Do you really know why and how menopause happens?
- Dr Magdalena Cybulska
- Mar 24
- 2 min read
About menopause, I am...
0%Very knowledgeable
0%Fairly knowledgeable
0%Not very knowledgeable
0%Not at all knowledgeable
All your friends are talking about it.
Menopause is on the news, in magazines. Your sister asks if you considered treatment. She assumes:
“Come on, you just turned 50, surely you need hormones now?”
You answer something random and change the topic. You realise you are not actually quite clear on facts about menopause. A thought crosses your mind:
“Hmm. Maybe I will book an appointment with my doctor to finally crystallise my understanding?”
If you consider not knowing enough about menopause – you are not alone! According to 2022 IPSOS report, 28% of women in the UK also feel ‘not knowledgeable’ about this topic.
So let’s take a deep dive into the basics.
First and foremost – menopause is NOT a disease. It’s a normal, physiological process. Just like getting the very first period in your life, getting the last one is a part of being a healthy female.
Imagine a hypothetical lady called Jane. The time-span in which Jane can bear children is referred to as ‘reproductive life’, and of course does not last for her lifetime. It occurs for as long as she menstruates. During this time, if she is healthy and not on contraception, her ovaries will ‘ovulate’ approximately once a month – produce an egg cell which can get fertilised. If that happens – she becomes pregnant.
Sometime in her 40s, Jane’s ovaries start preparing to cease their function, and once they do – she will no longer be able to bear children. This time, when the ovaries still function, but not as regularly as previously – is referred to as ‘perimenopause’. It will last approximately 4-7 years. Importantly, Jane can still get pregnant during the perimenopause! As her ovaries slowly become less and less efficient, they produce less and less of the main female hormone: oestrogen. Jane can tell things have changed – at first her periods become not as regular as in the past. They can be more or less frequent, heavier of lighter – they just get more erratic and less predictable. As this happens, and Jane’s oestrogen levels decline, she might start experiencing so called ‘menopausal symptoms’. At this point she is still in her perimenopause and still has periods.
Eventually Jane stops having periods completely.
Menopause, by definition – starts with the last period in woman’s life. In the UK, the mean age of natural menopause is 51 years. Once Jane has been period-free for at least 1 year, she will finish her ‘perimenopause’ and become ‘post-menopausal’. At this point she can no longer get pregnant. Menopausal symptoms, caused by lowering levels of oestrogen, can persist from perimenopause into the post-menopause; this varies for different women, but is likely to last for many years. There is a myriad of possible symptoms, and every woman may be affected differently. These symptoms can be non-specific, and can sometimes be related to a disease and not menopausal transition – that's why they should be discussed with a doctor.
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