by Dr Donna Robinson

Menopause”. A bittersweet word that symbolises the ending of an era. The monthly menstrual cycles that have caused our emotions to fluctuate, are finally coming to a slow and steady halt. For some women, menopause occurs naturally between the ages of 45-55, with changes in menstrual cycles and/or mood being noticed years before having the final period.

However, others may experience another type of menopause which is known as premature menopause. This is diagnosed when women begin to go through menopause in their early 40s. It is safe to say that menopause may trigger significant changes in both a woman’s physical and mental state. Some of these changes can be quite uncomfortable and cause disruption to a woman’s life.

In this article, we’ll explore what menopause is, what may happen during menopause and finally, the various treatment options to help manage the symptoms (and when you may want to consider these). If you are reading this article, and find that you are experiencing symptoms, it is important to understand that you are not alone in this experience – many women go through the similar struggles and hurdles of menopause to what you may be experiencing, and there are various ways to help manage these.

Most women face natural menopause usually between the ages of 45-55 years old. The most noticeable changes usually occur during the transition from perimenopause to menopause. For those who are wondering, perimenopause usually begins when a woman is in her 40s, but sometimes it can even begin in the 30s.

During perimenopause, the ovaries stop releasing eggs and levels of progesterone decline while oestrogen levels remain generally stable. For most women, this difference between hormone levels, otherwise known as oestrogen dominance, can cause serious discomfort and include symptoms such as;

• Breast swelling and tenderness
• Mood swings
• Lack of sleep
• Irritability
• Weight gain

During perimenopause, testosterone levels may also declineand some of the symptoms may be significant in some women. Although they may be more subtle than those of low progesterone, they include;

• Loss of sex drive

• Depression

• Decreased sexual response

• Lower energy levels

Once perimenopause reaches its final stages and you begin to transition into menopause, the oestrogen levels in your body significantly decrease by approximately 30%-60% (from your pre-menopausal oestrogen levels). Ultimately, this will cause substantial symptoms which often include;

• Hot flushes

• Night sweats

• Lower energy levels

• Mood swings

• Depression

• Headaches and confusion

The approach of and beginning of perimenopause and menopause can seem rather daunting.

However, it is important to know that mild symptoms can usually be managed by maintaining a healthy lifestyle, staying active and just generally keeping a positive mindset and knowing that there are options there to help you manage symptoms if you feel that these are hindering your daily life.


Although natural menopause is the most common form, some women experience what is called premature menopause. This occurs when women experience menopause in their early 30s or 40s. Not only does premature menopause occur earlier, but it also happens significantly faster than normal menopause.

Premature menopause can be caused by several conditions, including chronic stress, autoimmune disease and nutrition deficiency. Although some women may experience early menopause due to unknown reasons; for example, it is thought that an erratic, unhealthy lifestyle may be linked to premature menopause.

To see whether you are experiencing premature menopause, there are several hormone tests that can help you know exactly what is going on with your body, and whether you are experiencing premature menopause or ovarian failure.

The key test to establish whether you are experiencing menopause is called Follicle Stimulating Hormone (FSH) Blood Level Measurement. Essentially, a sample of blood is taken and if the results show high levels, it means your ovaries are not producing enough oestrogen. This indicates that your body is entering the stage of medicine. Below you will see how your FSH levels may be interpreted;

• Pre-Menopausal: 3-20 mlU/ml

• Perimenopause: Above 10-12 mlU/ml

• Menopause: 30-40 mlU/ml

Additionally, measuring oestrogen levels in the blood can also indicate whether you are experiencing menopause. If your oestrogen level falls below 25 pg/ml, this is usually considered in the menopausal range. Below is a guide that focuses on the oestrogen level that would be seen in each situation.

• Normal: 25-75 pg/ml

• Menopausal: 25 pg/ml or below, along with high FSH levels

• Menopausal experiencing symptoms: 50pg/ml or below It is important to note that there is not one test to ‘diagnose menopause’ – rather, the results of several hormone level tests (ie FSH, oestrogen, etc.) accompanied with the symptoms that you are experiencing can strongly indicate that you may be experiencing menopause.

Both premature menopause and natural menopause can severely affect a woman’s overall persona and mood. A naturally happy and energetic person can begin to feel depression and tidal waves of tears. Disturbed nights can begin to become a regular occurrence due to waking up hot and bothered.

Sleep deprivation can become a serious issue and can sometimes affect one’s day-to-day life as well as relationships with others. It is important to know that if you feel that perimenopause/menopause is interfering with your life, you are recommended to seek medical advice.

There are many treatment options which involve simple lifestyle changes (ie avoiding certain foods to reduce the occurrence of hot flushes, eating foods which contain phytoestrogens such as whole grains, soy and legumes), symptom management or hormone replacement therapy. Treatment options will be discussed further and in more detail in part 2 of this article.


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