The phases of menopause or the menopausal transition is usually broken down into four categories; pre-menopause, peri-menopause, menopause and post-menopause. The signs and symptoms of menopause experienced by every woman include cessation of menstrual periods and decreased hormone production by the ovaries. There is a long list of symptoms that may be associated with menopause and decreased hormone production. Not every woman experiences all of them, but most experience one or more.
The average age of menopause is 51, but a woman is only said to have experienced "premature menopause" if it occurs before the age of 40. Premature menopause is usually caused by illness or injury to the ovaries, but premature menopause occurs naturally in about 1% of all women. On the other end of the scale, some women do not enter menopause until they are well into their fifties. There is no way to predict at what age menopause will occur in a specific woman.
The different phases of menopause are experienced by all women, but may not cause any symptoms. During pre-menopause a woman's periods are regular. Symptoms such as worsening PMS, periods that are heavier or lighter than normal may be associated with "peri-menopause" or the time "around" menopause. Women in their late thirties may experience these symptoms, but may not enter menopause for another ten years. Symptoms such as this can also be caused by other more serious health conditions and sudden changes should be evaluated by a physician.
Menopause is simply a term that means the end of menstruation. When a woman has not had a period for 12 consecutive months, then she can no longer become pregnant. She is post-menopausal. Women may experience the signs and symptoms of menopause for several years before menopause and for several years following menopause. The most common symptoms for which women seek treatment are hot flashes, night sweats and vaginal dryness.
About 50% of all women have hot flashes and/or night sweats during the phases of menopause. About 10% have them in their pre-menopausal years and the percentage gradual increases as menopause approaches. Researchers refer to these symptoms as "vasomotor symptoms", because circulation and blood vessel dilation are involved. The exact cause of hot flashes and night sweats are unknown. It is known that women who are surgically menopausal, due to removal of the ovaries, typically have more severe vasomotor symptoms. Men who must take drugs to suppress hormone production also experience hot flashes. All of this seems to indicate that decreased hormone production causes hot flashes. But all women experience a gradual decrease in hormone production, but all do not have hot flashes.
Treating hot flashes and night sweats is nearly as confusing as investigating the cause. Other signs and symptoms of menopause, such as vaginal dryness, are more straightforward. There are clear answers as to their causes and remedies. Vasomotor symptoms, on the other hand, may respond to practically anything or next to nothing. Trial after trial has shown that placebo (an inactive substance) relieves hot flash symptoms by about 20%. Thus, finding an effective remedy means finding something that is more effective than placebo.
Researchers, doctors and experts debate about the effectiveness of different treatment plans. Clinical research yields confusing and sometimes contradictory results. The only long-term studies have focused entirely on hormone replacement therapy. The currently accepted philosophy is that while HRT is effective for relieving the unwanted signs and symptoms of menopause, the health risks should be taken into consideration. These include blood clots, breast cancer, uterine cancer, heart disease and stroke. The health risks increase with long-term use. Minimum dosage for the shortest duration possible is considered acceptable in most cases.
Various nutritional supplements, herbal remedies and plant components have been and are currently being studied for the benefits they provide during the different phases of menopause.
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