Menopause is a natural phase in every woman’s life. It marks the transition from the reproductive to the non-reproductive phase and comes with various physical and emotional changes. This process affects millions of women worldwide, usually beginning between the ages of 45 and 55, though it can start earlier. In Germany, around nine million women are currently going through menopause, with approximately 47 million women worldwide entering this phase each year.
What happens during menopause?
Menopause is not a sudden change but a long, often decade-long process. During this phase, the ovaries gradually reduce the production of the hormones estrogen and progesterone. You may have already noticed changes in your menstrual cycle, mood swings or disrupted sleep. These could be the early signs of menopause. Even if your period still occurs but has become somewhat irregular, this may indicate that the initial phases of menopause have already begun.
Menopause can be divided into four stages
Premenopause
Premenopause typically starts in the late 30s. During this stage, progesterone levels begin to decline gradually, although menstruation remains regular. Many women start to experience mild symptoms, such as mood swings. This stage can last up to ten years before the next phase begins.
Perimenopause
Perimenopause is the “wild” phase of menopause, marked by the most intense hormonal fluctuations. It is often called "the zone of chaos." This stage can last up to seven years, with both estrogen and progesterone levels fluctuating significantly, often leading to irregular cycles and intense symptoms. This phase can be particularly challenging, especially if you suddenly experience hot flushes or sleep disturbances that disrupt your daily life.
“I didn’t know what was happening to me. Suddenly, I was having these hot flushes and felt like I was constantly in a fog—my brain just didn’t seem to function properly. I often couldn’t concentrate and was irritable all the time. It felt like I had lost control over my body.”
– Sabine, 49
Menopause
Menopause is defined as the moment of the last menstrual period, which can only be confirmed after twelve months without a period. The average age for reaching menopause in Germany is 51. During this time, hormonal fluctuations ease, and estrogen and progesterone levels stabilize at a lower level. Symptoms can be less intense during this phase.
Postmenopause
Postmenopause begins one year after the last period and lasts for the rest of life. During this phase, hormones stabilize at a low level, which can increase the risk of certain conditions, such as osteoporosis or cardiovascular disease. Many women report that their menopausal symptoms lessen or disappear, although the body continues to adjust.
Menopause is a journey through four stages—Premenopause, Perimenopause, Menopause, and Postmenopause—that can last up to 15 years! Still having your period? Doesn’t mean menopause hasn’t started. Embrace lifestyle changes or hormone therapy to regain control.
So, menopause is not a single event but a long-term process that can span up to 15 years.
Common symptoms
The symptoms of menopause are varied and can differ greatly from woman to woman. The most common symptoms include hot flushes, night sweats, sleep disturbances, and mood swings, often quickly recognized as typical menopausal complaints. Less well-known symptoms include muscle and joint pain, brain fog, and changes in skin and hair. These symptoms, which often peak a few months after the last period, can be just as challenging and are especially common during perimenopause. It’s important to remember that all these symptoms are a normal part of menopause, and there are ways to manage them.
“But I still have my period... Once I finally understood that I was already in menopause anyway, everything suddenly made sense. The fatigue, the hot flushes, the mood swings—they weren’t just stress or exhaustion. It was actually a relief to know what was going on, and with that knowledge, I could start looking for solutions.”
– Magda, 52
Ways to manage symptoms
Menopause can be challenging, but there are ways to manage the symptoms. Each woman experiences menopause differently, so different approaches should be used and adjusted individually.
Nutrition, exercise, sleep, and mental health
A healthy lifestyle can be an effective way to positively influence menopausal symptoms. A balanced diet rich in fiber and healthy fats, as well as regular exercise or yoga, can improve well-being and help relieve symptoms like hot flushes and mood swings. Adequate sleep and stress management are also crucial in supporting the body. The best combination of these strategies varies from woman to woman and can be found through trial and error.
Menopausal hormone therapy (MHT)
Menopausal hormone therapy (MHT) is considered the most effective treatment method for relieving a wide range of menopausal symptoms. Studies show it can reduce hot flushes by up to 90% and is also effective for sleep disturbances, mood swings, and vaginal dryness. Therapy should be discussed with a doctor and tailored individually to weigh the benefits and possible risks.
Non-hormonal medication
If MHT is not an option or you prefer alternative approaches, non-hormonal therapies are also available. Medications specifically developed for menopause, as well as certain antidepressants or blood pressure medications, have been shown to help with hot flushes and other symptoms. Here, too, the best possible treatment can be found in consultation with a menopause specialist.
Sources:
Deutsche Menopause Gesellschaft e.V., https://www.menopause-gesellschaft.de
NHS (National Health Service, UK)https://www.nhs.uk/conditions/menopause/
North American Menopause Society (NAMS), https://www.menopause.org
Monteleone, P., Mascagni, G., Giannini, A. et al. Symptoms of menopause — global prevalence, physiology and implications. Nat Rev Endocrinol 14, 199–215 (2018). https://doi.org/10.1038/nrendo.2017.180