The menopause is a phase that only humans, orcas and pilot whales go through, but what really happens to the body and mind when hormones dip and periods stop? Find out more here about this important stage of life.
What is the menopause?
The menopause, climacteric or the change of life – all describe the stage surrounding the last period that marks the end of a woman’s fertility. It is divided into four phases:
Pre menopause – the stage with regular periods before any change sets in.
Perimenopause – the stage around the last period, often characterized by irregular periods.
Menopause – periods stop. The menopause is defined as beginning a year after the last period.
Post menopause – the stage from the last period and the rest of a woman’s life.
As the body ages, the ovaries stop producing the hormones required for a period. As long as the ovaries maintain the level of estrogen in the blood, you avoid the discomfort associated with menopause.
Periods stop in different ways. For some women, symptoms start while they are still bleeding. For others, they start when periods stop. Some women skip bleeds and then have regular periods again. Others stop bleeding from one day to the next. Whether it happens gradually or stops from one day to the next, over time the ovaries will stop producing sufficient amounts of estrogen.
This is when the signs start. The list of menopause-related symptoms is long: insomnia, hot flushes, weight gain, mood swings, dry mucous membranes, reduced libido, lack of energy, headaches and joint pains are some of the most common.
What is happening in the body?
Your bodily functions are regulated by hormones that send signals around the body. When the hormonal composition changes, a range of mild or severe symptoms of discomfort, physical as well as mental, can be felt until the body finds a new balance. When we talk about hormones and the changes taking place during menopause, the body is often compared to an orchestra in which every musician has a role and all the instruments a voice. When an instrument is lost, it may take some time for the orchestra to re-establish its melody.
The hormones that play the greatest role during menopause are:
Estrogen – the female sex hormone that is produced in the ovaries and helps to prepare for ovulation and building up the mucous membrane in the uterus to allow the fertilized egg to implant.
Testosterone – is known as the male sex hormone. It is also produced in the ovaries, but at a significantly lower volume. This is the hormone that controls the libido. This hormone level is at its highest in our 20s and is halved by our 50s.
Progesterone – is the hormone that controls our periods. When estrogen levels are at their highest and ovulation occurs, progesterone prepares the mucous membrane for receiving the fertilized egg by making it thicker. If no fertilized egg comes along, progesterone levels fall and the cycle starts all over again.
Hormonally, it is mainly the lack of estrogen that brings on the familiar symptoms of menopause, but testosterone also plays a role. As the production of female sex hormones decreases significantly, the imbalance between hormones also brings imbalance elsewhere in the body. Both progesterone and estrogen are mainly produced in the ovaries and, in addition to affecting the development of breasts, pubic hair, pregnancy and menstrual cycle, they also bolster the muscles, skin elasticity, connective tissue and mucous membranes.
Estrogen protects against a range of diseases. So when hormone production falls, the risk of cardiovascular disease, osteoporosis and diabetes increases. The increased risk of disease can be reduced with treatment which may also alleviate serious menopausal discomfort. Thanks to recent research, effective treatment options are available – you need to talk to your gynecologist or doctor about which would be most suitable for you.
Many women find that they can eliminate the worst of these problems by changing their eating habits to a greener, more fiber- and protein-rich diet with whole ingredients, vegetables, legumes, fatty fish and poultry – preferably combined with regular exercise and strength training, which also maintains muscle mass. It may not be enough for you, but all the research shows – menopause or not – that all this benefits your mood and general well-being.
How many years does menopause last?
The average age for women entering menopause is 52. For most women, menopause occurs between the ages of 45 and 55. Some women experience early menopause, already at 40 or even earlier. The start of menopause is partially down to genetics so it may be a good idea to ask your mother or sister when she started her menopause.
Menopause lasts for an extended period of about ten years. Sometimes longer – and sometimes shorter. Many women can now expect to live for about 30 years, or a third of their life, after their last period.
Men also experience a minor menopause at about 40 when their testosterone levels fall. This results in muscle and hair loss but can also lead to more serious problems such as insomnia, depression, reduced energy and erectile dysfunction.
Is menopause still taboo?
Many women hardly know anything, or at best very little, about menopause until they wake up one day in a sweat and feel that something has changed.
We are good at talking about puberty, the first period, the difficulties of giving birth, ‘mummy brain’ and saggy belly skin, but many keep their mid-life transition – with all its physical and psychological changes – to themselves.
It does not need to be like this. We cannot spend our whole life chasing an ideal of youth. Although changes are often horrible, they are unavoidable. This does not necessarily make things easier, but if we become better at talking about it and our experiences, we can help each other to feel understood and supported.
Sources: Gynækolog Helena Enger, Hetetokter og kalde fakta, frisk 2020, Anne Hjernøe, Stærk overgang, Politikens Forlag, 2022.