According to the dictionary, menopause is when a woman stops having periods. Simple, isn’t it? In that case, why are there all these other terms: perimenopause, surgical menopause, early menopause – even a temporary menopause? I mean, what is menopause?
The answer is that while there is one moment in time when menopause happens, there’s a lot going on in the years before and not every woman takes the same route to get there.
What is menopause?
Menopause is a normal, natural event that signals the end of a woman’s fertility and you are no longer able to get pregnant. It is defined the moment when you’ve gone 12 consecutive months without a period.
And yes, that’s a whole 12 months. If you go 11 months and then start bleeding, you have to start the whole count all over again. Mother Nature has a wicked sense of humour.
If you start bleeding after 12 months, go and see your GP straightaway. It is usually nothing, but it could be something that needs further investigation.
The average age for this to happen in the UK is 51, but that is average. I’m 53 and 11 months and still perimenopausal. Hashtag sigh.
After that magic 12-month moment, you’re postmenopausal, but you may still suffer some symptoms for a few years yet.
What is perimenopause?
Perimenopause means “around menopause” and is how GPs refer to the transition time when your body starts changing. It can start ten years before your menopause or just a few months before, but most women are perimenopausal for around 4-5 years.
This is the time when you may notice menopausal symptoms, such as irregular periods, hot flushes, mood swings, headaches, vaginal dryness etc. These are caused by the changing hormones (see my guides above) and affect every woman differently.
Some women breeze through the perimenopause without a problem (my mam had some hot flushes and that was it), while around one in four will have a tough time.
Perimenopause also differs by culture. BBC Breakfast GP Dr Nighat Arif describes it here:
And then there’s early menopause…
Early menopause is when you hit menopause – the full 12 months – before the age of 45. It can happen naturally or as the result of some medical treatments.
Then what is premature menopause?
Menopause that happens before the age of 40 is often called a premature menopause. It is also known as premature ovarian failure, or primary ovarian insufficiency (you may see it referred to as POI). The different terms all mean the same thing.
At its very basic, it means your ovaries are no longer working and while the causes are unknown (a recurring theme in women’s health), it can be caused by the likes of an autoimmune disease or an infection.
Premature menopause affects around 1 per cent of women and it can happen at any age – Hayley Cockman on Twitter had a premature menopause at the age of 14. Give her a follow, she’s great.
If you are affected by POI, there is great help, advice and support at the Daisy Network.
Women who undergo cancer treatment, such as chemotherapy or radio therapy, may go through a premature menopause, either temporary or permanent.
If you have both your ovaries removed in a hysterectomy under the age of 40, you’ll go through it, too.
Isn’t that last one a surgical menopause?
Yes, but it’s often also classed as a POI if you haven’t hit your 40th birthday. I know, this is why it gets confusing!
Usually, under-40s will be left with one or both ovaries if they need to have a hysterectomy. This means you’ll still produce your hormones but won’t have periods, so knowing when you’re menopausal can be difficult.
If you have a hysterectomy and you are perimenopausal age, you’ll more likely have both your ovaries removed and go straight to menopause, bypassing the perimenopause. This doesn’t mean, however, that you won’t have symptoms – and they could be more severe because of the abrupt loss of oestrogen.
Phew! Is that it?
Sadly, no – and this was one I hadn’t heard of until I met Vicky Chapman of Endometriosis UK Dundee Support Group.
Temporary menopause – or induced menopause – is when you have your menopause brought on through hormone treatments. When Vicky said she’d gone through this, I was confused. Why would anyone so young want this?
It turns out that it’s a way to help endometriosis and some other gynaecological conditions. It can also be used by women facing chemotherapy, to help preserve their fertility. (Obviously, this is used before a woman hits her perimenopause years.)
Unlike other menopauses, this one can be reversed – stop the hormone treatment and your own hormones will normalise and you’ll start having periods again.
And that’s it. Key to all this is understanding symptoms so you recognise if you’re entering menopause or not. And of course, our KnowYourMenopause poster is the perfect way to do this! Get yours free from Pausitivity.
What other aspects of the menopause would you like me to de-science-fy? Let me know in the comments below.
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