The menopause is a natural process that every woman undergoes at some time after the age of 40. From a woman’s first period, her body is set up to have children. The sex hormone oestrogen plays an important role here. However, during menopause, the production of this hormone by the ovaries greatly decreases. The ovaries slowly decrease in size. During menopause, a new hormone balance is established, which for many women may be associated with a variety of symptoms.
What actually is the menopause?
The menopause can be divided into a number of stages relating to the pattern of menstruation. These are based on averages and the age limits vary from one woman to another.
The first stage comprises the premenopause, which most women notice as a change in the pattern of menstruation. Periods remain regular but are in general shorter and often heavier. As the premenopause progresses, the menstrual cycle becomes more irregular and there are longer intervals between menstrual bleeding.
A new stage was recently added called the perimenopause, which covers the late part of the premenopause (> 45 years) through to 1 year after the menopause. During this stage, most women experience typical menopausal symptoms in addition to changes in menstruation.
The menopause is the time at which the last period takes place. This moment can only be determinated after the event, when no menstruation has occurred for 1 year. In the Netherlands, the average age of menopause is 51 years. Ninety percent of 56-year-olds have already undergone the menopause and their fertile years are over.
This is the stage at which no further menstruation occurs. For the first 5 years, the ovaries are still slightly active. Typical menopausal symptoms such as hot flushes, perspiration, etc. subside during the late postmenopause, but vaginal symptoms often persist. The late postmenopause actually refers to the rest of the woman’s life.