Menopause is not a disease or a malfunction, but a stage when the ovaries gradually stop producing estrogens and menstruation fades. Changes begin long before the last period, and it is during perimenopause that most noticeable symptoms usually appear. Below is what happens to the body, which manifestations are usual, and when a conversation with a doctor is needed.
What menopause and perimenopause are
Menopause is a natural part of life when periods change and eventually stop due to lower hormone levels. It affects anyone who has periods. Menopause is spoken of after a year without any bloody vaginal discharge; in women without a uterus, blood FSH levels are used as a guide.
Perimenopause is the period before the last period, which can last up to 10 years. Estrogen levels fluctuate widely during this time, and it is these swings that cause most symptoms. Postmenopause follows.
What symptoms occur
The most noticeable are hot flashes: from 30 seconds to 10 minutes of heat, sweating, and skin redness, which usually subside within a year or two.
- irregular periods — shorter, longer, or heavier;
- interrupted sleep and night sweats;
- vaginal dryness, pain during intercourse, reduced libido;
- dry skin, joint and lower back pain, fatigue.
Separately — sleep and mood: there may be anxiety, irritability, mood swings, depressive states. Forgetfulness and difficulty concentrating are noted by about half of women. The intensity of symptoms is individual, and how you experience this period also depends on social and cultural context.
Age: when this usually happens
The average age of menopausal changes is 50, ranging from 49 to 52, although variability is great. Natural menopause usually occurs between 45 and 55 and often — though not always — at roughly the same age as in one's mother.
Early menopause is at 40–45, and before 40 it is called premature ovarian failure; it occurs earlier in those who smoke. Women with menopause before 45 have a higher risk of heart disease, lung problems, and death. Late menopause is after 55. Artificial menopause is caused by removal of the ovaries, radiation, or medication. In women after surgical removal of the uterus but with ovaries intact, menopause is determined by the time of surgery or by a drop in hormone levels.
Bones and heart over the long term
Estrogen receptors are found not only in the reproductive organs but also in bones, skin, and the brain, so lower hormone levels affect the whole body. After menopause, the risks of osteoporosis and osteopenia increase, and for older women this significantly raises the risk of hip fracture.
Cardiovascular risks also rise rapidly after menopause: menopause overlaps with a higher risk of atherosclerosis. Factors that affect cardiovascular risk include smoking, high blood pressure, blood cholesterol levels, and excess weight.
How it is diagnosed
Separate tests that "show menopause" are usually not needed: the guide is a year without bloody discharge. If needed, the doctor orders screening of ovarian hormone secretion — a blood or urine test.
There is no routine reason to see a doctor just because of menopause: it is not a disorder or a disease. But if symptoms significantly affect quality of life, this is brought to a doctor.
When to see a doctor
Bleeding after menopause is always a reason to seek care, without exceptions. Any genital bleeding in postmenopause is a dangerous symptom and requires evaluation for malignant diseases; bloody discharge resembling menstruation may be a sign of endometrial cancer.
Also see a doctor for abnormal bleeding during perimenopause, symptoms that significantly interfere with life, persistent sleep or mood disturbances. What is normal: an irregular cycle and hot flashes that subside over time. What to discuss with a doctor: anything that lasts long and changes your quality of life.
When to see a doctor immediately: signs of stroke or heart attack, severe injury, or another life-threatening condition. In such cases call 103 or 112.
This material is for reference and does not replace a doctor's consultation — it only helps you prepare for a conversation with one.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer