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Read the full video transcript below
Today's topic
Hello, and welcome to my weekly video blog. And today on A.Vogel Talks Menopause, I’m going to be discussing the three stages of the menopause. Now, I get a huge number of women who contact me every week and they’re really not sure what is the menopause, when does it start, what’s going to happen to me, how long is it going to last, how am I going to feel afterwards. So I thought today, that I would just basically go right back to basics and start from the beginning.
The three main stages of the menopause
Now, there are three main stages to the menopause. There’s the perimenopause, there’s the menopause itself, and there’s the post-menopause phase.
At what age does the menopause start?
Now, the average age to start the menopause is 45 to 55. That’s the average age group. A number of women will start later. I mean, I heard somebody a few weeks ago who was still getting regular periods at 58 and wondered when she was going to start, and quite a few women actually start earlier. So this would be between sort of 35 and 45. Now, this earlier age group can be caused by a number of things. It can be hereditary, so it could be, you know, if your mom started early, if your gran started early, your sisters and your auntie started early as well, then there’s a good chance that you will fall roughly into the same age group as well. Not a guarantee though, that’s the only thing, so it’s just a rough estimate if you like.
Other issues can affect the menopause. You can get an early menopause if you smoke, if you are overweight, if you have chronic health issues such as diabetes or rheumatoid arthritis, and it can also be your ethnic origin as well. There are some countries and continents in the world where women will naturally start the menopause that little bit early. Now, there’s also a group of women and we would call it the premature menopause, and this can be some girls in their late teens to early 20s can start the menopause. This is more of a major medical condition, and that’s not something that I’m actually going to be discussing at this particular time.
Peri-menopause
So, let’s have a look at the three stages of the menopause itself. So we’ve got the peri-menopause. This is the phase leading up to the menopause. This can last about three to five years, it just depends on you as an individual, how this is going to sort of pan out. You can start to feel your hormones changing a number of years before your periods actually start to change. So you can be getting completely normal regular periods, everything just the exact same, and then you suddenly feel as if you’re starting to get some menopause symptoms. You could end up with things like your hot flushes, joint aches, digestive problems, headaches, and stress palpitations as well. And these tend to be some of the common ones that would happen at this particular point.
The problem with these symptoms at this time is that they are not often associated with the menopause. So women, they’ll start to get the stress palpitations and really worry about this or they start to get joint aches or digestive problems, and they will go along to the doctor and get tested, and the thing is, the tests will come back completely clear. And that’s quite a worry because you know that something’s not right, you know something’s going on, but very often the doctor will say, “Well, there’s nothing wrong with you. You just take painkillers or antacid tablets or something like that.” So there’s a lot of symptoms at this particular point that are often not realized that they are part and parcel of the menopause. So, if you are in the peri-menopause, it’s a good idea to just look at your general health at this particular moment in time. And if there is anything going on, maybe have a look and see whether it can be more associated with the menopause rather than anything else at all.
Now, in the peri-menopause, at some point, you will find your periods starting to change. Now, the menopause or the peri-menopause, it’s not a static state. Your hormones just don’t fall gracefully and that’s it. They can go up and down like a yo-yo, and you might find that for six months, you get one set of symptoms and then they disappear, and then you get another set of symptoms. So, during this phase of three to five years, you can actually end up getting a range of different menopause symptoms at different times. You know, if you start off getting hot flushes, that does not mean to say that you’re going to get hot flushes, you know, every single day for the next five years. It doesn’t actually work in that way.
Now, for some women, they may find that their periods start to get closer together, they might start to get a little bit heavier, they might start to get a little bit more prolonged. That normally means, at that point, that your progesterone is forming just that bit quicker than your oestrogen. So these are sort of high oestrogen symptoms. Some women find that their periods start to tail off, they start to get further apart, they get lighter, they start to go missing. You might find you get one period and then they miss for four months, and then get another period, and so on. And this is normally an indication that your oestrogen is falling that little bit quicker than your progesterone is falling. But you can get a combination of both. You can get heavy periods for a year and then they suddenly start to tail off. And then at some point, you will find your periods just stop for good. Now, there are some lucky women that don’t get any sign or any symptoms, their periods just stop and that’s it. That’s the menopausal stage. So, sometimes that does actually happen.
The menopause
So the next phase, once you think to yourself, “Oh, my periods have actually stopped.” The menopause itself, believe it or not, is just the moment in time when your periods just stop for good. Problem is, you don’t know your periods have stopped for good, until you’ve not had one for about two years. Now, there are some schools of thought that say you’ve gone through the menopause when you haven’t had any periods for a year, but we actually find that quite a large number of women can go for a year or more without a period and then get one or two back again. Sometimes, you know, it’s a last fling of their hormones. So, we tend to say, once you have not had any periods for two years, that you’re through the menopause.
Now, this phase, from when your periods have stopped for good until the two years to stop, your hormones are still changing, so you can still get a number of symptoms at this particular point. And some women find that this is when they start to maybe get a little bit worse purely, because your hormones are falling that little bit further. However, the majority of women find that, as you approach the end of the two years, that the body has learnt to rebalance itself and that your symptoms will start to ease off. Now, the only problem here is that the length of time it takes for your symptoms to ease off can be very often linked to your general health, your lifestyle, stress management, and your diet. So this phase is very important where you still need to keep looking after yourself well.
Post-menopausal
Now, once you’ve got to the two years without a period, you’re then considered post-menopausal. And that’s the point where your hormones will start to level off. It doesn’t get to the point where you have no hormones at all, or that’s very, very rare. You will just end up learning, your body will learn to cope with a lower level of hormones. That’s the point when you can actually start to feel better. You can start to get your old self back, your body can cope, your energy will come back, and there’s no reason at this point post-menopausal, when you can’t actually feel as good, if not better than you did before. Because the great thing is, you’ve got no hormonal ups and downs, there’s far less emotional ups and downs going on as well. So, this phase, the post-menopausal phase, can actually be a really great one. But again, you still need to keep looking after yourself well.
Remember everybody's menopause is unique
So, it’s quite a complex situation and you must all of you remember that, every single one of you is going to have a completely unique menopause. And the information that I gave today is just a general guide. Some women will have really, really long menopauses, other women will have very, very short ones. And the combination of symptoms that you get at any given time, are going to be different to everybody else’s.
See you next time
So I hope you’ve enjoyed today’s topic, and I look forward to seeing you next Monday on A.Vogel Talks Menopause, for my next video blog.
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shirley — 18.09.2017 20:01
i had my last period when i was 36, i am now 54 and still experiencing all the symptoms, i was on HRT from 45 to 50 years of age then stopped as i did not feel it was making any difference, has anyone else gone through similar? and if so was there an end to it!!!
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eileen — 19.09.2017 14:25
Hi Shirley
Unfortunately, coming off HRT can trigger withdrawal symptoms that can mimic menopausal ones. You are going from a high hormone level (the HRT) to your own natural level which would have been lower at that point. This sudden hormonal fall could have given you a sort of menopause all over again, albeit an induced one! Like a natural menopause this can take several years for the body to re-adjust and re-balance itself.
You may find trying the Menopause Support can help as this is known to gently raise and balance oestrogen. However, other health issues can creep in at this age so it is a good idea to ask your doctor to test you for low iron, low thyroid function, low vitamin D and B12, all of these can cause menopause-like symptoms and it can be difficult to differentiate between this and the menopause.
Daily relaxation is really important for this as it helps to strengthen the nervous system and the stronger this is the less likely you are to get symptoms.
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Anna Marie — 04.09.2017 18:22
Hi my fsh levels show that I'm going through the menopause but as I have the mirena coil inserted I haven't had a period for about 12 years. Should I get the mirena coil out now? I have the typical night sweats and sleeping very badly. Nothing seems to help
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Eileen — 05.09.2017 13:16
Hello Anna Marie, What age are you now and what was your main reason for getting the Mirena coil? Thank you
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Anna Marie — 05.09.2017 15:28
Hi I'm 51 now and my main reason for getting the mirena coil was as a contraceptive.
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Eileen — 05.09.2017 15:47
Hi Thank you for letting me know. The trouble with this type of contraception is that they keep your progesterone levels artificially high. Once you start the approach to the menopause, your oestrogen levels are going to start to fall, but your progesterone level is going to stay up here, and it's the gap between these two that can actually cause problems. So you may be experiencing menopause developments breaking through or side effects of the Mirena coil. You could ask the GP to have it removed in the near future and this might be helpful but if it is for contraception purposes you may need to see what other options are out there (e.g the Barrier method). You could try a calming herbal remedy like Passiflora complex and a magnesium supplement to support your nervous system for now. If I can be of further assistance let me know.
