Perimenopause can start up to ten years before you enter menopause. Symptoms may gradually ease during menopause and post-menopause. Post-menopause begins once you have gone an entire year without menstruating.

The first thing to remember is that menopause is a normal and natural part of aging. As you enter your 40s, your body will likely produce less and less estrogen until you no longer menstruate. Once you stop menstruating and have had no periods for 12 months, you will have reached menopause.

Natural menopause, which happens without medical intervention, occurs in three stages:

• Perimenopause
• menopause
• Postmenopause

Many people confuse menopause with perimenopause. Perimenopause is the stage when a woman begins to transition into menopause. Some common symptoms of the perimenopausal phase include:

• Hot Flashes
• Night Sweats
• Vaginal Dryness

During perimenopause, your body begins to make less estrogen. This continues until the last one or two years of perimenopause until your hormone levels drop rapidly. Perimenopause can start up to 10 years before you enter menopause. It often begins in your 40s, but some women enter perimenopause in their 30s.

Doctors will determine that you’ve reached menopause when you haven’t had a period for 12 consecutive months. After that, you will enter the postmenopausal stage. If you’ve had your ovaries surgically removed, you’ll experience “sudden” menopause.

HOW LONG DO SYMPTOMS LAST?

Perimenopausal symptoms can last four years on average. The symptoms associated with this phase will gradually ease during menopause and postmenopause. Women who’ve gone an entire year without a period are considered postmenopausal.

Hot flashes, also known as hot flushes, are a common symptom of perimenopause. One study found that moderate to severe hot flashes could continue past perimenopause and last for around ten years, however, that’s longer than the generally accepted timeframe for the duration of hot flashes and would be very unusual.

Researchers also found that Black women and women of average weight experience hot flashes for a longer period than white women and women who are considered overweight.

PREMATURE MENOPAUSE

It’s possible for a woman to experience menopause before the age of 55. Early menopause occurs in women who go through menopause before they’re 45 years old. It’s considered premature menopause if you’re menopausal and are 40 years old or younger.

Early or premature menopause can happen for many reasons. Some women can go through early or premature menopause because of surgical intervention, like a hysterectomy. It can also happen if the ovaries are damaged by chemotherapy or other conditions and treatments.

IS IT MENOPAUSE?

If you are having symptoms that are common during menopause, your doctor may ask questions about your age, symptoms, and family history to determine if it really is the menopausal transition causing your problems.

In some cases, your doctor may suggest a blood test to check your follicle-stimulating hormone (FSH) and estradiol (E2) levels to rule out any other causes for the changes you're experiencing.

While the menopausal transition may commonly be referred to as "menopause," true menopause doesn't happen until one year after a woman’s final menstrual period. For that reason, a woman who does not want to get pregnant should continue to use birth control for at least a full 12 months after her last period.

After menopause, women enter postmenopause. Postmenopausal women are more vulnerable to heart disease and osteoporosis. During this time, it is important to continue to eat a healthy diet, be active, and make sure you get enough calcium for optimal bone health.

EARLY SIGNS OF MENOPAUSE

Estrogen is used by many parts of a woman’s body. As levels of estrogen decrease, you could have various symptoms. Many women experience mild symptoms that can be treated by lifestyle changes such as avoiding caffeine or carrying a portable fan.

Some women don’t require any treatment at all, but for others, symptoms can be more severe. The severity of symptoms varies greatly around the world and by race and ethnicity. Here are some of the first signs you may notice:

Period Changes 

The first sign of the menopause is usually a change in the normal pattern of your periods. You may start having either unusually light or heavy periods.

The frequency of your periods may also be affected. You may have one every two or three weeks, or you may not have one for months at a time. Eventually, you'll stop having periods altogether. These are all normal changes, but to make sure there isn’t a problem, see your doctor if:
• Your periods happen very close together.
• You have heavy bleeding.
• You have spotting.
• Your periods last more than a week.
• Your periods resume after no bleeding for more than a year.

Hot Flashes

Many women have hot flashes, which can last for many years after menopause.

They may be related to changing estrogen levels. A hot flash is a sudden feeling of heat in the upper part or all of your body. Your face and neck may become flushed. Red blotches may appear on your chest, back, and arms and heavy sweating and cold shivering can follow.

Hot flashes can be very mild or strong enough to wake you up (called night sweats). Most hot flashes last between 30 seconds and 10 minutes. They can happen several times an hour, a few times a day, or just once or twice a week.

Bladder Control

A loss of bladder control is called incontinence. You may have a sudden urge to urinate, or urine may leak during exercise, sneezing, or laughing. The first step in treating incontinence is to see a doctor. Bladder infections also can occur in midlife.

Sleep

Around midlife, some women start having trouble getting a good night’s sleep. Maybe you can’t fall asleep easily, or you wake too early. Night sweats might wake you up. And if you wake up during the night, you might have trouble falling back to sleep.

Vaginal Health and Sexuality

After menopause, the vagina may become drier, which can make sexual intercourse uncomfortable.

You may also find that your feelings about sex are changing. You could be less interested, or you could feel freer and sexier because after one full year without a period, you can no longer become pregnant.

Mood Changes

You might feel moodier or more irritable around the time of menopause. Scientists don’t know why this happens.

It’s possible that stress, family changes such as growing children or aging parents, a history of depression, or feeling tired could be causing these mood changes. Talk with your doctor or a mental health professional about what you’re experiencing. There are treatments available to help.

Your body seems different

Your waist could get larger. You could lose muscle and gain fat. Your skin could become thinner. You might have memory problems, and your joints and muscles could feel stiff and achy. Researchers are exploring such changes and how they relate to hormones and growing older.

In addition, for some women, symptoms may include aches and pains, headaches, and heart palpitations.

Speak to a doctor

Follow up with a doctor if you start to experience menopausal signs and symptoms as sometimes, they can indicate an underlying health problem.

Menopausal symptoms may be caused by changing hormone levels, it is unpredictable how often women will experience symptoms and how severe they will be.

TREATING MENOPAUSE, WHATS RIGHT FOR ME? 

Deciding whether and how to treat the symptoms of menopausal transition can be complicated and personal. Discuss your symptoms, family and medical history, and preferences with your doctor and those you feel close to.

Every woman’s menopause journey is different, and every woman will have their own experience of the menopause and a differing range of symptoms. If you’re lucky, you may go through this period in your life with little to no symptoms however, others may really suffer, experiencing all the symptoms for quite some time.

This coupled with the fact there has been huge access and shortage issues, there’s been a huge shift away from the traditional HRT treatments that many women have been prescribed for decades to deal with menopause symptoms.

There are some positives though, this ‘menopause awakening’ has triggered a wave of new menopause products and services specially designed to help ease the transition during menopause and help manage the symptoms.

And with so women now more conscious than ever of their own health, many of these products and services are taking a much more natural and holistic approach to female health including the use of CBD oil, which is thought to help improve many, or even most, of the most common menopause signs.