Menopause: What is it? Everything you need to know about this natural stage of life.
Menopause: What is it? Everything you need to know about this natural stage of life.
Menopause represents a major transition in every woman's life, marking the end of her reproductive years. Yet, despite the fact that all women go through it, this stage remains surrounded by many questions, even taboos. Understanding what menopause truly is, its mechanisms, symptoms, and implications allows for a better understanding and a more peaceful experience of this period.
In France, 17.2 million women over the age of 45 are affected by menopause, and each year, 500,000 women gradually enter this new phase of their lives. This article offers a comprehensive guide to understanding everything about menopause: its precise definition, symptoms, age of onset, transition phases, and solutions to preserve your quality of life.
Definition: What is Menopause?
Menopause is the period in a woman's life marked by the cessation of ovulation and the permanent disappearance of menstruation. It is a natural physiological phenomenon that occurs when the ovaries stop producing hormones (estrogen and progesterone) and producing an egg each month. Natural reproduction is no longer possible.
From a medical standpoint, menopause is considered to have truly begun when a woman around the age of 50 has not had a period for twelve consecutive months. This retrospective definition means that it is only possible to identify a woman's last period after the fact, following a full year of amenorrhea.
The Biological Mechanism
At birth, the ovaries contain a reserve of approximately one million oocytes (or eggs), which naturally drops to 600,000 or 700,000 at the onset of puberty. Thereafter, their number decreases steadily with each menstrual cycle. Menopause is the period of life when this reserve is depleted, with fewer than 1,000 oocytes remaining in the ovaries.
This decrease in the follicular reserve is accompanied by a progressive decline in ovarian hormone production, leading to the cessation of menstruation and the end of fertility.
At What Age Does Menopause Occur?
The Average Age of Menopause
Menopause typically occurs between the ages of 45 and 55, with an average age of 50-51 in Western countries. This age is relatively stable and has varied little over the past few decades, unlike the age of puberty, which has decreased considerably.
Individual Variations
Several factors can influence the age at which menopause occurs:
Genetic factors : Heredity plays an important role. If your mother went through menopause early or late, you are more likely to follow a similar pattern.
Environmental factors : Smoking can advance the age of menopause by 1 to 2 years. Living at high altitude and malnutrition can also lead to earlier menopause.
Medical history : Certain conditions or treatments can influence the age of menopause.
Early and Late Menopause
Early or premature menopause refers to menopause that occurs naturally before the age of 40. This condition, which affects approximately 1% of women, is also called premature ovarian insufficiency or primary ovarian insufficiency. It requires specialized investigations and appropriate treatment.
Conversely, late menopause is defined as menopause that occurs naturally after age 55. This situation generally does not pose any particular problems but warrants regular medical monitoring.
Iatrogenic Menopause
Menopause can also be artificially induced through medical interventions: surgical removal of the ovaries, chemotherapy, pelvic radiation therapy. In these situations, it can occur at any age, and its effects are often more abrupt than a natural menopause.
The Different Phases of Menopause
Perimenopause: A Transition Phase
Perimenopause refers to the transition period leading up to menopause. This phase typically occurs 2 to 4 years before menopause, most often around the age of 47, but can extend over several years.
During this period, estrogen and progesterone production fluctuates. Hormone levels vary considerably from cycle to cycle, leading to changes in the menstrual cycle and the gradual onset of the first symptoms.
The characteristic signs of perimenopause include:
- Irregular periods (shorter or longer cycles)
- Variations in menstrual flow
- First hot flashes
- Sleep disorders
- Irritability and mood swings
- Premenstrual syndrome of varying intensity
This phase can be particularly confusing because symptoms fluctuate and periods may return after several months of absence. Pregnancy remains possible during perimenopause, hence the importance of maintaining contraception if you do not wish to conceive.
Menopause Proper
Menopause corresponds to the precise moment of the last menstrual period, identifiable retrospectively after 12 consecutive months without menstruation. It is the definitive turning point between the reproductive and post-reproductive periods.
Post-Menopause
This is the period following menopause, that is, the rest of one's life. During this phase, menopausal symptoms can persist for several years before gradually subsiding. Other symptoms, particularly genitourinary ones, may become more persistent.
Menopausal Symptoms: Understanding Climacteric Disorders
Not all women experience menopausal symptoms, and when they do, their impact on daily life varies greatly. Some women go through this period without significant discomfort, while others see their quality of life significantly affected.
The term "climacteric" (from the Greek meaning "step, stair") refers to the years of hormonal change that women experience around menopause. Climacteric symptoms encompass all the symptoms caused by a hormonal deficiency in estrogen and progesterone.