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Gillian White — 02.09.2017 06:39
This is really helpful and I've had symptoms as you discussed. It's reassuring to know that it is the menopause. I'm 55 and my periods have been erratic for about 2yrs but stopped at the end of May. The hot flushes were terrible but I've tried Sage tablets but they didn't do anything and now I'm trying Red Clover tablets and the flushes have reduced significantly which is brilliant. All the info you've supplied is brilliant, so thankyou. Xx
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eileen — 04.09.2017 10:21
Hi Gillian
Great to hear that the Red Clover is helping you!
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Caroline Whoriskey — 31.08.2017 15:48
Hi my eriods stopped when i hd a artial hysterectomy (am now 50) my question is how far into menopause am i ? i have all thr mood swings, hot flushed aching bones and the sleepless night for abut 3 yrs.
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eileen — 01.09.2017 10:58
Hi Caroline
It is difficult to tell how far through the menopause you if you don't have missing periods as a guide. As a rough estimate the average length of the menopause is 5 years from when you first notice symptoms until (if you hadn't had the operation) 2 years after your last period. After than you are considered post menopause. However, it can be shorter for some women and longer for others. For your symptoms you may find the Menopause Support helpful and remember to look after yourself well!
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Susannah Littman — 29.08.2017 20:36
Hi, I stopped my periods about 6 years ago at age 49. Until recently I didn't appear to have menopausal symptoms but now - all this time later, I am having hot flushes, joint aches, and tiredness. Is this normal to have symptoms so long after periods stopping? Could the shock of bereavement have brought this on?
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eileen — 30.08.2017 15:09
Hi Susannah
It is unlikely that your symptoms are hormone related after all this time. However, we do know that any emotional or physical shock can stress the nervous system enough to trigger menopause-like symptoms such as flushes or sweats. So it is more than likely this is the reason.
You may find taking a magnesium supplement and a calming remedy such as Stress Relief Daytime can help to ease this. Also remewmber to drink lots of plain water, flushes can dehydrate you very quickly and dehydration will put further stress on the nervous system making symptoms worse.
https://www.avogel.co.uk/herbal-remedies/stress-relief/index.php
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Sam — 28.08.2017 19:34
Hi - I think I've been in perimenopause for a while and am one of those women who have been diagnosed with anxiety and them cfs (maybe it's both, who knows!). So I've had flushes, moods, itchy skin, losing a bit of hair, weight gain on my middle and now my periods are becoming closer together and lighter... my question is that the article says that periods becoming lighter/closer can be seen sign of higher oestrogen - is Menopause Support still suitable for me (as the soy may mimic oestrogen)? I've started it recently - I'm got a bit nauseous with it, but this seems to have tailed off. Will know more re the effect it has as I approach my next period! Thanks - really helpful series of articles! X
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eileen — 29.08.2017 13:30
Hi Sam
Menopause Support can sometime work in two ways in this type of situation. If the high oestrogen is caused by one of the dominant oestrogens (we have several different kinds) then the gently plant oestrogens from the soya can help to prevent these from causing problems so your symptoms would improve. However, if the symptoms are caused by other oestrogens then it may not help. We tend not to recommend in this situation as we won't know which is what but if you feel it is helping then it is worth trying for a couple of months at least. Do let me know how you get on with it.
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Sally McMenamin — 21.08.2017 19:18
Hi Eileen thank you for all the great advice on the menopause my peri- menopause started in 2011 my hormones went crazy I was diagnosed with rhumatoid arthritis and was very bad for a while.due to extra family stress it was a bad few years my GP prescribed anti depresents and they have really helped I also take a Vogel sage and they are my life saver my periods stopped june2014 but the weight gain is my worst symptom and then the lack of energy to exercise I care for my mum 94year old and my brother as well as work so I don't eat healthy at all grab and go.your information has been great and I'm passing it on to my friend who seems to be starting the journey
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eileen — 22.08.2017 12:01
Hi Sally
Great to hear that you have found the information helpful and thank you for passing us on! Unfortunately, we do know that stress can have a huge impact on weight in the menopause and the usual methods of going on a low calorie diet and lots of exercise usually don't work.
