Menopause - Where the Story Starts
There is a classic book published in 1994 by Dr Miriam Stoppard all about menopause. It’s acomplete manual of how to navigate midlife and the hormone shift known as Menopause.
Pop the word ‘menopause’ into Amazon and you get over 10000 results! There are gadgets and gizmos galore, shakes, plans and programs to reset and balance your hormones - or my favourite misdirection “get to the root cause”.
The upcoming ‘menopause industry’ is said to be worth £5 billion. Despite the many ways the topic sits right in front of us everyday within books, magazines, workplace talks and on TV there is still an immense amount of confusion as to what menopause is. Let’s break it down in to simple terms and demystify this 24 hour paradox that occurs in a person with a uterus and ovaries.
There are a total of 4 key hormone shifts in a typical* hormone timeline from birth to death;
2. Periods (menarche)
3. Perimenopause (menopausal transition)
4. Postmenopause (after the final menstrual period)
[There is a 5th optional shift called pregnancy.]
*typical refers to the kind of menopause transition that the majority of menstruators will
Our first menstrual period is on average age 11. We are pre-programmed to experience 420-450
periods over 40 years. The first 30 years the periods are regular and defined as the time when we can ‘predict our fertility’. The following 10 years the periods move to an irregular pattern when we can ‘no longer predict our fertility’. By the age of 51 on average periods stop completely and we are said to have reached menopause (the pause of our menses).
This biological timeline is a fact and not a myth. So what is the menopause mystery?
You may notice that ‘menopause’ is not on the list above. Periods start at puberty and end on
menopause day. Medically defined, menopause is the day you have gone 12 consecutive months
without a period. As such it doesn’t qualify for the hormone shift status, because menopause itself is only 24 hours. It is the day we mark the end of menstruation. The day before this you are termed perimenopausal, the day after you are postmenopause. This is where we get the phrase “going through the menopause”. You go through the point in time from periods to no periods. It sounds simple, but here is where the confusion comes in. We can’t record that day until it’s gone.
What I mean to say is that Menopause Day is retrospective - we can only name it 12 months after it has happened! In addition the hormone shift or transition that occurs to reach our final menstrual period can take several years. It is the shift in hormone levels that can create signs and symptoms (whether you notice them or not is a completely different story). There are over 34 symptoms which can be divided into physical and psychological. If you don’t notice them is it because you don’t know what they are?
What we are not told about the hormone shifts and in particular periods, is that the hormones that circulate from the ovaries during the menstrual cycle are vital to every system in our bodies at a cellular level. They are not exclusive to the anatomy below our belly button. The ovaries speak to the brain, and the brain speaks back to the ovaries, every single day. This means that every menstrual cycle is a whole mind-body experience and likewise menopause transition, but more importantly post-menopause.
We just spent 50 years with a rich supply of essential hormones feeding every part of the body, to then reach a point of hormonal decline for the rest of our lives. The process of periods to no periods is not optional. It is what our bodies are designed to do. Yet we rarely have personal knowledge of what these hormone shifts are going to feel like, nor the physical and mental changes that will occur. Under the age of 35 we probably don’t give this hormone shift a second thought. Past this point we are not prepared for the move from periods to no periods.
Health Issues Post-Menopause
Did you know that the level of hormones post-menopause places women at higher risk than men of developing the following conditions? They are;
Type 2 Diabetes
Statistics from Alzheimer’s Research UK tell us one million people in the UK will have dementia by 2025 and this will increase to two million by 2050. 15.9% of women died due to Alzheimer’s disease and other dementias in 2019 in the UK. It was the leading cause of death for women. What's more, women are 2.3 times more likely to provide care for someone with dementia for over 5 years.
As for Osteoporosis, the British Menopause Society states this condition "is becoming an increasing burden to the health service both in financial and human terms with one in three women over 50 years suffering a fragility fracture. One in six women will have a hip fracture and, of these, 20% will die within one month, 30% within one year and over 50% will no longer be able to live independently.”