[In this article we will cover what menopause is, how to know if you’re in menopause, causes of early menopause, the different stages of the process, and common treatments.]
What is Menopause?
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Menopause is the natural point at which a woman’s period ends. The early signs of menopause, or perimenopause, will start to kick in sometime in the mid-to-late 40s. Women’s reproductive systems go through a variety of changes throughout their lives, and menopause can be thought of as a bookend to the fertile years.
Stages of Menopause
There are three main stages of Menopause:
What is Perimenopause?
Perimenopause is a term for the years (4 on average) leading up to menopause, when women may notice changes in their cycles, spotty periods, heavier or lighter flow, no periods for months.
Women describe this stage as subtle, and hardly noticeable in some cases. Like any elaborate process menopause does not simply “turn on” one day. You may have spotty periods for years, uncomfortable emotional and physical changes.
Menopause is confirmed when you have not had a period for twelve months. The average age of menopause is 51. Earlier on, doctors can measure hormone levels with a blood test, but since a woman’s hormones fluctuate through her cycle, tests can be misleading and may not be encouraged by doctors.
Symptoms & Signs
Some common symptoms of (peri-)menopause include:
- irregular periods (heavier or lighter periods)
- changes in cycle and duration of menstruation
- night sweats
- hot flashes
- libido changes (gain or loss)
- mood swings or depression (more pronounced PMS symptoms)
- brain fog and memory problems (also associated with pregnancy)
- decreased (or increased) libido
- vaginal dryness
- loss of skin elasticity
- sleep loss
- new hair growth or loss
The most common and well-known symptom of menopause is the dreaded “hot flash,” which seems to be an understatement for what many women experience. They talk about “flop sweat,” “power surges,” or “being on fire from the inside.” The other symptoms listed are highly individual to each case—the process will affect women differently based on medical history, expectation, lifestyle, and other factors.
Early Onset of Menopause
Early menopause is triggered by:
- Natural cause (Aging)
Some women are early starters, which is reflected in the age range at which young women get their period.
When menopause occurs under 40 years of age, it’s not considered normal.
Most commonly it’s caused by a disease of the reproductive system—endometriosis, cystic ovarian syndrome, for example. Other major illness like cancer, and with it radiation and chemotherapy, can effect these changes.
Early hysterectomy, or removal of the uterus, along with the ovaries or any other part of the reproductive system, can trigger early menopause.The ovaries store all of our eggs that we will use over a lifetime, and also produce estrogen and progesterone. Their removal has been linked to other diseases, like parkinsonism, cognitive impairment/dementia, depression and anxiety.
Hormonal Changes throughout life
Both estrogen and progesterone begin to decrease in the years leading up to menopause. These are the hormones that signal the process in the ovaries and uterus that lead to pregnancy.
Estrogen is one of the most common hormones in the body. It regulates the menstrual cycle and cholesterol levels, and is instrumental in the production of collagen and elastin. As it depletes, it shows as drier skin, more wrinkles and changes in skin tone. Inflammation can increase. It speeds the aging process, in other words.
Progesterone also decreases during menopause. It can affect the everyday functions of the body, and cause sleep loss and stress. It can lead to a change in libido (decrease or increase). Sexual activity itself seems to stimulate collagen.
The change in hormones can induce:
- Sleep loss (Insomnia)
- Dry skin
These, over time, work together to make us age faster. Doing things that calm anxiety and produce happiness can help slow the cycle.
The average monthly change in hormones gives us a little preview of the longer-term effects of lowered estrogen.
Estrogen levels start to increase as the period ends, peaking around day 12–14, ovulation occurs—the egg is ready for fertilization or release the egg travels down the fallopian tube, where it may or may not be fertilized.
There is a dip after ovulation followed by a spike in progesterone. If fertilization does not occur, both hormones then begin a slow decline until the final day of the cycle, around day 28, when bleeding begins.
Lots of women experience detectable emotional and physical changes through their cycle. If you start to notice fluctuations now, you will notice any changes, and have an idea of what to expect from menopause.
The period after menopause is when the symptoms start to stop and the system is regulating closer to normally again. Women are more subject to osteoporosis and heart disease after menopause. The aging process can seem to speed up.