In your situation you may find just tweaking your diet, cutting down on your carbohydrate intake - so less bread, pasta, rice etc and lots more veg, protein and healthy fats may make a difference. Water can be great for weight loss so remember to drink plenty of plain water every day.
If you can spare 10 minutes a day for a brisk walk even this can work wonders. A poor diet is nearly always a factor in fatigue so doing little changes can give you lots more energy!
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Siobhan F — 17.08.2017 09:45
Hi Eileen, great to read your blog. I have been thrown into menopause due to treatment for mBC. Every 3 months my ovaries are switched off - so I am not producing any oestrogen. Is there anything you can recommend that does not contain oestrogen that can help with my low mood. I've alot going on so to have my mood balanced would be a great help. Thanks x
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eileen — 17.08.2017 12:28
Hi Siobnah
You could look into the Flower Essences such as Mood Essence as there are usually no contraindications with other medications, although in this case I would advise that you just double check with your consultant or doctor. You could also see either a Medical Herbalist or a Homeopath who can formulate a safe, personalised treatment plan for you and also liaise with your doctor, which is important.
https://www.avogel.co.uk/jan-de-vries/bach-flower-remedies/mood-essence/index.php
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Michelle Gregory — 15.08.2017 06:22
Thank you so much. I lost my Mam eight years ago. She was the person I would go too. I've really struggled emotionally through my menopause. Your blogs have really brought me comfort & reassurance.
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eileen — 16.08.2017 12:30
Hi Michelle
You're welcome, just glad to be of help!
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Dawn — 01.08.2017 06:01
Hi I've been prescribed a anti depressant for the menopause, which from all reviews I've read isn't good for the withdrawal symptoms, also a side effect is weight gain, the tablet is Venaflaxine 37.5mg twice a day, have you had any experience with this?
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eileen — 02.08.2017 08:55
Hi Dawn
Please could you let me know what symptoms you were prescribed this for and has it helped, thanks.
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Dawn — 02.08.2017 08:55
I was prescribed it for hot flushes, I haven't tried it yet, as I'm not sure how I feel about taking anti depressants! I would prefer a natural remedy, however I have to be careful as I have high blood pressure.
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eileen — 02.08.2017 13:24
Hi Dawn
You could try our sage tablets, Menoforce, these are specifically for hot flushes and night sweats and usually works quite quickly. There are no contraindications listed with BP medication.
https://www.avogel.co.uk/herbal-remedies/sage-tablets-menoforce/index.php
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Linda williams — 26.07.2017 11:02
Thanks my age is 66
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Linda Williams — 25.07.2017 15:58
Hi Eileen I'm not sure what stage I am as had a hysterectomy but kept my overlies and have gone through cancer having chemo and radio therapy, my only symptom is hot flushes but they are really bad and my blood test came back with raised hormones, what do you think.
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eileen — 26.07.2017 10:27
Hi Linda
Please could you let me know how old you are, thanks.
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eileen — 26.07.2017 11:59
Hi Linda
When your ovaries are left you tend to have the menopause at roughly the same time you would have done had you not had the operation so you will be considered post-menopausal by now. If you are still getting menopause-like symptoms such as hot flushes they may be caused by other factors such as stress, low iron, low thyroid function or low vitamin D so it is a good idea to ask your doctor to test for these just to rule them out.
Having chemo and radio therapy could also be a trigger. You may find acupuncture beneficial or you could try the sage tablets as long as your doctor is happy for you to take them.
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Rachel — 25.07.2017 07:41
Very useful thank you. I'm 50 and wish I'd known all this five years ago when I became peri menopausal.
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eileen — 26.07.2017 10:27
Hi Rachel
You're welcome!
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Angela — 17.07.2017 18:42
Hi there, Thank you!
I'm 42 and I'm in the menopause. I have found your advice very very helpful. You have given me a greater understanding than anybody. There's lots I'm struggling with, the worst thing is I'm unrecognisable, I've gained 4 stone in a year and a half,my facial features have totally changed!!! I'm devastated with this. I've been eating healthy and exercising but it's not working, can you help me ? What else can I do, I'm at the end of my tether. Xx
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eileen — 18.07.2017 08:43
Hi Angela
Unfortunately, the usual methods of dieting such as going on a low fat, calorie counting diet and exercising like mad don’t work in the menopause and will almost always cause weight gain! In the menopause your nervous system (adrenals) are brought into play and will cause almost constant ‘flight or fight’ responses. So if you cut calories and go low fat the body thinks there is a famine and will slow down your metabolism. The same with exercise, the more you do the more the body thinks it is losing energy reserves so it will store as much food as it can as fat!
