Menopause: What symptoms indicate that I am entering this stage?

Menopause is a stage in a woman's life that generally occurs between the ages of 45 and 55, with an average age of 51. During this period, there is a gradual decrease in the production of sex hormones (estrogens and progestogens) by the ovarian follicles. Many women believe this stage begins when their periods stop. However, these hormonal changes produce some classic symptoms before menstruation ceases. Our specialist explains them in detail. in Gynecology and Obstetrics and in Functional Medicine, Elisa Llurba, Professor at the Autonomous University of Barcelona and Medical Director of BeDona.

What are the stages of menopause?

1. The transition to menopause, or perimenopause, begins when we notice changes in our periods around this age.
2. Menopause. It is defined as 12 months having passed since the last menstrual period. A blood test is not necessary to confirm it, especially if you also have the symptoms described below.
3. Postmenopause. It is the stage after menopause.

How do hormones change during these stages?

Hormone levels in the blood fluctuate during these stages. The two hormones that signal the ovaries, FSH and LH, which are synthesized in a gland in the brain called the pituitary gland, may remain at normal levels or may begin to rise to try, for example, to compensate for an ovary that is beginning to fail. At this specific time, FSH will be higher. The increase in FSH will stimulate the last follicles in the ovary. This also increases estrogen levels, which can lead to irregular periods or cause symptoms such as bloating or breast tenderness. When estrogen production is finally exhausted, FSH and LH levels are very high, as they continue trying to stimulate the ovary.

6 symptoms that may make you think you are starting menopause even if you have periods

1. Irregular rules. The changes can be different for each woman. Some have more or less frequent periods, for others their period may last more or fewer days, some have more or less bleeding than usual, or some miss their period for 2 or more months.
2. Hot flashes. If you suddenly feel a rush of heat rising from your chest and spreading throughout your body for two to four minutes, you're likely experiencing a hot flash. You might also sweat, followed by a chilly feeling and cold sensations. It could also coincide with a racing heart (tachycardia), or a feeling of overwhelm or anxiety. They occur once or twice a day, sometimes several times throughout the day or night. For most women, it's a very unpleasant sensation that limits their activity, work, exercise, or sleep. Therefore, hot flashes significantly impact their quality of life. Hot flashes last between two and four years and can begin before menstruation ceases. What causes hot flashes? This is a question that still lacks a scientific answer.
3. Night sweats. These are due to night sweats. They often cause profuse sweating and can wake us up in the middle of the night. We wake up drenched in sweat and with a very unpleasant sensation, and then, as we cool down, we feel cold. These sweating episodes can occur several times in a single night, which partly explains the poor sleep quality and lack of rest. Not sleeping well results in other typical symptoms of this stage: fatigue, irritability, and lack of concentration.
4. Trouble sleeping. Regardless of whether or not we experience night sweats, it is also common for women to start noticing difficulty falling asleep or waking up in the middle of the night without being able to fall back asleep.
5. Vaginal dryness. The sexual organs, especially the vagina and urinary system, have many estrogen receptors. These substances keep the skin and mucous membranes strong and well-lubricated. But what happens when estrogen levels drop? The skin and mucous membranes thin and become weaker. This makes penetrative sex painful. It also causes imbalances in our immune system and vaginal flora. These new conditions increase the risk of urinary tract infections and yeast infections. This hormone deficiency also affects the other tissues of the pelvic floor, weakening them and making urinary and fecal incontinence, or organ prolapse (such as uterine prolapse), more likely.
6. Mood swings, information processing ability, anxiety, and depression. Given everything we've discussed so far, it's no wonder that women often feel unwell during this stage, with a greater tendency towards irritability or sadness. Our brains also undergo changes due to the lack of estrogen. This is why it's common to experience forgetfulness or difficulty concentrating on tasks. The decrease in hormones also directly impacts our libido, which, combined with changes in our intimate health, affects our sexual and romantic relationships.