Ahh, the menopause journey. No clear starting or ending point, odd diversions, and an estimated time of arrival that could span years. Menopause is certainly a trip. And needless to say, you could use some turn-by-turn directions.
First Point of Interest: Perimenopause
Ready, set, perimenopause. In this phase, your body will start providing helpful physical clues that the menopause process is starting. And it can still be years before your last menstrual period.
Some common, normal signs include irregular periods, hot flashes, vaginal dryness, sleep disturbances, and mood swings—all results of unevenly changing levels of ovarian hormones (estrogen) in your body. Read more about
how you'll know you're near menopause.
Pit Stop: Check your Contraception Options
Trip Tip: In perimenopause, there is still a slight chance you could become pregnant. So if you’d rather not go down that road, birth control is recommended until one year after your last period. Five effective options for midlife women include:
- Birth control pills, patches, or rings—added benefits include regular cycles and decreased bleeding, hot flashes and ovarian/uterine cancer risk.
- Progestin-alone pills, implants and injections—an option for those with a history of certain cancers, heart disease, high blood pressure, diabetes, blood clots, obesity, and smoking.
- Intrauterine devices with or without hormones—safe, highly effective, convenient, and long-term.
- Sterilization (Tubal ligation, fallopian tube inserts, or vasectomy for men)—low risk, effective, and permanent.
- Barrier methods (condoms, diaphragm, spermicide)—condoms are the only method than provides some protection from HIV and other sexually transmitted infections.
Detour: Primary Ovarian Insufficiency (POI)
One way to get to menopause earlier than usual is a condition called POI. With POI, younger women (under 40) have no or only occasional periods and elevated FSH levels, which signify fewer eggs in their ovaries. Some women with POI may have typical menopause-related symptoms, others may not.
Trip Tip: POI means lower estrogen levels, which means negative effects on your bone density and possibly your brain and sexual function. Timely diagnosis is key. So if this sounds like you, the next stop should be your healthcare provider.
Arriving at Destination: Natural Menopause
And here we are—natural menopause, the spontaneous, permanent ending of menstruation that is not caused by any medical treatment. Menopause is a normal, natural event. It’s defined as the final menstrual period and is confirmed when a woman has not had her period for 12 consecutive months.
Women in North America will likely experience natural menopause between ages 40 and 58, averaging around age 51. Some women, however, reach this phase in their 30s, others in their 60s. Typically, women reach menopause around the same age as their mothers and sisters.
Trip Tip: Smokers may get there about two years earlier than nonsmokers, while race, age at first period, use of birth control pills or fertility medications do not seem to be determining factors.
Recalculating: Postmenopause
The final stop along our midlife tour is postmenopause. This phase includes all the time after menopause, and still manages to muster up a surprise or two. Due to the continued decrease in estrogen levels during this time, symptoms like vaginal dryness and hot flashes may linger.
Trip Tip: Lower hormone levels also increase your risk for related diseases like osteoporosis.
Enjoy the Ride
Signs. Symptoms. Stops. Starts. Yep. This menopause tour is unique for every woman. So for all the where-the-heck-am-I moments along the way, stop by your menopause navigation station at
www.menopause.org. Ready for a trip to class? Enroll in
Menopause 101.