Menopause Definitions: (peri)menopause
Despite so much information about menopause being available online, in magazines, and on other media, I’m always surprised when I give workshops and find that women are still confused about menopause definitions .
We can’t play a game properly if we don’t know the rules, and today’s blog post focuses on definitions about menopause, so when we talk or read about menopause we know what the terms mean and are able to understand the information better.
To start with, I and many other menopause experts tend to use the words menopause, menopause change, menopause transition, and even perimenopause interchangeably—but each has a specific meaning.
Let’s start with menopause.
What is menopause?
All women will go through menopause if they live long enough and for most it is a normal and natural event.
Menopause is the end of ovarian function, that means the ovaries stop producing eggs, ovulation stops, and consequently periods stop as well. Menopause is the end of ovulation, menstruation, and fertility. The word menopause literally means the end (pause) of menses, the plural Latin for what we medically call menstrual flow.
How do you know when you are in menopause? How do you know it was the last period? Menopause is confirmed when you haven’t had a period for 12 consecutive months.
If you are experiencing irregular periods and want to track them to determine when you reach menopause then I suggest you download or print the Menstrual Calendar. When you haven’t bled for 12 months in a row you’ve reached menopause. Congratulations! Celebrate this milestone! I can help you throw a Menopause Party!
Menopause usually happens between 40 and 60 years of age, and the average age of menopause in North America is 52. Smokers may experience menopause a few years earlier.
Some women may experience early menopause, before 40 years old.
Induced menopause occurs when a woman undergoes removal of both ovaries and/or chemotherapy and radiation treatments for certain types of cancer that damage the ovaries. Women who experience induced menopause usually experience more severe symptoms due to the very sudden drop in estrogen levels.
A hysterectomy, removal of the uterus without removal of the ovaries, doesn’t cause menopause but the ovaries may end the production of estrogen 2-3 years earlier than usual. Because a woman without a uterus no longer has menstrual bleeding she’s not able to judge if she’s in menopause based on bleeding patterns. For these women other symptoms of hormonal change and decline plus blood tests may be necessary to determine menopause. Otherwise blood tests aren’t necessary or recommended to determine if a woman is in menopause.
What is perimenopause?
Perimenopause is the years leading up to menopause (cessation of periods) and may start in the 30s or 40s. It’s impossible to predict how long perimenopause will last, usually 4-8 years. I also like to refer to perimenopause as the menopause transition because it is a journey.
Most women have regular menstrual cycles, they bleed every 24-31 days and when estrogen production by the ovaries starts fluctuating the time between periods changes and women experience longer or shorter cycles. This is usually the first change noticed in perimenopause.
Women may also experience changes in flow, bleed more heavily or more lightly, have spotting, or miss periods. This unpredictability upsets and frustrates many women. Not knowing when the next period is going to come, when or if ovulation is going to occur, and experiencing spotting can be annoying and upsetting. I jokingly say that if a women in perimenopause wants to know when her next period will come all she has to do is book a beach vacation…!
Women who are sexually active and who do not wish to get pregnant must use a method of birth control until 12 months after the last period – some experts suggest 24 months because ovulation is unpredictable during perimenopause but may happen.
What is postmenopause?
Postmenopause are the years after menopause is confirmed. Since menopause is confirmed 12 months after the last menstrual period, the day after that, and till their death, women are in postmenopause. With the population aging and women living well past their 80s, many women spent one-third of their lives in postmenopause.
It’s important to understand the protective effect of estrogen against diseases like stroke and heart attack, osteoporosis, and diabetes to help us make healthy lifestyle choices to ensure healthy aging and prevent disease. I’ll be writing about this in a future blog.
I hope I made things clearer than mud!
Now we can talk about this topic and know exactly what we mean when we use words like menopause, menopause transition, perimenopause, and postmenopause. Let’s talk about menopause!
There’s help. I can help you!
Teresa Isabel Dias is a pharmacist and Certified Menopause Practitioner (NCMP) who provides education and support on symptom management for women at work and at home so they’ll feel like themselves again and enjoy a vibrant and productive life.
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