What is Menopause?

Menopause is a remarkable stage in our lives, symbolizing the moment when our menstrual cycles gracefully come to an end. It arrives as our ovaries gently retire, no longer producing those eggs, and our trusty hormonal companions—oestrogen, progesterone, and even testosterone—begin to take a bow. The official "menopause badge" is earned after enduring 12 consecutive months without the monthly visitor i.e. no menstrual period.

But let's be clear, Menopause isn't merely a biological event; it's a profound biopsychosocial transition. It signifies our journey from the reproductive phase to something entirely new. While aging is a natural part of the process, it often brings along a suitcase of symptoms that can impact our daily lives, work, relationships, and even our future health. Women entering the world of menopause face a heightened risk of conditions such as heart disease, osteoporosis, diabetes, clinical depression, and dementia. It's crucial to remember that menopause, in and of itself, is not a disease or an ailment; it's just the next beautiful chapter in our lives, and it's perfectly natural.

When does Menopause occur?

Now, let's talk timing. Menopause has a unique schedule for each of us, but on average, it makes its entrance at around 51 years of age. However, the menopausal journey is more like a meandering river, spanning up to a decade and starting as early as our late thirties or early forties. Those initial stages are affectionately known as perimenopause. It's during this time that our hormone levels gracefully bow out, making way for menopause, and, boy, do they bring some signs along for the ride. Oh, and don't forget, during perimenopause, our bodies can still play host to that rare guest, pregnancy, although the chances are generally very slim. Perimenopause can last for a few months or stretch out into several years, but it's worth noting that some of us might bypass this phase entirely and move right into menopause.

Sometimes, the curtain rises on menopause much earlier than anticipated. Roughly 1 percent of us women start this act before the age of 40, and it goes by the name "premature menopause" or "primary ovarian insufficiency." About 5 percent of us join the club between the ages of 40 and 45, earning the title of "early menopause." Signs of premature menopause might include a lighter flow, irregular periods, irritability, fatigue, and those famous hot flashes.

And what can prompt the early appearance of menopause? Well, it seems that a mix of genetic factors and our lifestyle choices can have a say in the matter. Some studies suggest that pollution, smoking, stress, and a lack of exercise might invite menopause to the party a bit earlier. Not to mention that chemotherapy, prior ovarian surgery, and even our ethnicity can influence the timing. Hispanic and African women often experience it a bit sooner, while Chinese and Japanese women may graciously delay the event compared to our Caucasian sisters.

Why do we go through Menopause?

As for why we go through menopause, the ovaries, those little hormonal factories, gradually reduce their production of estrogen and progesterone as we approach our late 30s. Our menstrual cycles might become unpredictable, with periods lasting longer or shorter, heavier or lighter, and more or less frequent. Eventually, around the age of 51 on average, the ovaries retire and stop releasing those eggs, marking the end of our periods.

But it's not just a natural course; sometimes, surgery takes center stage. If our ovaries are removed (oophorectomy), menopause arrives like a shooting star, bringing a sudden end to periods and unleashing a flurry of menopausal symptoms. In cases where only the uterus is removed (hysterectomy), without disturbing the ovaries, the menopause show may not start immediately. The ovaries continue to release eggs and produce hormones, maintaining the status quo.

For some of us, chemotherapy and radiation therapy may dictate the script. These treatments can induce menopause, accompanied by those hot flashes. However, it's worth noting that menstruation (and fertility) might not always bid us farewell after chemotherapy, so birth control could still be on the menu. Radiation therapy affects ovarian function only if it's directed at the ovaries themselves.

Now, let's talk about the rare and mysterious primary ovarian insufficiency, where roughly 1% of women experience menopause before age 40. It's like receiving an early invitation to the menopause ball. This condition results from our ovaries not producing the usual levels of reproductive hormones. Sometimes, genetics or autoimmune factors play a part, but often, there's no clear culprit. In such cases, hormone therapy is typically recommended, at least until the natural age of menopause, to safeguard our brain, heart, and bones.

Take away

Menopause is a journey that should be celebrated for its uniqueness and wisdom. It's not the end; it's the beginning of a new chapter. Embracing the knowledge and understanding of this transition allows us to navigate it with grace and well-being. After all, menopause is just one more beautiful thread in the rich tapestry of our lives.