December 27, 2024, 4:14 pm | Read time: 4 minutes
Menopause can manifest itself through a variety of symptoms. STYLEBOOK explains the different phases and how women can recognize that menopause has begun.
Menopause and climacteric are often mistakenly used as synonyms. However, the climacteric should be understood as an umbrella term for this period, which includes menopause as one of its phases. Medically, the climacteric is divided into four phases: Premenopause, perimenopause, menopause, and postmenopause. “For those affected, however, the last three terms are more relevant,” explains gynecologist Dr. Christian Albring, MD, explaining the respective menopause symptoms.
As Dr. Katrin Schaudig, President of the German Menopause Society, emphasized at Bild‘s first Women’s Health Summit, the symptoms of menopause are often surprising: “I believe that many women have not even realized that there are so many complaints. This certainly also has to do with the fact that menopause is socially associated with getting older.”
Overview
Phase 1 of Menopause: Premenopause
Women are born with a certain number of follicles. These are partially “used up” every month in the course of menstruation. Premenopause begins when the reserve of follicles decreases. This is accompanied by a reduced production of estrogen and progesterone, resulting in a drop in fertility. Women who want to have children may find it a little more difficult at this point.
Cyclical Fluctuations and Other Possible Symptoms
At this point, menstrual cycles may already be altered in some cases. Possible symptoms include intermenstrual bleeding or unusually long or short periods. Premenopause can last from a few months to years and varies from woman to woman.
Phase 2: Perimenopause
Perimenopause usually begins in women in their mid to late 40s. It refers to the first years of the climacteric – the transition to menopause, which can also vary in length.
During perimenopause, the severity of cycle fluctuations generally increases as the production of sex hormones continues to decline. Typical symptoms of this phase of the climacteric are mood swings, sometimes sleep disorders, night sweats, and a feeling of tightness in the breasts. 85 percent of all women suffer from hot flashes.
Vaginal Dryness, Incontinence, Reduced Libido
The progressive hormonal decline changes the condition of the mucous membranes in many parts of the female body. In the genital area, this can manifest itself in vaginal dryness. This increases the susceptibility to injuries and can lead to itching and burning in the vagina. Libido decreases at this stage. Furthermore, the likelihood of bacterial infections increases due to pH value disturbances in the vaginal flora.
The breakdown of the mucous membrane in the abdomen often also affects the bladder. Because the female pelvic floor muscles also slacken with increasing age, urinary incontinence often sets in during the climacteric.
Phase 3: Menopause
Menopause marks the complete cessation of menstruation. This does not mean that there is no bleeding at all. As Dr. Albring explains, the ovaries still function partially, which means that oestradiol and progesterone are released irregularly. However, this is no longer a “period” in the original sense during this phase of the climacteric.
Typical Symptoms Are Sleep Disorders and Hot Flashes
Menopause causes some mild and some very severe symptoms in those affected, such as sleep disorders and hot flashes of varying severity. Some sufferers now lose their libido completely, and depressive moods are also not untypical.
Phase 4: Postmenopause
Around a year after the start of menopause, postmenopause sets in. In this phase, the symptoms and changes manifest themselves, and menstruation stops altogether. “If you do start bleeding again, the cause must be clarified,” warns Dr. Albring. This is because it is important to rule out a problem in the uterus.
Menopausal Symptoms Can Be Treated
Hormone replacement therapy is the most effective way of treating menopausal symptoms. This involves supplementing the sex hormones that the female body no longer produces in sufficient quantities. Estrogen gels for external application are commonly used here. Various gynecologists advocate such treatment, which is said to be particularly effective if it is started early. At the same time, it is repeatedly proclaimed that the intake of hormones can promote the development of cancer if there is a corresponding predisposition. Patients should be well informed by their doctor.
There are also hormone-free, but usually less effective, treatment options. Those affected are advised to eat a balanced, vitamin-rich diet. It is also advisable to take omega-3 fatty acids (e.g., as a dietary supplement, such as fish oil capsules). Avoid stress as much as possible and focus on sufficient exercise and muscle building to keep the body fit and provide the best possible protection against bone loss.
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Sources
- Menopausal symptoms / climacteric symptoms, Gynecologists on the Net
- with expert advice from Dr. med. Christian Albring, specialist in gynaecology