How do I know if I am in the Menopause?

By Julie Dargan | Menopause

May 02

Continue reading and you will discover…

  • what to expect in the time leading up to Menopause (the Perimenopausal phase)
  • time frames of perimenopause and menopause
  • advice on how to ease the transition through diet and lifestyle.

How to know if you are entering the menopause.

“At first I found myself throwing off the blankets at night. At first I put it down to the warm nights. Then I wondered if I was coming down with something. Due to the interruptions to my sleep I was tired and grumpy during the day. I did not think to tell anyone about it as I thought it was a passing phase. I was 46 years of age and menopause was the last thing that entered my mind.” Sarah-Jane V.

Many women are not ready for when their body starts to show signs of entering the menopause. It is not as simple as when they had their first period. That was easy, you had your first bleed, and bam, you suddenly became a woman ready to have children (well perhaps not quite ready to have them just yet). You knew exactly where you stood. And just as there were some hormonal changes leading up to the big day, so too can you expect some upheaval at the other end of your life’s cycle

When most women think of the menopause, they immediately think of hot flushes. They may have seen a woman experiencing a hot flush but most likely did not pay much attention to what was going on. I have dedicated a whole module on hot flushes, so I will not go into further detail here. If you would like to read more click here.

My Tests are all coming back normal so why do I feel like S***?

This is a question I am commonly asked.

Due to the irregular and intermittent secretion of oestrogen and progesterone by the diminishing ovary and eggs, measuring hormone levels can be of little value at any given time. This can make it especially difficult for women to be able to ascertain as to whether they are actually in the menopause transition or not.

For me, signs and symptoms expressed by each woman is a more important predictor of peri-menopause status. Also keep in mind that many doctors will not address the peri-menopause status which can be quite crippling for women who are showing the symptoms of erratic oestrogen levels but still having the odd period.

Some doctors will be emphatic that while you are having periods, regular or not, you are not menopausal. This only adds to the confusion for many women. Just as you were feeling strange leading up to having your first period (I can still remember being intensely tired) so too will you feel out of sorts as you approach your date of one year since your last period, and the day you started your menopause. The menopause is more a transition over time with the actual “day of the menopause”.

It is the time frame up to that day that many women can be in the dark and not mentally prepared for what can be an emotional upheaval and frightening, lonely experience.

Before we move on, let me explain what is happening in your body. Once you understand this a little it may help you to cope with the changes. Once you have awareness and clarity on your condition, the next step is acceptance and action.

Awareness & Clarity

From the age of 35-40, the levels of oestrogen in the blood start to change. You can read more about the change in your oestrogen and progesterone here.

There are two ways of looking at what is happening in the menopause.

  1. Doctors look at the menopause as a medical condition due to hormonal deficiency which needs to be treated with drugs.
  2. Psychologists see the menopause as a period of change when the woman needs to learn to adapt and cope with a different role in life.

As in everything in life, there  will be a mixture of the two. Whether you feel the need to take HRT medication or not is your choice. I am not here to give you advice on this issue. I am here to help you to understand what is going on and how you can ease the transition through diet and lifestyle changes.

Menopause should not be seen as the end of life but as one of the many factors involved in the ageing process.

Time Frames

Women will actually start their menopausal journey months, or even years, prior to the actual day of reaching menopause. This journey is referred to as Perimenopause.

Where are you on your journey?

Some women can experience menopause very early in life, either as a result of surgical intervention (such as hysterectomy) or damage to ovaries (such as from chemotherapy).Menopause that occurs before the age of 45, regardless of the cause, is called early menopause. Menopause that occurs at 40 or younger is considered premature menopause.

PERIMENOPAUSE

Perimenopause is when the body has higher oestrogen to progesterone ratios compared to your younger years. This may not mean you have too much oestrogen but simply that the oestrogen action is stronger than progesterone and has taken control. What was once a harmonious relationship is now a coup. You may have normal oestrogen levels (when having blood tests) but the levels are high in comparison to progesterone levels, and certainly higher than what you are used to having. This is why your are feeling the effects that you are not used to.

Typically for most women,  from the age of 45, your ovaries will suddenly start to produce more oestrogen. This is due to the fact that you are starting to run out of ripe eggs.  The number of eggs left in the ovaries is insufficient to continue the normal ovulation process. Initially the ovaries release more oestrogen to try and counter balance the situation, but this can only occur for a short time.

After a while (can be months or years)  your oestrogen levels will start dropping when finally it will no longer be produced by the ovaries.

During peri-menopause many women will have the following symptoms:

  1. Irregular and heavy bleeding. Up to 25% of women may experience heavy  bleeding in peri-menopause due to the fact of oestrogen and progesterone being ultra significantly disproportionate. There are other reasons for heavy bleeding such as fibroids and polyps so any episode of unusual heavy bleeding should be check-out before putting it down to “menopause”. Do keep in mind also that increased oestrogen is a cause of fibroids and polyps.
  2. Marked mood changes. In peri-menopause, oestrogen levels can fluctuate dramatically and can have a major effect on how your are feeling. Many women find themselves weepy etc
  3. Night sweats & hot flushes. True menopause symptoms of vasomotor symptoms leading to insomnia leading to forgetfulness and fatigue
  4. Insomnia
  5. Loss of libido
  6. abrupt & intermittent mood swings
  7. anger/temperamental outbursts
  8. general episodes of abnormal behaviour

I was having my own issues with hormonal swings when I found myself laughing at my 14 year old, pre-pubescent son. The anger, the snapping, the rolling of the eyes. Just as I was going through my hormonal upheaval, so was he. It made me feel human after all and glad to know that no only females have hormonal issues!  Elizabeth C.

Acceptance & Action

It is important to remember that you are not as young as you used to be. When you were younger you may have been able to tackle stress or lack of sleep and coped better. I certainly was in a position before I was married and had children to take time out for myself. But, as we age, we seem to accumulate a lot of extra burdens that makes us put ourselves last and less able to cope with the stresses we once were able to. From the age of 35-65 you may never have had so many things going on in your life that need your  management and attention leading to stress.

On top of the fluctuating hormone levels, women may also have to contend with constant stress and inadequate sleep. Compound this with a poor diet, little exercise and environmental influences and many women can crumble under the stress that the body has to endure.

I am writing this so you do not blame everything on your hormones. By addressing the external influences such as stress and lack of sleep, you can ease the symptoms of perimenopause. If you think that HRT will help with some of the side effects of menopause without paying attention to your diet, exercise and stress levels, you will be bitterly upset.

Many women find themselves during meno/midlife years having developed very bad habits, both in the kitchen and lifestyle. They may have been busy, dynamic and accomplished in the workplace but were eating crap and leading a very sedentary lifestyle,

Foods that assist in the conversion of oestrogen into good metabolites include insoluble dietary fibre such as lignin found in green beans, peas, carrots, seeds and brazil nuts. Fibre binds harmful oestrogens in the digestive tract so they can then be excreted in the faeces as opposed to being reabsorbed in the body.

Cruciferous veggies shift oestrogen metabolism to favour the friendly “harmless” oestrogen metabolites. Omega 3 apples, cabbage, all decrease reabsorbed oestrogen from the digestive tract.

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About the Author

Julie Dargan RN, ND, BHSc works with Successful, Busy, Menopausal Women find relief from hot flushes and night sweats, & lose weight gained in their middle years, through diet and lifestyle changes.