Strictly speaking, menopause is your last menstrual period, but you only become aware of this in retrospect, when you haven’t had a period for a year. The average age of menopause in this country is 52, although it is not unusual to experience it during your early 40s or mid-50s.

Stages of Menopause

Menopause is also sometimes called the “climacteric.” It encompasses three distinct stages: premenopause, the beginning of the climacteric (usually the early 40s) when periods may become heavy or irregular; perimenopause, the stage (usually a few years) on either side of your last period when physical symptoms such as hot flushes begin and periods become more irregular; and postrnenopause, which encompasses the rest of your life, after your periods stop.

Can I Predict My Menopause ?

Most menstrual periods stop gradually. A few years before menopause, they may become irregular: you have them for several months then skip a month or two, then start again, with the interval between becoming longer and longer until eventually they stop completely. If you are over 50 and have not had a period for over six months, you have probably reached menopause.

There is no way that you can predict when your last period will be. The age at which you first menstruated could be significant, and the earlier you start, the later you finish. The age at which your mother experienced menopause may also affect when you have yours, although this is difficult to prove. Whether you took the oral contraceptive pill and the age at which you had your first and last child do not affect the timing.

It seems most likely that each one of us has our own built-in biological clock that dictates both when we start to menstruate and when we stop, although a variety of physical factors including diet, smoking, and obesity can either slow the clock down or speed it up.

Premature Menopause

A premature natural menopause, which occurs before the age of 35, is very rare, affecting less than one percent of women. Surgical removal of the ovaries (oophorectomy) is the most common cause of premature menopause and is carried out for a variety of reasons, such as a ruptured ectopic pregnancy or ovarian cancer. It is usually done as part of a total hysterectomy, which entails removal of both the ovaries, the fallopian tubes, and the uterus. Other factors that can cause an artificial menopause include radiation therapy (for stomach and pelvic cancers and, rarely, mumps).

For natural menopause, hormone replacement therapy is given immediately to offset possible problems arising from the earlier-than-usualloss of estrogen. Estrogen replacement therapy is used if the uterus has been removed.

Late Menopause

Anyone still menstruating after the age of 55 is considered to have a late menopause. Late menopause can have health consequences, too, since your body is exposed to estrogen for longer than normal, which, theoretically, carries a slightly increased risk of uterine and breast cancer. You can protect yourself against this risk by making sure that you receive regular mammograms and pelvic examinations.

What Happens During The Climacteric?

Many women experience the symptoms of estrogen deficiency during the time that menstruation begins to decline. Periods become less and less frequent and then menstruation finally stops. Old-fashioned phrases like the “change of life” imply that menopause means an unavoidable decline in life. This is not so. In fact, most women find that life improves.

What Causes Menopausal Symptoms?

The decline in monthly menstrual periods is only a symptom of a parallel decline in the production of female hormones, particularly estrogen, by your body. What started at puberty with a first period and a change in your physical shape, now wanes as ovarian activity falls off and you fail to ovulate. Nearly all the symptoms of menopause may be attributed to these decreasing levels of estrogen in your blood.

Should I See The Doctor?

Three out of four menopausal women have symptoms that are worth treating and that should be treated. Don’t grin and bear it. Decide to have the menopause you want, and seek medical advice and treatment. Don’t ignore self-help remedies: there are many to try (see overleaf). By far the most common menopausal symptoms are hot flushes, night sweats, and vaginal dryness; these can lead to other symptoms, such as insomnia and reduced sexual desire.However, if any of the symptoms trouble you, make sure that you see your doctor immediately. It is never normal to have frequent heavy or painful periods nor to pass blood clots during menopause, so do consult your doctor if you experience any of these symptoms.

What Might The Doctor Do?

By far the majority of women manage to cope with menopause reasonably easily. Because of the unsympathetic attitude of some male doctors, however, many women view it as something to be suffered and not worth treating. This is not so. Hormone replacement therapy can replace the estrogen deficiency so that the symptoms disappear. HRT is more than 90 percent effective. If you feel your doctor isn’t being very helpful or sympathetic, or wont let you try hormone replacement therapy, go to another doctor.

With the end of the protective effects of female hormones, women are at equal risk with men from heart disease. Plenty of exercise and a low-fat diet with healthy combinations of foods will help to keep this problem at bay. Some emotional problems cannot be treated with hormone therapy alone and your doctor may prescribe tranquilizers and counseling to get you through the roughest patch.

Are There Natural Remedies?

You don’t always have to rely on medical doctors. Complementary therapies, such as homeopathy, aromatherapy, herbalism, yoga, and massage, all offer treatments for menopausal symptoms.

Homeopathic remedies

Many women consult homeopathic practitioners to relieve menopausal symptoms. Remedies administered in minute doses include Lachesia for hot flushes; Pulsatilla for insomnia, premenstrual syndrome, and joint pain; Sepia for dry vagina, thinning hair, and prolapse; Sulfur for itchy vulva and skin; Bryonia for PMS and breast pain; and Belladonna for night sweats.

Aromatherapy remedies

Essential oils from certain flowers and plants are also believed to relieve symptoms. Oils from cypress, geranium, and rose are recommended for heavy menstrual periods; avocado and wheatgerm for dry skin; juniper, lavender, and rosemary for muscle and joint pain; lavender and peppermint for headaches; basil for fatigue; neroli and lavender for insomnia; lemon-grass for premenstrual syndrome; and clary sage and rose for depression.

Guidelines for taking herbs

If you’re interested in herbal remedies, consult a trained herbalist, but also bear the following points in mind:

• Always use herbs in moderation.
• Stop using them if you experience any side-effects.
• Assess each herb’s efficacy over a week or so.
• Start by taking an herb in tea form. Increase the amount from half a cup a day to several cups over a period of a week.
• If you’re taking medication, check with your doctor before taking an herbal remedy.
• Don’t defer seeking medical advice because you are using an herbal remedy.

What Can I Do?

A good diet is as important in maintaining health during and after menopause as at any other time of your life. In particular, calcium levels and vitamin D need to be kept up after menopause to avoid thinning and brittle bones a condition that can lead to osteoporosis.

Never view yourself as over the hill. Keep up your self-respect and self-assurance with your work, or retrain or get involved in voluntary activities. This is often the time in your life when your children leave home, adding extra stress when you may be least capable of coping with it.

On the other hand, many women experience a new lease on life once they are freed of reproductive responsibilities. We hear all the time about women who really come into their own in middle age. Those women who have a positive view of menopause suffer fewer symptoms less seriously. Remember that it marks the end of one phase of your life and the beginning of another. It should not be a time for sadness and regret; in fact, it should be a time for looking forward to enjoying new interests and new experiences.

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