Every woman will experience menopause – but your experience of menopause is unique to you, which is the main reason why there’s so much confusion about symptoms and treatment.
Put simply, menopause refers to the time when you stop having periods and can no longer get pregnant naturally. This occurs because your ovaries stop producing eggs and, as a result, levels of the hormones they produce (oestrogen, progesterone and testosterone) fall.
Although many of us use the word ‘menopause’ to describe the period of time when we notice our periods begin to change and we experience typical menopause symptoms, it actually refers to a single day: when you haven’t had a period for 12 months in a row.
The average age of menopause for women in the UK is 51, but there’s a lot of variation, so your menopause may happen sooner or later than this.
Early menopause
If you reach menopause before the age of 45, this is known as ‘early menopause’. In women under 40 this is sometimes referred to as Premature Ovarian Insufficiency (POI). Some women have POI without realising, so it’s important to check with your doctor if you’re under 40 and have irregular or infrequent periods.
POI or early menopause can be triggered by surgery involving the ovaries, treatment for cancer, such as chemotherapy and radiotherapy, an underlying condition such as Addison’s disease or Down’s Syndrome, or an autoimmune disease like type 1 diabetes.
Surgical menopause
If you’ve had a hysterectomy (an operation to remove your womb), you might have had your ovaries removed at the same time. If this happens, you’ll immediately reach menopause. This is known as surgical menopause, and can happen to women of any age.
What is perimenopause?
For most women, the menopause doesn’t happen overnight. This is because, unless you’ve had a surgical menopause, your ovaries don’t suddenly stop working. Instead, they gradually slow down over a period of time as part of the natural menopause. This transition period leading up to the menopause is known as the perimenopause, and it can last for a few months or several years – the average is around four years.
During the perimenopause, you may notice that your periods get lighter or irregular, and you might also experience symptoms including hot flushes, mood swings, brain fog and fatigue. It’s common to start noticing these changes around the age of 45, but you might notice them earlier or later. Don’t be surprised if it takes you a while to realise what’s happening – it’s easy to ignore these symptoms and put them down to the everyday stresses of your busy life.
If you are over 45 and have noticed changes to your periods, and are experiencing symptoms such as hot flushes, night sweats, mood changes, poor sleep or brain fog, your doctor should be able to diagnose the perimenopause without the need for any tests.