The secret in the menopause is to eat enough calories for your intended weight needs, cut carbs but increase good fats and protein, this fools the body into thinking there is plenty so will keep your metabolism running well. Exercise needs to be hard and swift, if you are fit enough, such as HIIT, to fool the body into thinking there is no energy loss threat.
It is very hard, when you get to the menopause, having to rethink how you manage your weight as we have been almost brainwashed into thinking low calorie, low fat diets with lots of exercise will help! You may find books on the Low GL Diet or the Paleo Diet or the SIRT Diet helpful.
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Mary — 10.07.2017 18:59
This is a great help for me at least l know the stage am in.
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Maryna — 05.06.2017 10:18
Good day Eileen, I have been having early onset of menopause and have been prescribed Activelle (started using it around mid May). Since the middle of last week I began feeling very bad - nauseousness and indigestion (as if I am pregnant :( ). At first I thought it was a bad stomach bug but then realised that it is not going away. I contacted my gynecologist who indicated that it might be a side effect of the hormone replacement medication. I have now stopped using them (as per the gynaecologist's advice). She has now prescribed Livifem. I was wondering instead of going the western medicine route is there not a natural remedy that I can start using for menopause instead.
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eileen — 05.06.2017 12:27
HI Maryna
Please could you use the Ask Eileen box at the top of the page to let me know how old you are and what is happening with your periods, thanks.
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brigette cavanagh — 16.04.2017 08:00
i have very severe depression and suger binges leading to weight gain as a redult of menopause can you suggest anything im on hrt and it was helping
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eileen — 19.04.2017 14:21
Hi Brigette
You may find taking a Chromium supplement helps the sugar cravings, you can get this from most healthstore, check out Pharma Nord's one
https://www.multivits.co.uk/chromium
Severe depression does need to be treated by your doctor as over the counter remedies are unlikely to be effective enough to help, sorry.
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Paula — 30.03.2017 15:42
Hi Eileen , I'm obviously in the early stages of menopause. I've been having hot flushes mainly early evening and night . Keep waking throwing covers off. Get up tired. I'm on thyroxine for an under active thyroid as well. Just want to sleep . Please help !
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eileen — 31.03.2017 08:46
Hi Paula
You could try the sage tablets as these are known to help reduce/stop hot flushes and night sweats, you can take it with your evening meal. Falling oestrogen can also make existing health issues such as low thyroid function worse so it is really important to get your thyroid and medication checked regularly and this situation can change very quickly.
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Debbie Kirkman — 28.03.2017 11:16
Hello Eileen,
You recently sent me my trial pack which I took at I think it possibly helped with my libido but for 2 weeks it is quite difficult to tell......
My symptoms are mainly hot flushes and I take a high dose of sage for this in the mornings (which definitely helps), sleepless nights and I want to eat all the time!!! The night times are the worst really. I get lots of hot flushes, need to go to the toilet at least once a night (usually twice) and just wake up for no apparent reason a couple of times a night. I was wondering what you would suggest for me going forwards? I am not aware that I have mood swings or any other major issues but just need to get some sleep!!
I very much look forward to hearing back from you.
Kind regards
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eileen — 31.03.2017 08:53
Hi Debbie
Unfortunately, falling oestrogen can interfere with our ability to sleep hence waking up a lot more. You may find Dormeasan helpful as this is traditionally used to help with sleeping and it usually works quite quickly.
Wanting to eat all the time is often an indication that your blood sugars are fluctuating to much so just make susre that you eat little and often but go low carb and up youir protein and healthy fats - these keep your blood sugars much more stable. You could also take a Chromium supplement which is known to help balance blood sugars. However, if you feel this is getting out of control then just check with your doctor, for some women the hormonal flux can interfere with their insulin control.
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Oladunni Deji-Afuye — 27.03.2017 21:08
Thank you for those tips on menopause. Kindly talk on how to manage side effects of total hysterectomy
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eileen — 31.03.2017 08:59
Hi Oladunni
For a total hysterectomy you would either need to take HRT for a while to help with the sudden loss of hormones. If you can't take HRT or want to try it without it is better to seek the advice of a practitioner who can support you through it, such as a Medical Herbalist or Naturopathic doctor or you could check out acupuncture.
