How to recognise the menopause

There's no getting away from it: the menopause is a perfectly normal life change and every woman will experience it. Dr Lesley Hickin looks at the signs and symptoms.

Everyone reacts to the menopause in different ways, so you need to know what to expect in order to help yourself to stay healthy and happy and to know what treatment and lifestyle changes could be of benefit to you. The menopause is not something to fear - although some women dread reaching it, others look on it as a new lease on life physically, emotionally, sexually and spiritually.

What is the menopause?
The precise definition of the menopause is the time when your periods stop permanently, recognised retrospectively after an absence of periods for 12 months. This happens to most women between the age of 40 and 58, with an average age of 51.4 years. A few women reach their menopause in their thirties (before 40 this is called premature menopause and can be induced surgically or by drug treatment), and a smaller number don't reach menopause until they are 60.

When will it happen to me?
There are several things influencing the timing of the menopause in individual women. When your mother and grandmother went through their menopause influences the timing of yours. Factors influencing the possibility of an earlier menopause include having no children and being a smoker (smoking may make it happen two years earlier). Childhood treatment of cancer, with radiation to the pelvis or chemotherapy, may also bring on an early menopause.

What is the perimenopause?
During the years leading up to the time when your periods stop, you may notice changes occurring to your body. These carry on for some time after the menopause as well. So when we talk of 'going through the change of life' we are describing an ongoing process rather than a sudden event. This time is technically known as the perimenopause, and it usually lasts for about four years. The changes happen as the ovaries' production of oestrogen slows down, with hormone levels yo-yoing just as they did in adolescence.

It is not easy to diagnose the perimenopause using blood tests because your hormone levels can yo-yo about for several years before periods finish. After your last period there are two hormones commonly used to indicate that it has happened - LH and FSH. These are very high once oestrogen levels are low. Menopausal symptoms are caused by changes in levels of oestrogen, mainly produced by your ovaries but some is made in fatty tissue and the adrenal glands.