Understand the complexities of menopause, including when menopause starts, how long it lasts, its symptoms, and the hormonal changes involved. Gain insights into the risk factors for early menopause and how to manage it effectively.

Key takeaways

• Menopause typically starts between the ages of 45 and 55.
• The duration of menopause can vary significantly. On average, menopause lasts seven years, but can last up to 14 years for some women.
• Hormonal changes during menopause lead to common symptoms such as hot flushes, vaginal dryness, mood and libido changes, difficulty losing weight, and sleep disturbances.
• Early menopause can be influenced by factors such as genetics, medical treatments, or lifestyle issues such as stress, diet, exercise and weight.

Menopause is a significant phase in a woman's life, marking the end of her reproductive years. Understanding when menopause starts, how long it lasts, and the changes it brings can help women navigate this transition more effectively.

What is menopause?

Menopause is the stage when you stop having menstrual periods permanently. This process is characterised by the cessation of menstruation for 12 months. Not all women will experience symptoms, but for those who do, the severity and duration can vary.

Common symptoms of menopause include:

• Hot flushes and night sweats
• Sleep disturbances and insomnia
• Mood changes, including anxiety and depression
• Vaginal dryness
• Decreased sex drive
• Weight gain and difficulty losing weight

Hormonal changes during menopause

Menopause is driven by changes in the levels of the sex hormones produced by the body.

Oestrogen and progesterone

These are the primary female sex hormones, produced mainly by the ovaries. They are responsible for regulating the menstrual cycle and fertility, but they play an important role in a whole host of different organ systems, including the heart, the bones, the brain and the metabolism.

In the years leading up to menopause (perimenopause), the ovaries' production of oestrogen and progesterone becomes more erratic and generally starts to decrease. This decline is not usually steady or predictable, and there may be months where hormone levels remain relatively normal. This fluctuation can lead to irregular menstrual cycles, changes in menstrual flow, and many other symptoms, including mood changes, fatigue, sex drive and cognitive issues.

Once a woman reaches menopause and is postmenopausal, the ovaries produce significantly less oestrogen and progesterone. This decrease in oestrogen can lead to dramatic long-term changes in the body, such as changes in bone density and blood vessel elasticity, increasing the risk for osteoporosis and heart disease respectively. Oestrogen also impacts the health of a woman’s brain, gut, and muscles.

The drop in progesterone levels is equally impactful. Progesterone is known as a key modulating hormone and helps to balance the role of oestrogen. It too supports bone, gut, brain and immune function. It also supports sleep, muscle relaxation and supports the nervous system. New research shows how powerful and widespread the role of progesterone is. One of its key impacts is as an “anti-stress” chemical.

Follicle stimulating hormone (FSH) and luteinising hormone (LH)

These hormones are produced by the pituitary gland in the brain. They play a key role in regulating the production of oestrogen and progesterone by the ovaries.

As the ovaries start producing less oestrogen during perimenopause, the levels of FSH and LH in the blood begin to rise. This is the body's attempt to stimulate the ovaries to produce more oestrogen. FSH levels are often used as an indicator to determine whether a woman is going through menopause.

Testosterone

Testosterone is considered a male hormone, but women make significant quantities too. Testosterone, like oestrogen and progesterone also tends to decline around this time too. Research, led by Australian Gynaecologist, Professor, Susan Davies has shown that it may be a potential treatment for the sexual dysfunction that can occur in many women during this time. Sexual dysfunction is associated with significant personal distress and relationship strain during this time.

Insulin

Belly fat and changes in weight distribution is common over the perimenopause and postmenopausal period. The reason for this is the relationship between oestrogen and insulin. Oestrogen is an insulin sensitiser, meaning that the cells become more responsive to insulin. So when oestrogen levels start to drop, the cells become less sensitive which leads to changes in fat distribution and energy metabolism. This is why many women complain of weight gain and fatigue.

How long does menopause last?

There is no exact age when menopause starts and age varies between women. It's a gradual event that is often referred to as a transition. On average, menopause lasts seven years, but can last up to 14 years for some women.

The menopause transition can be divided into three stages.

Perimenopause

This phase often begins in a woman's 40s, but it may start earlier or later. Perimenopause lasts up until menopause, the point when the ovaries have stopped releasing eggs. During this stage, women can start experiencing menopausal symptoms due to fluctuating and decreasing levels of oestrogen, testosterone and progesterone. The impact of associated hormonal shifts in insulin and cortisol can also be felt around this time. The length of perimenopause can vary greatly among women and can last anywhere from a few years to a decade or more.

Menopause

Menopause is officially reached when a woman has not had a menstrual period for one full year. This indicates that the ovaries have stopped releasing eggs and producing most of their oestrogen. The age at which women reach menopause can range from their early 40s to late 50s. The average age is 51 in Australia.

Postmenopause

The years following menopause are known as postmenopause. Menopausal symptoms like hot flashes may ease for many women during this stage, but due to lower levels of oestrogen, postmenopausal women have an increased risk of certain conditions such as heart disease and osteoporosis.

The duration of menopause is primarily determined by the rate at which a woman's ovaries decrease their hormone production. This rate can be influenced by factors such as genetics, ethnicity and overall health.

Who is at risk for early menopause?

Early menopause is menopause that occurs between 40-45 years of age. Premature menopause is when it occurs before the age of 40.

Factors that can influence early or premature menopause include:

• Genetics: women with a family history of early menopause may be more likely to experience it.
• Medical treatments: certain treatments, such as hysterectomy, chemotherapy or pelvic radiation therapy, can induce early menopause.
• Autoimmune diseases: conditions such as thyroid disease and rheumatoid arthritis can increase the risk of early menopause
• Smoking: the toxins in cigarettes can damage the ovaries and accelerate the onset of menopause

Maintaining a balanced diet, minimising stress, optimising sleep and maintaining an active lifestyle, in addition to seeking support from your health care practitioner, can help you to manage your menopause symptoms more effectively.

For those navigating menopause, monitoring metabolic health can be a game-changer. The Vively app can be a valuable tool in managing lifestyle factors and metabolic health. It offers a comprehensive solution to track glucose levels and other key markers, such as stress and sleep and provides personalised insights, education and suggestions to improve metabolic health. By understanding and managing glucose fluctuations, women can help reduce the stress load on their systems, allowing them to take control of their health, reduce menopause symptoms and improve their quality of life.