Menopause: understanding and coping better
Menopause is a natural stage in a woman's life that marks the end of menstruation and the reproductive years.
It usually occurs between the ages of 45 and 55. The transition into menopause—also known as the climacteric or menopausal transition—includes the time before (perimenopause) and after (postmenopause) this point. For many women, the transition can be a stressful phase, involving physical changes such as hot flashes and vaginal dryness as well as emotional challenges. Understanding this stage and the changes that come with it can significantly help in coping with the transition. This article addresses the most important questions about menopause, including its symptoms and its effects on various areas of life.
Table of Contents
- What is meant by menopause?
- Are menopause and the climacteric the same?
- Phases before and after menopause
- What is considered early menopause?
- What are the typical symptoms during the menopausal transition?
- Which conditions are associated with menopause?
- Is it still possible to become pregnant during menopause?
- Treatment options during menopause: an overview
- Summary
What is meant by menopause?
Menopause is officially defined as the point at which a woman has not had a menstrual period for 12 consecutive months and marks the end of her reproductive years. This transition results from the natural decline in reproductive hormones, particularly estrogen and progesterone, which are produced in the ovaries. These hormones are chemical messengers essential for regulating the menstrual cycle and releasing eggs. When the ovaries stop releasing eggs, hormone levels drop and the transition toward menopause begins (NIH, 2024).
Are menopause and the climacteric the same?
No, menopause and the climacteric are not the same. Menopause refers to the specific point in time when a woman has not menstruated for 12 months, whereas the climacteric (or menopausal transition) encompasses the entire transition period around menopause, including perimenopause and postmenopause. These phases are explained below.
When does menopause occur?
Menopause typically occurs between the ages of 45 and 55, with the average age being 51. However, several factors can influence the timing of menopause. Genetics play a major role, but lifestyle factors such as obesity, smoking, or autoimmune diseases can lead to an earlier onset. Regular menstrual cycles and childbirth are often associated with a later onset (WHO, 2022).
Phases before and after menopause
The phases before and after menopause are key to understanding the hormonal changes that take place. The following table provides an overview of the main characteristics of each phase:
| Phase | Description |
|---|---|
| Pre-perimenopause | The time before the first hormonal changes occur, when no symptoms are yet present. |
| Perimenopause | Hormonal fluctuations, irregular menstrual bleeding, onset of symptoms such as hot flashes, sleep disturbances, and mild mood swings. Usually begins in the 40s and lasts 4–10 years. |
| Menopause | 12 consecutive months without menstruation, marking the end of the reproductive years. |
| Postmenopause | The time after menopause. Symptoms may subside, although mild symptoms can persist for several years. Increased risk of cardiovascular disease and osteoporosis. |
Source: Cleveland Clinic, 2024
What is considered early menopause?
Menopause is considered early if it occurs before the age of 40. If it begins between the ages of 40 and 45, it is referred to as premature menopause. In both cases, medical treatment may be necessary. Women affected should seek medical advice to detect potential complications early (Cleveland Clinic, 2024).
What are the typical symptoms during the menopausal transition?
The following image shows the typical symptoms that can occur both before and for some time after menopause. The type and severity of symptoms can vary greatly from person to person and depend, among other things, on individual hormone levels.
Source: adapted from NHS, 2022
Additional symptoms that may occur
In addition to the classic symptoms, other possible signs include breast tenderness, intensified PMS symptoms, and an increased urge to urinate. Some women also report reduced sexual desire, difficulty concentrating, and hair loss.
Which conditions are associated with menopause?
Due to hormonal changes, women going through menopause are at increased risk for certain health conditions, including:
Cardiovascular diseases
Women in menopause face a higher risk of cardiovascular diseases. This is because the protective effect of hormones—especially estrogen—diminishes. Many women are unaware of this increased risk, even though cardiovascular diseases (CVD) account for around 50% of deaths in women after menopause. By knowing the symptoms of cardiovascular disease, minimizing risk factors such as smoking, obesity, and lack of physical activity, and regularly testing blood markers related to heart health, complications can be detected early.
Osteoporosis
Another increased risk during menopause is osteoporosis. Osteoporosis is a condition in which bone density decreases, causing bones to become porous and brittle. The drop in estrogen levels plays a central role, as estrogen is important for maintaining bone density. Up to 20% of bone loss can occur during the menopausal transition, and on average, one in two postmenopausal women will develop osteoporosis. Preventive measures, such as a diet rich in calcium and vitamin D as well as regular physical activity, can help reduce the risk of osteoporosis. Exercise not only strengthens bones but also improves balance and coordination, helping to prevent falls and fractures.
Source: NHS, 2023; PennMedicine, 2016
Would you like to assess your health yourself?
During menopause, women experience many changes in their bodies that can significantly affect their health. In addition to the Menopause Test, Homed-IQ offers two other tests that can be especially valuable during this phase of life and can be conveniently taken at home: the Heart Disease Blood Test and the Vitamin D Test.
