Menopause age corresponds to the end of the reproductive period of the woman, usually around the age of 50 years. It is marked by the cessation of menstruation and by the cessation of ovulation and ovarian secretion of the sex hormones (estrogens and progesterone). Medically speaking, it is known that a woman is menopausal when she has not had menstruation for 12 consecutive months. Nevertheless, the onset of menopause, that is, the permanent cessation of menstruation, is at the beginning of these 12 months. It can, therefore, only be established retrospectively.
The period from two to seven years preceding menopause is called perimenopause (and not premenopause). Ovulation becomes more irregular. The estrogen level can vary greatly. It is during these transitional years that menstrual irregularities and uncomfortable symptoms appear: hot flushes, sleep disturbances, mood swings, etc. Some use the term postmenopause to describe the period following menopause, which is not entirely appropriate since menopause is a definitive state. A woman said, “menopausal.” The intensity of the symptoms varies from one woman to another: some have no symptoms other than cessation of menstruation. In contrast, others have symptoms of moderate to severe intensity (20 to 30% women).
Note: After menopause, even if the ovaries do not secrete estrogens, the adrenal glands and adipose tissue (fat stores) continue to release small amounts of estrogens.
The symptoms of menopause
Symptoms are usually more pronounced during perimenopause. These symptoms are related to the hormonal changes that occur during this transition period, and also to aging. They manifest themselves unpredictably and vary significantly from month to month.
- Irregular menstruation
They are a frequent manifestation of the hormonal instability that occurs during perimenopause.
Hot flushes and night sweats
Hot flushes are usually first felt in the abdomen or thorax. The heat rises in seconds to the neck and face.
Their duration varies from a few seconds to a few minutes. Their frequency and intensity are very variable from one woman to another. They are sometimes accompanied by palpitations and sweating. 50 to 80% of women feel it. Hot flushes are the main reason for women to consult a health professional at menopause.
Characterized by strong sweating throughout the body, they occur at night and can interrupt sleep. The important thing is to consider whether hot flushes and night sweat adversely affect the quality of life to require treatment.
Sleep problems are a prevalent cause of complaint during this period of transition. In general, with age, nights are shorter, and the quality of sleep tends to be less good. Hormonal changes can also affect sleep. For example, difficulty falling asleep and frequent awakening during the night is usually related to hot flushes and night sweats. These sleep disorders can cause significant fatigue, irritability, mood disorders, and difficulty concentrating.
Although it remains controversial, the period before menopause appears a period of greater emotional vulnerability. Irritability, tendency to cry more often, mood changes, anxiety, and lack of motivation or energy are the most commonly reported discomforts during this period of life. Women who suffered from depression before menopause also sometimes see their symptoms worsen.
Sexual desire is a complex human phenomenon that, on the hormonal level, depends mainly on sex hormones: estrogens and androgens (testosterone and dehydroepiandrosterone or DHEA). According to the results of an extensive study on women at menopause, libido and sexual arousal tend to decrease over the years. For more information about sexuality with age, see our Sexuality section.
Dryness of the mucous membranes
Stopping estrogen secretion by the ovaries decreases the production of mucus in the vagina and bladder—this decrease in production results in drying and thinning of the mucous membranes. Besides, the vaginal secretions change: they become more aqueous and more alkaline (less acidic). More than half of postmenopausal women experience discomforts related to vaginal dryness. These discomforts include itching, burning sensation in the vagina, and vulva, and pain during sexual intercourse. This dryness of the mucous membranes presents no health risks. There are solutions to relieve the discomfort it causes.
Aging of the skin, drier hair
Skin tends to become drier, and wrinkles, more pronounced. The hair grows drier and fragile. Indeed, the decrease in estrogen leads to a reduction in the production of collagen and elastin. These two substances play an essential role in the elasticity of the skin, as well as in its tone. However, the leading causes of the appearance of wrinkles remain time (aging) and cumulative exposure to the sun. Also, other factors may affect the appearance of the skin and hair, such as a slowing down of thyroid activity (hypothyroidism). The situation must, therefore, be assessed globally. See our Skin Aging and Dry Skin sheets.
Slight weight gain
Women who take 2 to 4 kg (5 to 10 pounds) at menopause would stay healthy longer and survive longer than those who do not gain weight, lose or take more weight. Fat cells transform adrenal hormones into female hormones. A slight weight gain, because it alleviates the hormonal decline of menopause, seems beneficial for health.
Menopause Age: People at risk
Factors that may influence the intensity of menopausal symptoms:
- Cultural factors: The severity of the symptoms depends very much on the conditions in which the menopause occurs. In North America, for example, nearly 80% of women have symptoms at the onset of menopause, especially hot flushes. In Asia, it is barely 20%. These differences are explained by two factors, characteristics of Asia: abundant consumption of soy products (soy), a food with a high phytoestrogen content, and a change in status leading to a valuation of the role of the older woman for her experience and wisdom.
Genetic factors do not appear to be involved, as studies of immigrant populations have shown.
- Psychological Factors: Menopause occurs at a time of life that often involves other changes: early departure, early retirement, etc. Moreover, the end of the possibility of giving birth (even though most women have given up this age) is a psychological factor that confronts women with aging and, therefore, with death. The state of mind of these changes influences the intensity of the symptoms.
- Other factors: Lack of exercise, sedentary lifestyle, and poor diet
Note: The age at which menopause occurs is partly hereditary.
Menopause Age: Prevention
Menopause is the result of natural evolution. Nevertheless, studies across the world show that differences in lifestyle, diet, and physical activity can influence the intensity and type of symptoms experienced by women during menopause. Generally speaking, every chance will be taken by adopting the following preventive measures before age 50, especially during the quarantine.
- Focus on foods that promote healthy bones and the heart: rich in calcium, vitamin D, magnesium, phosphorus, boron, silica, vitamin K and essential fatty acids (omega-3 in particular), but Low in saturated fat, and providing vegetable protein instead of animal protein.
- Eating foods rich in phytoestrogens (soy, linseed, chickpeas, onions, etc.)
- If necessary, take calcium and vitamin D supplements.
- Practice regular physical activity that makes the heart and joints work, as well as exercises of flexibility and balance
- Cultivate a positive attitude towards life
- Stay sexually active
- Practice Kegel exercises, both to combat urinary stress incontinence and to improve sexual life by increasing the tone of the vaginal muscles
- No smoking: In addition to harming the bones and heart, tobacco destroys estrogen.
In addition, as explained above, women, not because they are menopausal, but mostly because they are older, are at greater risk of having osteoporosis, cardiovascular disease, endometrium, and breast cancer. Care should be taken to apply the preventive measures associated with these diseases.