Hot Flashes and Night Sweats
Hot flashes are the most emblematic symptom of menopause. Present in 75 to 85% of women, they are characterized by a sudden and intense sensation of heat in the face, neck and chest, often accompanied by skin redness, sweating and sometimes palpitations.
These episodes typically last from 30 seconds to a few minutes and can occur several times an hour. They usually appear first at night (night sweats disrupting sleep), then during the day.
Several factors can trigger or worsen hot flashes:
- Spicy foods
- Hot drinks
- Alcohol and caffeine
- Ambient heat
- Stress and strong emotions
Hot flashes usually begin during perimenopause and can persist for an average of 7.4 years, or even more than 10 years in some women.
Sleep Disorders
Sleep disturbances affect many menopausal women. They manifest as difficulty falling asleep, frequent nighttime awakenings (often linked to night sweats) and non-restorative sleep.
These disorders can generate chronic fatigue which significantly impacts quality of life, concentration and mood.
Genitourinary Syndrome of Menopause
The decrease in estrogen leads to progressive atrophy of the genital and urinary mucous membranes, resulting in:
Vaginal dryness : The mucous membranes thin and produce less lubricating secretions. This dryness can cause itching, burning sensations, and make
Urinary disorders : Atrophy of urinary tissues promotes recurrent urinary tract infections, urgent urges to urinate, and sometimes stress urinary incontinence (during exertion, sneezing, or laughing).
These symptoms, unlike hot flashes, generally do not lessen over time and may even worsen without proper management.
Mood Disorders and Cognitive Function
Hormonal fluctuations can affect emotional balance and cognitive abilities:
- Increased irritability and anxiety
- Episodes of sadness or depressive state
- Difficulty concentrating
- Short-term memory problems
- Feeling of mental fog
These manifestations are partly linked to direct hormonal disturbances, but also to the indirect consequences of menopause, including fatigue due to sleep disorders.
Body Modifications
Weight gain : Menopause is often accompanied by an average weight gain of 2 to 4 kg, with a redistribution of fat towards the abdominal area. This metabolic change results from the hormonal decline and the slowing of the basal metabolic rate.
Skin changes : The skin becomes thinner, less elastic and drier. Wrinkles may deepen more quickly.
Joint and muscle pain : Many women report joint pain, especially upon waking, as well as muscle stiffness.
Changes in Libido
The drop in sex hormones can lead to a decrease in sexual desire in some women. However, this change is not always the case, and many women maintain a fulfilling sex life after menopause.
Long-Term Impact of Menopause
Beyond the immediate symptoms, prolonged hormonal deficiency increases certain health risks.
Cardiovascular Health
Before menopause, women are relatively protected from cardiovascular disease thanks to estrogen, which has a protective effect on the cardiovascular system. After menopause, this risk gradually increases to the same level as men.
Estrogens do indeed have beneficial effects on lipid profile, endothelial function, and blood pressure. Their disappearance alters these parameters and promotes atherosclerosis.
Bone Health
The decline in estrogen accelerates bone loss, increasing the risk of osteoporosis and fractures. In the years following menopause, women can lose up to 20% of their bone density.
The most concerning fractures are those of the femoral neck, vertebrae, and wrist. Osteoporosis generally causes no symptoms until a fracture occurs, hence the importance of active prevention.
Other Risks
Hormonal deficiency can also influence:
- The risk of dementia (although the data is still debated)
- Oral health
- Thyroid function
- Glucose metabolism
Experiencing Menopause Peacefully: Solutions and Support
Hormone Replacement Therapy (HRT) for Menopause
Hormone therapy for menopause, formerly known as hormone replacement therapy (HRT), consists of compensating for the hormonal deficiency by providing hormones similar to those naturally produced by the ovaries.
This treatment is particularly effective in relieving hot flashes, night sweats, vaginal dryness, and preventing osteoporosis. It can also improve sleep quality and mood.
Hormone replacement therapy (HRT) is not routinely prescribed and is prescribed individually after a healthcare professional has assessed the benefit-risk ratio. Contraindications include a history of breast cancer, active cardiovascular disease, and certain liver conditions.
Non-Hormonal Approaches
For women who cannot or do not wish to undergo hormone therapy, various alternatives exist:
Drug treatments : Some low-dose antidepressants, antiepileptics, or clonidine may reduce hot flashes.
Local treatments : Vaginal moisturizers and lubricants effectively relieve vaginal dryness without systemic effects. The Miyé brand offers excellent products.
Phytoestrogens : Some plants contain compounds with weak estrogenic activity (soybeans, red clover, raspberry buds). Their effectiveness remains moderate and varies from person to person. Consult a specialist if you are interested.
