Pre-menopause

During this phase, the menstrual cycle still proceeds normally: the pituitary gland releases the follicle-stimulating hormone (FSH), causing the egg to mature and ovulation to occur. Simultaneously, the ovaries release more oestrogen, causing the uterine lining to grow. This growth inhibits the production of FSH but stimulates the release of Luteinising Hormone (LH). When the LH peak is at its highest, ovulation occurs. In addition to oestrogen, the ovaries now also produce more progesterone, supplying the growing uterine lining with extra nutrients for the potentially fertilised egg. If the egg is not fertilised, oestrogen and progesterone levels drop again, triggering menstruation.

Complaints

The most common complaints during pre-menopause include PMS complaints, PMDD complaints (a severe variant of PMS), oestrogen dominance, and POCS.

Peri-menopause

This phase is characterised by the absence of ovulations; menstrual bleeding may still occur but often irregularly. The bleedings can also become heavier or lighter or occur between menstrual periods. FSH production rises, but the production of oestrogen, particularly the oestrogen metabolite estradiol, is no longer sufficiently produced by the ovaries, preventing the growth of the uterine lining and additional LH production: ovulation does not occur. In this period, which lasts on average 4-6 years, oestrogen production continues to decline. This also applies to progesterone production. Often, the progesterone level drops even faster than the oestrogen levels, resulting in oestrogen dominance.

Complaints

Complaints that may arise from oestrogen dominance and other typical menopausal complaints include:

Physical

•       hot flushes
•       night sweats
•       weight gain
•       osteoporosis
•       sleep problems
•       vaginal dryness
•       joint pains
•       headaches
•       low libido

Psychological 

•       anxiety
•       depression
•       mood swings
•       irritability.

Menopause

The last menstruation occurs when the ovaries have no fertile eggs left. Almost no oestrogens and progesterone are produced, and the reproductive system loses its function. The woman is no longer fertile. Menopause can only be determined retrospectively if a woman has not had a new menstruation for a year after the last one. During this period, the same complaints can occur as during peri-menopause.

Post-menopause

In the period after menopause, the post-menopause, the ovaries no longer produce hormones, disrupting the hormonal balance. The female oestrogen hormones that still enter the body are produced in the adrenal glands and fat tissue instead of the ovaries. However, this is usually not sufficient to balance your hormones, so the well-known transition complaints persist even in this phase. It may take several years for the body and mind to find a new balance. On average, post-menopause lasts two to five years, but for some women, it lasts longer. The female body begins to adjust to a new hormonal balance. Even during this period, women may suffer from the well-known transition complaints, but the most common ones are a dry vagina, thinning, sagging, and drier skin, but also dry hair, joint and muscle complaints, and weight gain.

Western women usually have their last menstruation between the ages of forty and sixty (average age 51). The transition is a normal physiological process with significant variations in duration, course, and severity of complaints. Some women hardly notice the transition, while others suffer from severe transition complaints. The latter group will often actively seek relief from complaints in the form of hormone therapy and/or supplementation.