Many women take hormone-replacement therapies (HRT), which provide estrogen and/or progesterone to balance out the hormonal changes associated with menopause. HRT therapies are associated with an increased risk of breast cancer, and so women who are at risk for it should consider the warning. All women on HRT are advised to be vigilant about breast cancer screenings. Estrogen and progesterone also feed tumors like fibroids, which typically end at menopause. Creams are considered safer than other types of HRT (pills, etc.) because they are delivered through the skin and don’t affect the liver.
Antidepressants (SNRIs like Effexor) have been slightly less effective than HRT for many women for reducing hot flashes. Antidepressants often have side effects to deal with, include sweating, which is unhelpful in the event of hot flashes. Antidepressants can also be effective for depression during menopause. However, the mood swings associated with menopause are not necessarily depression, and so it is worth looking into dealing with the hormonal (physical) symptoms first.
Also available are collagen boosters for a more topical solution to the problems of the skin as estrogen wanes.
For some women, the idea of taking hormone replacement therapy is a non-starter. Others will sing the praises of them all day long. It is a very individual choice, and we can only provide you as many of the unbiased facts as possible and to encourage you to make your own decision (along with trusted specialists).
Specific herbals, to be taken with advice of a doctor/herbalist:
[table “” not found /]
Sage (Salvia officinalis) hot flashes
Black cohosh (Actaea racemosa, Cimicifuga racemosa) hot flashes
Red clover (Trifolium pretense) estrogen mimic
Dong quai (Angelica Sinensis) blood tonic, balance hormones
Wild yam root (Dioscorea villosa) contains phytoestrogen
American skullcap (Scutellaria lateriflora) mood and anxiety
Motherwort (Leonurus cardiaca) menopause (various symptoms), PMS symptoms
Evening Primrose Oil breast pain, endometriosis, and menopausal symptoms[table “” not found /]
General tonics that can boost the mood and promote health and better moods are St. John’s Wort, Ginseng and Kava.
You hear a lot about the health risks associated with menopause, but also just as many women say it’s not a big deal aside from the physical changes being uncomfortable. There’s an associated aging process. The rate of aging increases as you age, which is why aging seems to proceed more rapidly each year—and bone loss is associated with the estrogen depletion of menopause as well.
There’s a natural process happening, regardless of how resistant to the “change of life” we may be. It’s like going through adolescence again, except in reverse. For some women the emotional and psychological underpinnings of this are strong, and medication can help to make symptoms more manageable. But it’s not always easy to separate out the emotional symptoms of hormonal changes and, say, the psychic impact of “being old” for women.
Some holistic or lifestyle changes to accommodate our “change of life” include:
- Moisturize skin regularly and avoid direct sun on the face, neck, and hands
- Use cool baths for the regulation of temperature, and dress lightly
- Take vitamin C to stimulate skin tone balance/fight aging spots
- Take herbal supplements (under guidance of a doctor or health coach)
- Eat a whole, healthy diet of unprocessed foods
- Try to catch up on loss of sleep with naps or meditation
- Find some ways to seek out information, and to vent with other women going through the same thing
- Consider any medications critically and use them only in need
Lots of women feel like they are going through this alone. Women’s sexual health might not be discussed in the family, and there is still a relative taboo on this topic. Lots of women struggle with it alone, dealing with the change of life, not knowing what’s happening. But once you get women talking, they have a lot to say about it!
It can be comforting (and humbling) to realize how powerful hormones are. You are going through changes, it’s easy to feel suddenly out of control, easy for others to think you’re exaggerating.
Women who feel like something is definitely off or wrong, describing themselves as “crazy” or “nutty,” will get blood work done telling them that they are normal or “within range.”
Nothing’s worse than going to a doctor and hearing, “It shouldn’t be bothering you that much.” It’s frustrating. That’s why you should arm yourself with your own research into the topic, avoiding making a decision based on others’ opinions.
Also with the “change of life” can come a new assertiveness. After coming out of it, having had to deal with all the ramifications of being post-fertile, many women report being happier, more even-keeled. They say things like, “I just stopped caring so much. I just started doing what I wanted to do.” They don’t have anyone to impress and their sex life can deepen and evolve again.
Maybe the nature of the emotional moods of menopause is not something we can control, so in time, we learn to accept it and find renewed energy in this.
Other Advice and Tips for further reading:
There’s tons of research out there for herbal supplements that mimic estrogen and progesterone and can be used in the treatment of symptoms of menopause. As with any medicine, plant medicines can be strong. Review optimal dosage, interactions with other herbs or medications, and side effects with a doctor or qualified healer or coach.