Menopause

What is menopause?

Menopause is the natural part of the ageing process that all women experience. Although it is a normal part of life, this biological and physiological process has an enormous impact on some women’s psychological, social, and sometimes spiritual well-being too.

The word menopause is derived from a combination of two Greek words including ‘menos’ meaning month and ‘pausis’ meaning to stop. Healthwise, it’s defined as the point in a woman’s life when the menstrual cycle stops for good and the end of her ability to have children.

The medical definition of menopause is the absence of a monthly period for twelve consecutive months at the expected age together with a significant drop in oestrogen and progesterone which are female hormones. The buildup to menopause known as perimenopause happens over several years. True menopause typically happens between the ages of 49 to 52 but it can happen sooner or later in life.

The word menopause was first used in 17th century France. It only entered mainstream awareness over the last century as women started to live longer. This is thanks to the improvements in healthcare Before then, few women lived long enough to experience menopause. Those who did, were most likely from the wealthier elite who had better diets and living conditions, but in those circles menopause and its symptoms were considered a taboo subject and were not spoken about.

What causes menopause?

A healthy baby girl is born with all her eggs for life. After puberty,  a woman typically releases eggs during her monthly periods and ovulates only one egg. This process is controlled by the female reproductive system and a small gland in the brain called the pituitary gland. The number of viable fertile eggs in the ovaries are depleted over time.

As a woman ages, the quantity and quality of her eggs declines.  The risks associated with carrying and then caring for a baby also increase. Nature recognises this and once the supply of viable eggs is exhausted, her reproductive cycle is programmed to end.

When this happens, the entire female reproductive cycle starts to slow down.  Hormones start to drop off, ovaries start to release fewer eggs less regularly, and ovulation eventually stops. The previously regular cycle which includes the thickening and shedding of the lining of the womb, is no longer required and monthly periods gradually start to stop over time. This happens as levels of oestrogen and progesterone as well as other hormones start to fall. Many other life and lifestyle changes tend to happen at the same time in a woman’s life making it noteworthy and sometimes quite stressful.

Biologically, menopause marks the end of the fertile period in a woman’s life. It helps to serve the purpose of ensuring that the chances of a woman bearing a child are minimised. Menopause starts when periods stop permanently.

When does menopause start?

Most women experience actual menopause between the ages of 49 and 52 years of age. Menopause is defined by the absence of periods for a  full 12 months. The process of arriving at menopause,  often called perimenopause, goes through phases. These phases don’t always have very clearly defined boundaries.

Periods don’t just disappear overnight. During perimenopause periods can become irregular, the odd one might be missed or arrive late. Similarly, the menstrual flow may become heavier or lighter and less regular before stopping completely.

Changes and fluctuations in the levels of certain hormones during this time can   cause common symptoms such as hot flushes, night sweats, and mood swings. These menopausal symptoms may be experienced for a few months or even years as the body starts to find its new normal.

Many women describe this phase as ‘going through menopause’, ‘the change’ or ‘the change of life’.

What are the stages of menopause?

Menopause has several phases:

Premenopause	This is the earliest phase of menopause. At this stage menstruation starts to become less regular. The menstrual cycle becomes shorter or longer and menstruation heavier or lighter.
Perimenopause	Female hormones like oestrogen and progesterone start to  decline. Perimenopause tends to start a few years before actual menopause. It can last four to seven years but it is difficult to predict exactly when it will start. Perimenopause is reached between the age of 40-50 years with an average onset at 47 years of age. This is when the symptoms are most noticeable. Fertility typically diminishes at this point, but it is still possible to fall pregnant.
Menopause	This is medically defined as the moment when a woman has had her last period. A better definition might be after a woman has not had a period for more than one year. During this time, the female hormones continue to drop. Many menopausal symptoms are still common for some women. For most women, menopause occurs in their early fifties. The average age is 52 years old.
Postmenopause	This is considered after not having had a period for two years or more. As a rule, most of the hormones have balanced out. Many women feel more stable. Some women still present some menopausal symptoms.

How do I know that it is menopause?

This popular question doesn’t have a simple answer. There are no hard and fast rules when it comes to going through menopause. That’s because of how hormones work and how they affect the body.

Hormones affect many different processes in the body and work slowly over time. Women may experience menopausal symptoms for some time before their final period and for some time after periods stop.

Oestrogen is more than just a sex hormone that regulates the menstrual cycle. In fact, even men produce this hormone. In women, oestrogen is responsible for sexual development, the menstrual cycle, development and maintenance of strong  bones, heart and circulatory health, processing of cholesterol, plays a role in mood management and the regulation of sleep, and so much more.

The first thing to consider is your age. The average age for a woman to reach menopause is 52 years old. Some women start going through perimenopause as early as 35 or as late as 60 years of age. If you are under 45 years old, it is less likely (but not impossible) that the symptoms you are experiencing are menopause related.

There are many typical symptoms associated with the menopause such as hot flushes, night sweats, mood swings, headaches and weight gain. Many women also report experiencing muscle aches and joint pains. Understanding the signs and symptoms and your menstrual cycle is vital to interpreting how menopause might affect you. By gaining a deeper understanding, every women can empower herself to taking a more proactive and knowledgeable stronghold of her own journey to wellness.

Some of the symptoms described above could also be related to other causes such as your adrenal glands, an iron deficiency, undiagnosed autoimmune disorders, or perhaps poor thyroid function.

There is no single test for diagnosing menopause. Hormones fluctuate during menopause on a daily basis which might explain the array of symptoms such as mood swings. There are tests available which look for the presence of hormones but they are not considered reliable. Even in this modern day and age, there is no proven role for blood testing. A diagnosis of menopause is received based on the lack of menstrual periods for 12 months.

If you are in any doubt, we encourage you to consult your doctor or relevant healthcare professional.

What can I expect from menopause?

Although all women go through menopause, there is no fixed or standard experience that can be described. Everyone is different. For a few women, the symptoms are mild and imperceptible except for the fact that monthly periods become irregular and eventually stop.

For many women, menopause brings a change in the pattern to their periods. They become irregular, the flow fluctuates and become either heavy or light, and other symptoms such as sweating, hot flushes or night sweats may be experienced.

A minority of women experience significant symptoms during menopause severe enough to interrupt daily routine or disrupt quality of life.

As the levels of female hormones start to drop and fluctuate, different symptoms can be experienced and tend to include hot flushes, night sweats, mood swings, irritability, anxiety and sleep disruptions. Weight gain and changes to the elasticity in the skin are also common. Other common symptoms include bloating and joint pain.

However, it is important to remember that menopause is not an illness but a natural process that the body transitions through with age.

Treating menopause symptoms naturally

Many women go through menopause experiencing few if any symptoms without needing any treatment. However, others find that menopausal symptoms drastically affect their quality of life. There is nothing wrong with seeking advice or asking for help.

Hormone replacement therapy (HRT) was favoured by the medical profession several years ago. For many, this form of treatment has lost its appeal due to the side effects. Some doctors recommend it for women with severe menopausal symptoms or for those who experience early menopause.

A healthier diet and lifestyle are shown to help with menopausal symptoms. A diet rich in wholefoods, fresh fruit and vegetable, raw nuts and seeds, and drinking at least 1.5 litres of filtered water a day, combined with at least 30-minutes of moderate exercise daily is a good place to start. More tips for a healthy menopause can be found here.

Two of the most common symptoms of menopause are hot flushes and night sweats. These are experienced by over 80% of menopausal women. These may be helped with the use of A.Vogel Menoforce, an extract of freshly harvested, organically grown sage. Sage extracts are well known and widely used for their ability to help relieve the symptoms of menopausal sweats and hot flushes.

Top tip: Find out more about menopause symptoms and our recommended treatments here.

What are the benefits of menopause?

Menopause is not a not a dread disease. Let’s face it, it is often thought of as something bad. It has a negative connotation and is cast in a bad light. That’s probably because it is associated with  getting older and ageing, and it also brings with it some emotional aspects.

here are some benefits to menopause, these include:

• With menopause, monthly periods stop, bringing a revolution to a woman’s life.
• Those with heavy bleeds, period pain and pre-menstrual syndrome (PMS) find that menopause will bring welcome relief to days of feeling unwell.
• In addition, the end of the fertile period of life also brings benefits.

References and further reading:

1. Menopause podcast (no date) Living Naturally. Available at: https://livingnaturally.co.za/podcasts/general-healthcare-podcasts/menopause-podcast
2. Menopause (2023) Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397
3. Professional, C.C. medical (no date) Menopause: What it is, age, stages, signs & side effects, Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/21841-menopause
4. Menopause (no date) World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/menopause
5. What you need to know about menopause (no date) Healthline. Available at: https://www.healthline.com/health/menopause
6. Menopause symptoms and when they often begin (no date) Medical News Today. Available at: https://www.medicalnewstoday.com/articles/155651
7. Melissa Conrad Stöppler, M. (2022) Menopause symptoms, age, supplements & definition, MedicineNet. Available at: https://www.medicinenet.com/menopause/article.htm
8. NHS choices. Available at: https://www.nhs.uk/conditions/menopause
9. Menopause symptoms and relief (no date) Menopause symptoms and relief | Office on Women’s Health. Available at: https://www.womenshealth.gov/menopause/menopause-symptoms-and-relief
10. Menopause (2023) Wikipedia. Available at: https://en.wikipedia.org/wiki/Menopause
11. Levine, B. et al. (no date) 10 symptoms of menopause and perimenopause, EverydayHealth.com. Available at: https://www.everydayhealth.com/menopause/perimenopause-symptoms/
12. PonJola Coney, M. (2023) Menopause, Practice Essentials, Overview, Physiology. Available at: https://emedicine.medscape.com/article/264088-overview
13. The menopause years (no date) ACOG. Available at: https://www.acog.org/womens-health/faqs/the-menopause-years
14. The Menopause (2022) Women’s Health Concern. Available at: https://www.womens-health-concern.org/help-and-advice/factsheets/menopause
15. Endocrine Society (2022) Menopause, Endocrine Society. Available at: https://www.endocrine.org/patient-engagement/endocrine-library/menopause
16. Menopause (2023) Encyclopædia Britannica. Available at: https://www.britannica.com/science/menopause
17. Menopause (no date) Psychology Today. Available at: https://www.psychologytoday.com/intl/basics/menopause
18. Mandal, Dr.A. (2023) What is menopause?, News. Available at: https://www.news-medical.net/health/What-is-Menopause.aspx
19. Roxby, P. (2023) What is the menopause and what are the signs?, BBC News. Available at: https://www.bbc.com/news/health-48258910