Perimenopause Signs and Postmenopause Symptoms

Menopause Photo courtesy of Society for Women's Health ResearchOpens in new window

When a woman’s ovaries stop producing eggs and female hormone levels drop, her menstrual periods cease, and she experiences menopause.

Menopause—signaling the cessation of reproductive fertility—usually occurs during midlife (usually between the ages of 45 and 55; Xu et al., 2005).

Menopause can occur as a normal part of aging or can be a result of surgery (e.g., hysterectomy), chemotherapy, or radiation.

Menopause, from the Greek roots men (month) and pauein (to bring to an end), literally means “end of monthly cycles.”

The period of time leading up to menopause, known as perimenopause, is marked by irregular menstrual cycles. Other menopause symptoms may occur during perimenopause.

The perimenopause period may last between 1 and 10 years (average is 4 to 5 years). Menopause period may last between 1 and 10 years (average is 4 to 5 years). Menopause (or postmenopause) is said to have occurred after there have been no menstrual periods for 12 consecutive months (Twiss et al., 2007).

Estrogen (estradiol) and progesterone are female hormones (although estrogen is also found in males, as testosterone is found in females). Female hormones serve many functions. These include promoting the formation of female secondary sexual characteristics (e.g., breast development), onset of menstruation, supporting pregnancy, metabolism, and maintenance of bone density.

Estrogen levels in females may affect energy level and mood. Fluctuating levels of estrogen and other (e.g., serotonin and beta-endorphins) hormones may manifest as mood swings, depression, anxiety, or irritability at different points in the menstrual cycle (Dickerson, Mazyck, & Hunter, 2003). Female hormones decrease naturally with age.

Symptoms and Treatments

While some women experience menopause symptoms, including depression, irritability, mood swings, decreased libido, sleep problems, night sweats, and hot flashes, many women have no symptoms (Liu et al., 2009).

Women may also experience loss of bone density during and after menopause. Symptoms may vary according to overall health or the existence or severity or preexisting symptoms (e.g., premenstrual syndrome). Menopause symptoms may also vary by culture, social group, and ethnicity (Xu et al., 2005).

Some women use hormone replacement therapy (HRT)Opens in new window to treat menopause symptoms. HRT consists of female hormones, usually in pill or skin patch form. HRT has been promoted as a means to treat menopause symptoms and prevent loss of bone density. However, a large study in 2002—the Woman’s Health Initiative—raised concerns about th long-term safety of HRT and breast cancer (Rossouw et al., 2002).

Some women use natural treatments for menopause symptoms, including botanicals (black cohosh, donq quai root, ginseng, kava, red clover, and soy) and dehydroepiandrosterone (DHEA), a dietary supplement.

However, there is little good-quality research to support the safety and effectiveness of these alternative treatments (National Center for Complementary and Alternative Medicine, 2008). Women may also use physical exercise, calcium supplements, and social support to help them deal with the symptoms and risks associated with menopause.

The male equivalent of menopause, known as andropauseOpens in new window, is a mildlife condition experienced by some men. Although men do not have monthly menstrual cycles, their testosterone (male hormone) levels droop. Male testosterone levels affect sexual functioning, energy level, physical agility, bone health, and mood.

See also:
  1. Dickerson, L.M., Mazyck, P.J., & Hunter, M.H. (2003). Premenstrual syndrome. American Family Physician, 67, 1743 – 1752.
  2. Liu, D., Lu, Y., Ma, H., Wei, R. C. Li, J., Fang, J., et al. (2009). A pilot observational study to assess the safety and efficacy of menoproggen for the management of menopausal symptoms in Chinese women. Journal of Alternative and Complementary Medicine, 15, 79 – 85.
  3. National Center for Complementary and Alternative Medicine. (2009, February). Menopausal symptoms and CAM (National Institutes of Health Publication No. D406).
  4. Rossouw, J.E., Anderson, G.L., Prentice, R.L., LaCroix, A.Z., Kooperberg, C., Stefanick, M.L., et al. (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results from the Women’s Health Initiative randomized controlled trial. Journal of the American Medical Association, 288, 321 – 333.
  5. Twiss, J. J., Wegner, J., Hunter, M., Kelsay, M., Rathe-Hart, M., & Salado, W. (2007). Perimenopausal symptoms, quality of life, and health behaviors in users and nonusers of hormone therapy. Journal of the American Academy of Nurse Practitioners, 19, 602 – 613.
  6. Xu, J., Bartoces, M., Neale, A. V., Dailey, R.K. Northrup, J., & Schwartz, K. L. (2005). Natural history of menopause symptoms in primary care patients: A MetroNet study. Journal of the American Board of Family Practice, 18, 374 – 382.