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All About Menopause

Menopause means the time when you have your last period. Menopause symptoms can start several years before the end of menstruation. In the below Sisko shares with you all about menopause.

Have you talked about menopause with your mother and friends? Have you found good and neutral information about menopause and the symptoms have not been hidden and ashamed?

If not, you’re not alone. Menopause is talked about much more than before, but there is still quite a lack of information. Hot flashes and the end of menstruation are talked about, but more comprehensive information about how menopause affects the well-being of the whole body and the mind is usually not talked about enough.

What is menopause and perimenopause?

Menopause usually occurs between the ages of 42 and 57. The first symptom of approaching menopause is a shortened menstrual cycle. However, there can be many kinds of symptoms and they are not always recognized as menopause symptoms.

Perimenopause refers to the years before menopause when you begin to have symptoms. Menopause, on the other hand, is the one moment in time when menstruation stops. This time can only be determined in retrospect, but perimenopause can be recognized by the symptoms even before this. Menstruation usually stops between the ages of 42 and 57.

Oestrogen production in the ovaries decreases little by little over several years. The egg cells in the ovaries decrease and thus the secretion of oestrogen decreases and almost stops at the time of the last period. With that, the hormonal balance in the body changes.

Important hormones in menopause are oestrogen and progesterone, i.e. the yellow gland hormone. In addition, testosterone is also important in women and other people with vulvas as part of overall well-being.

Am I in perimenopause?

Menopause symptoms vary a lot between individuals. For some period just stops without any other symptoms, while for others physical and psychological symptoms can reduce the quality of life considerably.

Common symptoms of perimenopause and menopause include:

  • irregular bleedings, heavy bleedings
  • hot flushes, sweating
  • palpitation ie when you suddenly notice your heartbeat clearly
  • vaginal and vulval dryness (mucous membranes can also be dry in the eyes and nose!)
  • urinary symptoms, such as itching, burning or having to go to the toilet often
  • anxiety and depressive symptoms
  • headaches or migranes that are worse than usual
  • difficulty sleeping
  • joint and muscle pain
  • reduced sex drive

One or more of these symptoms may be present. The combination of symptoms can be different for everyone, and therefore often the symptoms are not immediately recognized menopause related.

You may only have symptoms from time to time and sometimes you may feel the same as before.

Irregular and heavy bleedings

Often the first symptom of approaching menopause is shortening of the menstrual cycle. The previously 28-day cycle may change to 24 days, but the periods come regularly and there are no other problems with them.

After this stage, the cycles usually become longer. Ovulations occur less frequently, and therefore there can be several months between bleedings. This is not dangerous but can significantly affect your life when a heavy bleeding can occur completely unpredicted.

Changes to your periods are often the first sign of approaching menopause. However, you don’t have to suffer from heavy bleedings, as there are different treatments for it.

Hot flushes, sweating

According to current knowledge, estrogen affects the thermoregulatory center of the brain. Estrogen levels fluctuate greatly during menopause. Because of this, the body is more sensitive to sensing even small temperature differences. A small change in temperature causes a hot flash or frostbite.


Menopause causes changes in nervous system activation. This can cause throbbing. Coffee and alcohol can worsen this symptom and therefore should be used in moderation.

Vaginal dryness

Oestrogen affects the mucous membranes in vagina and vulva. The lack of oestrogen makes the mucous membrane thin. It dries out, thins and the bacterial population changes. Vulva and vagina can be sensitive to touch, and it can itch and feel uncomfortable.

Urinary Symptoms

The urethra is also covered by a mucous membrane. This lining becomes thin like in vulva and vagina due to the lack of oestrogen. A thin mucous membrane can cause symptoms similar to a urinary tract infection, such as increased need to go to pee and burning sensation. A thin mucous membrane also exposes you to urinary tract infection.

Oestrogen also affects the tissue of the pelvic floor. The tissue loses elasticity, due to which urinary incontinence becomes more common.

Anxiety and Depressive Symptoms

Menopausal mood symptoms can be very similar to depressive symptoms. Some can get anxiety as a symptom. These symptoms are often not correctly associated with menopause, but are treated simply as depression. Therefore, in the age of possible perimenopause, one should bear in mind that depressive symptoms might as well be a symptom of hormonal changes of perimenopause instead of a true depression. Hormone replacement therapy is usually very effective to these perimenopausal symptoms.

Irritability and Mood Swings

Fluctuations in hormone levels often cause mood swings and irritability. In the premenopausal phase, PMS symptoms can also get worse.

Difficulty sleeping

Difficulty sleeping is often caused by hot flashes and sweating that wakes you up at night. However, change in hormonal levels may even be a direct cause of insomnia. Regardless of the cause, sleep disorders affect overall well-being.

Poor sleep increases fatigue. This often leads to a poorer diet, reduced exercise and thus weight gain.

Poor or insufficient sleep also increases mood symptoms.

All of this greatly affects the well-being of the mind and body, as well as coping at work. Sleep disorders are something that you should not try to cope with alone for a long time. Seek help from a gynecologist where you can consider whether hormone therapy is necessary.

Muscle and Joint Pains

The decrease in estrogen affects the muscles and joints. The joints may become stiff and there may be pain and aches in the joints and muscles.

Low sex drive

For some the changes in your hormone levels affect the sex drive. Menopausal symptoms can also affect this through overall wellbeing. If you wake up during the night, have barely energy to cope work then it’s not so strange sex drive is affected.

For others the end of periods can be a new possibility to bloom. There’s no risk of pregnancy and your kids have moved out – suddenly you feel free. Testosterone levels do not significantly decrease and affects the libido positively. These changes in total might affect sex drive positively.

Do I need contraception during perimenopause?

The egg is normally released once a month in the middle of the menstrual cycle. However, as menopause approaches, the egg is released less frequently and irregularly (this is exactly what causes bleeding disorders) and therefore pregnancy is also less likely.

However, ovulation can occur until the period ends and contraception is also necessary, unless pregnancy is desired.

The chance of pregnancy is about 25% for 40-year-olds and 5% for 45-year-olds. The risk of miscarriage also increases with age, and in the age of 45 every second pregnancy ends in miscarriage.

Did You Know? With age, the chance of a twin pregnancy increases. This is probably due to fluctuations in hormones, when several eggs can grow large and be released at the same time. Twins born in this way are always non-identical twins.

Sources: NHS