Can you get pregnant during menopause?
During perimenopause—the transition phase leading up to menopause—pregnancy is still possible, although it becomes increasingly unlikely due to declining fertility. After the official onset of menopause, defined as 12 consecutive months without menstruation, natural pregnancy is no longer possible (Scaccia, 2017).
Treatment options during menopause: an overview
Menopause (including all transitional phases and the menopausal period itself) is a biological process that generally requires no medical treatment and is a normal part of aging. However, treatment may be advisable in certain situations. Options include:
- Hormonal treatments
- Non-hormonal treatments
- Lifestyle modifications
When should I consider treatment?
Treatment during menopause may be necessary if:
-
... severe symptoms occur, such as vaginal dryness and pain during intercourse.
-
... symptoms significantly affect daily life and well-being.
-
... menopause-related health risks, such as osteoporosis, are increased.
Source: Mayo Clinic, 2023
What hormonal treatment options are available?
Hormone replacement therapy (HRT):
HRT helps compensate for the declining hormone levels during menopause and can relieve many symptoms such as hot flashes and vaginal dryness. There are two main types:
| Estrogen therapy | Estrogen-progestin therapy |
|---|---|
| Involves taking pure estrogen to compensate for hormonal loss. | Combines estrogen and progestin to reduce the risk of uterine cancer. |
| Available as patch, pill, cream, vaginal ring, gel, or spray. | Available as pill, patch, gel, or injection. |
| Suitable for women without a uterus, as estrogen alone increases the risk of uterine cancer. | Suitable for women with a uterus to prevent thickening of the uterine lining. |
| Typically used during perimenopause and early postmenopause to treat severe symptoms. | Used to manage menopausal symptoms and reduce the risk of uterine cancer. |
Source: Mayo Clinic, 2023; Endocrine Society, 2022
What non-hormonal treatment options are available?
Non-hormonal treatments focus on specific symptoms and may include:
- Medications for vasomotor symptoms: Help with hot flashes and night sweats.
- Vaginal moisturizers and lubricants: Relieve vaginal dryness and discomfort during intercourse.
- Calcium and vitamin D supplements: Support bone health and help prevent osteoporosis.
- Psychological support and therapy: Assistance from a therapist can help manage emotional and mental challenges.
Speak with your doctor about your symptoms and get advice on appropriate measures. (NHS, 2022).
What lifestyle measures can support the menopausal transition?
General tips:
-
Phytohormones: These are plant compounds that can mimic natural hormones. Foods like soybeans, chickpeas, and flaxseeds contain phytoestrogens that may help reduce hormonal fluctuations. However, scientific evidence remains inconclusive.
For hot flashes:
- Avoid triggers: Spicy foods, caffeine, and alcohol can trigger hot flashes. Try to avoid them.
- Adjust your environment: Keep your bedroom cool and wear lightweight clothing to ease symptoms.
For vaginal dryness:
- Helpful products: Use vaginal moisturizers or lubricants to relieve dryness and discomfort during sex.
- Avoid irritants: Refrain from using scented soaps or douches that may irritate the area.
- Breathable clothing: Wear breathable fabrics and avoid tight-fitting pants.
- Communication: Talk with your partner about your symptoms to prevent relationship strain.
To prevent osteoporosis:
- Calcium- and vitamin D-rich diet: Include dairy products, leafy green vegetables, almonds, fatty fish, eggs, and fortified foods in your diet to prevent deficiencies.
- Regular exercise: Engage in physical activity to strengthen bones and build muscle. Outdoor activities are especially beneficial as sunlight boosts vitamin D production.
To prevent cardiovascular diseases:
- Exercise and healthy weight: Regular physical activity plays a crucial role in heart disease prevention. Maintaining a healthy weight reduces the risk of high blood pressure, diabetes, and heart disease.
- Avoid smoking and limit alcohol: Smoking is one of the major risk factors for cardiovascular disease. Alcohol consumption should also be moderate, as excessive drinking can raise blood pressure and heart disease risk.
- Routine screenings: Regular checkups and monitoring of risk factors such as cholesterol and blood sugar levels are essential.
For mental health challenges:
- Relaxing and enjoyable activities: Incorporate activities that bring joy and relaxation into your daily routine—they can help stabilize your mood and reduce stress.
- Social support: Spending time with friends and family can help you cope with mood swings and emotional stress.
Source: Harvard Health, 2017; NHS, 2022
Summary
Menopause is defined as the point when a woman has not had her period for 12 months and marks the end of the reproductive years. The menopausal transition, also known as the climacteric, includes the period before and after menopause, during which hormonal changes occur. Typical symptoms include hot flashes, vaginal dryness, and mood swings. Treatment options include hormone therapy, non-hormonal interventions, and lifestyle changes. Early medical consultation and regular preventive care can help relieve symptoms and reduce health risks.