Lifestyle Changes
Adopting healthy lifestyle habits forms the basis of menopause management:
A balanced diet : Favor a diet rich in calcium and vitamin D (dairy products, oily fish, green vegetables), omega-3 fatty acids (oily fish, nuts, flax seeds), and antioxidants (colorful fruits and vegetables). Limit processed foods, salt, sugar, and saturated fats.
Regular physical activity : Exercise offers numerous benefits: weight maintenance, preservation of bone and muscle mass, improved mood, reduced hot flashes and cardiovascular risk. Aim for at least 150 minutes of moderate activity per week.
Stress management : Relaxation, meditation, yoga or heart coherence can alleviate symptoms and improve overall well-being.
Sleep quality : Maintain regular schedules, create a restful environment (cool, dark and quiet room), avoid screens before bedtime.
Quitting smoking : Smoking worsens menopausal symptoms and increases cardiovascular and bone risks.
Menopause and Intimate Life: Preserving Your Comfort
Menopause can impact your daily intimate comfort, but solutions exist to preserve your quality of life.
Managing Urinary Incontinence
Stress urinary incontinence affects many women after menopause. Pelvic floor rehabilitation, performed by a specialized physiotherapist or midwife, is the first-line treatment. It helps strengthen the pelvic floor muscles and significantly improve symptoms.
In addition, suitable incontinence products like Perdième period panties, specially designed for light incontinence, offer a discreet, comfortable, and eco-friendly solution. Unlike disposable products, they protect your skin from irritation and respect your privacy, allowing you to live your daily life with peace of mind.
Preserving one's sexual intimacy
Vaginal dryness doesn't have to be inevitable. Water-based or hyaluronic acid-based lubricants can make intercourse easier. Regular use of vaginal moisturizers helps maintain the hydration of the mucous membranes.
Local estrogen treatments, prescribed by your doctor, can effectively restore vaginal trophicity without significant systemic hormonal exposure.
Choosing the Right Underwear
During menopause, choosing your underwear becomes particularly important. Breathable fabrics like cotton or moisture-wicking technical fibers contribute to your comfort, especially in case of perspiration.
For women experiencing light urinary incontinence, Perdième underwear combines effective protection, elegance, and environmental responsibility. Their technical design ensures optimal absorption while maintaining a feeling of freshness and dryness.
Medical Monitoring During Menopause
Regular Consultations
Regular gynecological checkups remain essential during and after menopause. These consultations allow for the early detection of potential conditions, the adjustment of treatments, and the answering of your questions.
Recommended Exams
Several tests are recommended starting from menopause:
- Mammograms every 2 years as part of the organized breast cancer screening program
- Cervical-vaginal smear according to current recommendations
- Bone densitometry in cases of osteoporosis risk factors
- Lipid and glycemic profile
- Blood pressure monitoring
When to Consult?
Don't hesitate to seek prompt consultation if you experience:
- Bleeding after 12 months of amenorrhea
- Very debilitating symptoms impacting your quality of life
- Signs of depression
- Unusual pains
Menopause and Well-being: A Period of Transformation
Menopause is not an illness but a natural transition to a new phase of life. While it may be accompanied by discomfort for some women, it also marks the end of the constraints associated with menstruation and contraception.
Many women report a feeling of liberation and increased self-confidence after menopause. It is often a favorable time to refocus on one's aspirations, develop new projects, and cultivate well-being.
Breaking Taboos
Menopause remains too often a taboo subject, rendered invisible in society. Yet, talking about it openly with those around you, your friends, or healthcare professionals can help you cope better and find support.
More and more women are publicly sharing their experiences, helping to normalize this transition and inform future generations.
Stay informed and anticipate
Learning about menopause before it even occurs allows you to better understand it and adopt beneficial lifestyle habits early on. Anticipation is a valuable asset for navigating this transition smoothly.
Conclusion
Menopause is a natural physiological stage that affects all women, generally around the age of 50. It is characterized by the permanent cessation of menstruation and ovarian function, resulting in a deficiency of sex hormones.
While this transition is accompanied by symptoms that vary from woman to woman (hot flashes, sleep disturbances, vaginal dryness, mood changes), many solutions exist to preserve your quality of life: hormonal or non-hormonal treatments, lifestyle changes, psychological support and appropriate protection.
At Perdième, we understand the specific challenges of this period and offer innovative solutions for your intimate comfort. Our period panties designed for menopausal women support you every day with discretion, effectiveness, and elegance.
Menopause is not an end but a new beginning. Well-informed, well-supported, and well-equipped, you can navigate this transition smoothly and fully embrace this new phase of your life as a woman.
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