Menopause, as the term suggests, marks the end of menstrual cycles. The prefix "meno-" refers to your menstrual cycle, and "pause" signifies its cessation. Medically, menopause is reached when a woman hasn't had her period for a year. It's the point when the ovaries no longer produce eggs, consequently causing a decline in crucial hormones like oestrogen, progesterone, and testosterone.Oestrogen safeguards various bodily systems, including the brain, skin, bones, heart, and genitourinary. Lower levels of oestrogen, in particular, influence many bodily organs and systems because there are oestrogen receptors all over the body from head to toe!
What exactly is perimenopause?
"Perimenopause" describes the phase preceding menopause, where symptoms are experienced whilst still having regular cycles. During perimenopause, periods typically undergo changes. They may appear further apart or closer together, and they can vary in flow, being heavier or lighter. This is, without a doubt, the time to expect the unexpected. But why is this?
During perimenopause, the hormones oestrogen and progesterone, which regulate the menstrual cycle and egg production, experience significant fluctuations. It's often this hormonal imbalance that gives rise to menopausal symptoms. Some women only experience symptoms for a few months before their periods stop, while others endure them for months or years before menopause.
Very often, the words perimenopause and menopause are used interchangeably as the symptoms can be similar, but experiences vary from woman to woman.
When does menopause happen?
In the UK, the average age of menopause is around 51 years. However, this can be earlier or later. Perimenopausal symptoms often kick off during the mid-forties, but this isn't always the case.
If menopause occurs before age 45, it's referred to as early menopause. If it happens before 40 years old, it's classified as Premature Ovarian Insufficiency (POI), which can sometimes run in families.
Whilst menopause is a natural life event, specific conditions can trigger an early onset, such as:
• Surgical removal of ovaries
• Radiotherapy for cancer treatment
• Certain chemotherapy drugs for cancer
• Medical or surgical treatment for endometriosis or premenstrual syndrome
• Genetic and autoimmune factors
Suppose a hysterectomy (removal of the womb) is performed before menopause. In that case, early menopause may occur, even if the ovaries are left intact. This is due to a potential reduction in oestrogen levels. It's a tricky situation because women won't experience periods post-hysterectomy, making it challenging to pinpoint the onset of menopause. However, the tell-tale symptoms associated with declining oestrogen levels may act as clues. For instance, hot flushes, insomnia, and anxiety.
How is menopause Diagnosed?
For women over 45 with irregular periods and menopausal symptoms, diagnostic tests aren't usually necessary. Your personal account of symptoms forms the basis for diagnosis. Tracking symptoms in a diary, app, or questionnaire can be helpful to you and your doctor.
For women under 45, healthcare professionals might recommend further tests before confirming a diagnosis. A common test measures follicle-stimulating hormone (FSH) levels in the blood. Elevated FSH levels strongly suggest menopause. This test is often repeated 4 to 6 weeks later for confirmation. If you're under 40, additional investigations might be advised to rule out other conditions affecting periods or hormones.
How Are Symptoms Managed?
Hormone Replacement Therapy (HRT) stands as the most effective treatment for menopausal symptoms, essentially replenishing the hormones your body no longer produces. HRT typically consists of oestrogen and, if needed, a progestogen (or progesterone) and, in some cases, testosterone. The choice to use HRT is personal; your individual 'cocktail' will depend on your medical history and circumstances. And, of course, some women don't want to take medication and would prefer to experience menopause naturally.
Besides alleviating symptoms, HRT offers protective benefits against osteoporosis, heart disease, type 2 diabetes, bowel cancer, dementia, and potentially better long-term health. For most women, the advantages of HRT outweigh any risks. For a discussion on the HRT controversy caused by the Women's Health Initiative in 2002, please refer to Oestrogen Matters by Avrum Bluming and Carol Tavris.
In addition to HRT, adopting a healthy lifestyle can minimise the negative impact of menopause on your health and wellbeing.
Lifestyle changes such as quitting smoking, reducing alcohol intake, regular heart-healthy exercise, eating a well-balanced diet and adopting relaxation techniques can significantly aid your journey through menopause. Although it's also essential to build and maintain social connections.
Menopause can be lonely, and the highs and lows of symptoms might make you want to hibernate and feel sorry for yourself. Help is out there, so make sure you find your tribe!
How can Nu Mind help?
The great thing about our Menopause Support blend is that it's suitable for use with or without HRT. It doesn't make any wild claims about specific symptoms because we prefer to work on the bigger picture of women's health.
Why? Because if you support overall nutrition status, blood sugar balance, stress, and energy - guess what? You'll most likely experience relief from your most troublesome symptoms, such as hot flushes, insomnia, and fatigue.
We hope you'll join the Nu Mind Wellness tribe so we can support you through perimenopause and beyond.