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Tracey — 24.03.2017 16:13
Thankyou for keeping me informed about the many effects of menapause.I have made changes to diet etc and followed your tips.Im especially intrigued with the brain fog and mild low mood and anxiety linked with menapause.Also the embarrassing issue of wetting myself when snezing.Eostrogen cream perscribed helped.
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Eileen — 27.03.2017 09:30
Hi Tracey
Great to hear that you have changed your diet, this can make such a difference. Just remember to drink lots of water as dehydration can be a factor in brain fog, anxiety etc. Specific Pilates exercises or the Kegel Exercises can often help to strengthen the bladder so worth checking out.
See my video blog on brain fog for more lifestyle tips. https://www.avogel.co.uk/health/menopause/videos/loss-of-memory-poor-concentration-and-brain-fog/?parentDoc=30177&rows=6
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LISA — 21.03.2017 23:18
Hi Eileen. At the age of 40 I had a partial hysterectomy. I am now 55. I already went through the hot flashes and night sweats. My question to you is: is dry eyes, dry and itchy skin, dry and sore scalp and sore muscles a part of menopause? If so, how long do it last for?
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Eileen — 22.03.2017 11:14
Hello Lisa, Dry and itchy skin is common due to the hormonal shift. I often recommend Sea Buckthorn oil capsules form the Health food store, as this supplement can aid dryness in different areas of the body and eyes. Stress can be a contributory factor as histamine levels rise at this time. Looking after your self in very important. Drink plenty of plain water throughout the day to hydrate and nourish your skin and the herbal remedy Milk thistle complex may be of benefit here to act as a gentle liver tonic. While the Neem cream can be applied and a cup or two of nettle tea can cleanse and detox the skin. Swap over gradually to more organic shampoo and shower gels to see if this helps your situation.
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Stacy — 17.03.2017 01:53
I have had minor pre-mentalause symptoms. My worst was the palpitations. I have been off periods for almost a year.
And the palpitations subsided and the night sweats.
I only experienced day sweats briefly and it was last summer. However, I expected to dry up and I am still juicy,
In fact my labito returned with a wild vengence....odd.
That makes me curious as to whether my body is wanting to get pregnant...mind you..my body...cuz my mind has no desire for more children..somehow I think Intemate desire is trying to fix some grieving aspects of my life as well...but is the sorrow another menapause symptom..are our feelings more magnified? How do we tame our emotional anxieties..is it life? Or exaggerated menapause?
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Eileen — 21.03.2017 14:40
The transformation and changes in the menopause can cause lots of different symptoms. The rise and fall of the hormones still occur even when periods stop and symptoms can change. Every woman is different due to health conditions, stress, diet and lifestyle. I am not sure what age you , however, as periods cease, there may be some sense of loss and this can have an impact. The fall in oestrogen levels can make you feel very vulnerable or sad. There are several things that may help here. If you do feel stressed or anxious then one of the stress remedies such as Passiflora Complex or Avena sativa may help. I would also suggest a magnesium supplement and a vitamin B Complex to help support and calm the nervous system. You may also find Menopause Support helpful, this is traditionally used to help gently raise and balance oestrogen thus reducing symptoms, Best wishes.
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Tina Valkeith — 15.03.2017 21:47
not quite sure where I am the hot flushes are hear the periods have stopped haven't had one for a year now, not sure if this is also a symptom but have been having a very itchy vagina and dry have some cream which eases the symptoms but can be a pain in more ways than one.
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Eileen — 17.03.2017 12:19
Hi Tina, symptoms like Hot flushes can continue for quite a while even once periods have ceased. Try to avoid caffeine or high sugar foods as these can trigger symptoms of make symptoms worse and drink plenty of plain water through out the day. Sage extract like Menosan can tackle bothersome Hot flushes. Falling levels of oestrogen can cause a reduction of protective mucus in the vagina too, resulting in symptoms such as itching, irritation and infection, and this is a common symptom in the menopause. You may find that taking a good probiotic and Molkosan (which is traditionally used to help rebalance the pH) will help to rebalance the vaginal fluids. A company called Optibac have now just released a specific probiotic for menopause women
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