of menopause, marks the transition into menopause and commonly begins around the age of 40, although it may start earlier or later for some women.
During this stage, the ovaries gradually produce less oestrogen, leading to fluctuations in hormone levels as the body prepares for the complete cessation of menstruation and the end of fertility.
This process involves a decrease in the release of viable oocytes (eggs), contributing to changes in menstrual regularity and an overall reduction in fertility. The symptoms and timing of perimenopause can vary significantly among women.
The first signs of perimenopause include irregular periods, vaginal dryness, and, in some cases, hot flushes. These symptoms occur due to fluctuating levels of oestrogen and progesterone.
- Irregular periods result from unpredictable oestrogen production, which disrupts the normal menstrual cycle by affecting the regular growth and shedding of the uterine lining.
- Decreased oestrogen reduces blood flow to the vaginal tissues and affects the production of natural lubricants, causing the tissues to become thinner, drier, and less elastic, leading to discomfort.
- Hot flushes are caused by hormonal changes affecting the hypothalamus (the brain's temperature regulation centre), resulting in sudden episodes of intense heat, sweating, and flushing.
Menopause
The menopause stage begins when a woman stops experiencing menstrual periods for at least 12 months. During this stage, the ovaries stop releasing eggs, and the body stops producing as much oestrogen, resulting in reduced fertility and the gradual cessation of menstruation.
The initial symptoms of menopause are similar to those of perimenopause, including irregular periods, night sweats, hot flushes, difficulty sleeping, vaginal dryness, and mood changes. Both stages involve fluctuations in the body’s levels of oestrogen and progesterone.
As menopause approaches, these symptoms can intensify due to the progressive decline in hormone production by the ovaries. The reduced oestrogen affects the hypothalamus located in the brain, leading to hot flushes and night sweats, disrupting sleep patterns, causing vaginal dryness, and influencing brain neurotransmitters, resulting in mood changes.
Postmenopause
The postmenopause stage commences immediately after menopause, signalling the end of a woman’s reproductive years. During this stage, the follicular activity of the ovaries ends, meaning they stop releasing eggs and significantly reduce hormone production. As a result, oestrogen levels drop because the ovaries no longer produce significant amounts of hormones.
The lower oestrogen levels may lead to hot flushes, night sweats, and vaginal dryness while the body tries to adapt to the hormonal changes. However, for most women, these symptoms of menopause dissipate within a few months as the body adjusts to the new hormone levels.
How long do the stages of menopause last?
The perimenopause stage can last between 4 and 8 years depending on factors such as genetics, lifestyle, the use of menopause treatments such as Gina, and the affected woman’s overall health.
Following this, the menopause stage lasts for 12 consecutive months, during which time menstruation ceases.
The final stage, known as postmenopause, lasts from the end of the menopause stage throughout the remainder of a woman’s life.
Recommended reading: Your Complete Guide to Menopause
What are the most common menopause symptoms?
According to the NHS[1], some of the most common symptoms of menopause include:
- Hot flushes
- Mood changes
- Skin changes
- Discomfort during sexual intercourse
- Hair loss and thinning
- Headaches or migraines
- Night sweats
- Recurrent urinary tract infections (UTIs)
- Reduced libido
- Vaginal dryness
- Muscle aches and joint pain
If an individual experiences severe and persistent menopause symptoms, they should contact a healthcare professional as soon as possible.
What is the best prescription medicine for menopause?
One of the most commonly used prescription medicines to relieve menopause symptoms is Gina, a form of hormone replacement therapy (HRT) which works by replacing the hormones that decrease in a woman’s body during menopause, such as oestrogen and progesterone.
HRT treatments such as Gina help restore the body’s hormone levels during menopause, alleviating symptoms such as hot flushes, night sweats, mood swings, vaginal dryness, and sleep problems.
Individuals who wish to purchase Gina HRT tablets to treat menopause symptoms can complete our online consultation to determine treatment eligibility.
What are the best vitamins for menopause?
Multivitamins that are specifically formulated for women going through menopause, such as Vitabiotics Menopace Plus and Vitabiotics Menopace Night, contain a number of key vitamins and minerals that can help relieve symptoms.
Vitamin B6
Vitamin B6 contributes to the production of serotonin, a neurochemical responsible for transmitting messages from the nerve cells in the brain to the rest of the body to regulate mood.
Women undergoing menopause typically experience a drop in serotonin levels which can contribute to mood changes. Taking vitamin B6 supplements, in addition to eating foods rich in vitamin B6 such as bananas, peanuts, and poultry, can contribute to serotonin production.
Vitamin D
Vitamin D promotes the absorption of calcium in the small intestine, thereby promoting new bone production and reducing the risk of lower bone density and joint pain in menopausal women[2]. This is particularly important because oestrogen levels fall during menopause, which can affect the efficiency with which the small intestine absorbs calcium.
In addition to taking menopause supplements, Vitamin D levels may be increased by eating certain foods such as cereals, egg yolks, and oily fish. Moreover, vitamin D is uniquely synthesised by the body when ultraviolet (UV) rays from sunlight strike the skin, making it important for women undergoing menopause to spend time in the sun.
Calcium
Calcium is crucial for maintaining strong bones, making it a vital mineral for women undergoing menopause. During menopause, the decrease in estrogen levels can accelerate bone loss, increasing the risk of osteoporosis.
Consuming calcium-rich foods such as dairy products, leafy green vegetables, and fortified foods, in addition to taking calcium supplements, can ensure adequate calcium to support bone health in menopausal women.
Vitamin E
Vitamin E is known for its antioxidant properties, which help protect cells from damage. It also supports skin health and may alleviate some of the common symptoms of menopause such as hot flashes and night sweats.
In addition to taking menopause supplements, women undergoing menopause are recommended to eat vitamin E-rich foods such as almonds, sunflower seeds, and spinach to help reduce the impact of the symptoms.
Folic Acid
Folic acid is vital for cell growth and the formation of red blood cells, which are important for overall health. During menopause, maintaining adequate folic acid levels can help manage symptoms such as fatigue and irritability. Folic acid can be supplemented or naturally sourced from foods like lentils, asparagus, and fortified cereals.
What are the signs of coming to the end of menopause?
The postmenopause stage marks the end of menopause, and the signs can be different for each woman. For some women, menopause symptoms will cease, while for others, the symptoms can persist.
The positive signs that menopause is coming to an end include:
- Higher energy levels
- Increased libido
- Higher concentration levels
- Improved sleep quality
- Fewer or no hot flushes
However, this is not the case for all women. As outlined by the NHS, do not be alarmed if you experience the following postmenopausal symptoms[3]:
- UTIs (lower oestrogen levels may alter the bladder and vaginal tissue, increasing the risk of UTIs)
- Urinary incontinence (the tissue of the vagina and urethra loses elasticity during menopause, which can lead to involuntary loss of urine and strong urges to urinate)
- Pain during sex (some women experience vaginal dryness due to lower oestrogen levels, which may cause discomfort during intercourse due to increased friction)
- Weight gain (hormonal changes during menopause can cause the body to store more fat and burn calories less efficiently, leading to weight gain)
Pharmica offers clinically proven menopause treatments to help manage symptoms effectively
At Pharmica, we offer several clinically proven menopause treatments such as Gina hormone replacement therapy tablets. Each order is dispensed quickly and discreetly following thorough clinical checks to ensure patient safety, and we provide a number of delivery options, including same-day delivery.
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