World Menopause Day: Understanding Perimenopause and menopause
October 18 is World Menopause Day and let’s talk about something all women—half the world’s population—will eventually experience: menopause. Even though it’s a huge part of being a woman, many of us are still navigating it without a real understanding of what’s happening to our minds and bodies. We need to know more than just “periods stop,” and there’s no reason to accept the weird things happening to us as something to suck it up and live with. There’s so much more to this journey and its long-term health implications.
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Explore: October 18 is World Menopause Day: Let’s bust some myths
We’re well into the 21st century, so why does so much about this important life stage remain shrouded in mystery? According to one study in Nature Aging, nearly 99% of studies examining the biology of aging don’t factor in menopause.
That’s a problem, says Fabrisia Ambroso, an HMS associate professor of physical medicine and rehabilitation at Spaulding Rehabilitation Hospital. “When we look at age-related diseases, over 75% of them are likely influenced by menopause in one way or another. But the great majority of preclinical biology research studies in aging fail to consider menopause in their experimental setup,” she said.
Here’s the thing: menopause isn’t a one-size-fits-all experience. Some women experience a barrage of intense symptoms, while others sail through with relative ease. But one truth remains for us all. Menopause is far more than hot flashes, and it definitely doesn’t happen naturally overnight (if you have a hysterectomy, that’s a totally different story). Beyond the physical, emotional and even cognitive shifts you may experience, society and workplace elements come into play during this transition, too. It’s well past the time to start talking about menopause (and perimenopause) openly and getting the information out there.
What exactly is menopause?
We often hear women say they’re “in menopause,” and while that’s typically how we all talk about it, including our doctors, the official definition is pretty specific. We enter the stage of menopause when we’ve gone 12 consecutive months without a period. But that simple definition doesn’t even begin to scratch the surface of this multi-year, multi-phase journey that marks the end of our reproductive years and the beginning of a whole new chapter.
Just like puberty, we all hit this milestone at different ages. Most women officially reach menopause somewhere between the ages of 45 and 55, although surgeries and some medical treatments can start it sooner. It’s also not one big event; your menopause journey has three distinct stages: perimenopause, menopause and post-menopause. Each has its own set of symptoms and lasts a different amount of time for every one of us.
Perimenopause: The real story
The part of the journey that most people think of when they say “menopause” is really perimenopause. During this stage, your hormones (specifically estrogen and progesterone) begin to do a bit of a dance, fluctuating erratically and unpredictably. For most of us, this ‘dance’ kicks off sometime in our 40s, although some women may experience it sooner or later.
Perimenopause isn’t a quick sprint but more like a slow marathon that lasts anywhere between four and 10 years—or longer. During perimenopause, you experience the bulk of those well-known (and much-cursed) symptoms like hot flashes, night sweats, brain fog and weight shifts or gain. Understanding this phase and getting help from your doctor, if needed, is key to navigating this transition with confidence (and without losing your mind).
Menopause: The official milestone
If perimenopause is the long, winding road leading to the big event, menopause is the main attraction. You’ve officially reached menopause once you’ve gone 12 consecutive months without a period. But a little unpleasant heads-up: If your period stops for a few months and then unexpectedly reappears, your 12-month countdown begins again. Take it from someone who was 11 months, 2 ½ weeks away from a full, period-free year: it sucks.
On average, most women reach this milestone around age 51. However, Black and Latina women tend to enter menopause about two years earlier than white and Asian women. Knowing these averages can sometimes help us understand our own unique timeline.
Postmenopause: A new chapter begins
Once you cross the finish line and enter menopause, you transition into postmenopause. It’s during this phase that, for most women, those often-challenging symptoms finally begin to quiet down and subside.
However, this milestone doesn’t mean we can simply forget about our health, as some long-term health considerations become more prominent in postmenopause, including increased risk of cardiovascular disease, bone loss (hello, osteoporosis!) and vaginal, sexual and urinary symptoms. Knowing about these health conditions empowers us to be proactive with our doctors and keep ourselves healthy.
Most of us will live, on average, at least 30 more years after reaching menopause. What’s even better? Many women report that this postmenopause phase is one of the happiest times of their lives. The postmenopause chapter is often filled with freedom, self-discovery and a vibrant sense of well-being.
Looking ahead
We’ve covered the basics of menopause, and by now it should be clear that this phase is more than an “off” switch. Future articles will peel the layers back further. We’ll talk about some of the more common—and uncommon—symptoms you might experience in perimenopause, exploring why they happen and, more importantly, what you can do about them.
Speaking of doing something, we’ll talk about treatment options. From lifestyle adjustments and natural remedies to hormone therapy and other medical interventions, we’ll explore the spectrum of choices available (and dispel some of the myths).
We’ll talk about the importance of finding the right resources and support, including where to find reliable information, supportive communities and healthcare professionals who understand and are educated in what you’re experiencing.
Beyond the physical, we’ll also touch on those societal and workplace implications we mentioned earlier. How can we advocate for ourselves and create environments that support women during this transition? We’ll look at strategies for navigating career changes, workplace challenges and how to talk about menopause with friends, family and colleagues—it doesn’t have to be awkward or embarrassing!
Our goal is to empower you with knowledge and choices and build a community to help you navigate your personal journey with more comfort and confidence. Stay tuned!
