What is the menopause?

The menopause is a natural stage in a woman’s life. The hormonal changes, which lead to the menopause mostly, occur in women between the ages of 45 and 55.

What changes in the body during menopause?

The female cycle is an interplay between the diencephalon, pituitary gland, ovaries and uterus with the goal of making a pregnancy possible. The pituitary gland in the middle of the skull signals when ripening egg cells should be released for fertilisation. The ovaries in the lower abdomen then recruit the desired follicle and ensure that the uterus forms a thick mucosa in which the embryo can implant. The most important role is played by the hormones oestrogen and progesterone. If no pregnancy develops, the corpus luteum can no longer provide enough progesterone and the pre-prepared mucosa sloughs off. Menstruation occurs and the cycle starts again.

Long before menopause happens, this interplay begins to misfire. Thus, the ageing ovaries sometimes react belatedly to the signal from the pituitary gland or allow only a few - or eventually no – follicles to ripen. Or they recruit the necessary egg cells, but the ovary does not react to the signal, so that the follicle enlarges too far beyond its usual size.

The hormonal changes, which lead to the menopause, occur in every woman after a certain age, but do not necessarily produce symptoms. On average around a third of women experience no noteworthy effects, a third are noticeably affected and a third feels very burdened in their everyday life by the changes associated with the hormonal turbulence. The symptoms affect a time period with the peak between 45 and 55 years of age.

  

Cycle of menopause

Peri-menopause – menopause – post-menopause

The menopause is a normal, natural event in a woman’s life. The menopause is defined as the last spontaneous menstrual bleed and is mostly identified as such in retrospect, generally when in a twelve-month period there have been no menstrual bleeds and there are no other reasons for this, other than the natural, age-related hormonal changes. 

The phase before the menopause is called the «peri-menopause». The phase after the menopause is called the «post-menopause». The climacteric is the transition from the fertile to the infertile period of life. 

The first signs of approaching menopause often begin years before the actual final menstrual bleeding. In the peri-menopause the levels of oestrogens – the most important female sexual hormones – fall lower and lower. The decrease of oestrogen levels changes the woman’s health and symptoms and changes develop, which are typical for this time of life. The cycles get noticeably longer and menstruation weaker. Hot flashes, vaginal dryness, sleep disturbance and mood swings are frequent, typical signs of the peri-menopause.

Nocturnal hot flashes lead to bad sleep, which can itself worsen restlessness, irritability and also depressive symptoms. With severe symptoms the quality of life as a whole is severely diminished, which can affect fitness for work and daily life.

  • Follicle: Is the shell of a ripening egg cell left in an ovary 
  • Oestrogen: Oestrogens are the most important female sexual hormones. They are involved in steering the cycle and play an important role in pregnancy. They are mainly produced in the ovaries. Oestrogens also act on metabolism and bone formation.
  • Progesterone: Progesterone is, like oestrogen, a female sexual hormone, which plays a decisive role in women wanting children, since it prepares the body for pregnancy. During the menopause the concentration of the hormone in the body falls. 
  • Corpus luteum: The corpus luteum develops in the ovary from the shell cells left behind after the egg has been shed.
  • Ovaries: These are the ovaries (the source of eggs) 
  • Climacteric: The transition from fertile to infertile periods of life 
  • Peri-menopause: The phase before the menopause 
  • Menopause: Last spontaneous menstrual bleed mostly identified as such in retrospect. 
  • Post-menopause: The phase after the menopause