Perimenopause

This is the time you begin experiencing menopausal signs and symptoms, even though you're still ovulating. Your hormone levels rise and fall unevenly and you may have hot flashes and variations in your periods. This is a normal process leading up to menopause and may last four to five years or longer.

Post-menopause

Once 12 months have passed since your last period, you've reached menopause. Your ovaries produce fewer hormones and they don't release eggs. The years that follow are called post-menopause.

Why Does It Happen?

The primary cause is the decline in levels of female hormones, namely, oestrogen, progesterone and androgens.

Estrogen is the main female sex hormone and prompts the growth of the uterine lining. However, oestrogen is far more than a reproductive hormone, as it has wide-ranging effects on other parts of a woman's body. This includes the urinary tract, heart, blood vessels, bones, breasts, skin and portions of the brain.

Progesterone is important in maintaining a regular menstrual cycle.

A reduction in androgen levels may contribute to the reduced energy levels and sexual desire that women sometimes experience during menopause.

Other factors that may contribute to the early onset of menopause include a history of smoking, poor nutrition, a co-existing medical condition or even a traumatic experience.

What to Look For

Every woman has a different experience through menopause. Some have very few of these symptoms and find them easy to manage. In severe cases, you may have trouble sleeping and will suffer from mood swings.

Common Symptoms Include:

• Erratic monthly periods and unusually heavy menstrual bleeding.

This may be your first clue that menopause is approaching.

• Hot flashes and night sweats

During a hot flash, you feel a sudden rush of heat move from your chest to your head. Your skin may turn red and you may sweat.

Most hot flashes last from 30 seconds to several minutes, although they can last much longer. The frequency and duration of hot flashes varies from person to person.

• Vaginal dryness, thinning of the tissues of the vagina and urethra

During menopause, the thinning of the mucus membranes, along with a loss of elasticity in the walls of the vagina due to decreased oestrogen, causes a sensation of dryness in many women. This thinning does not always cause problems, but it can be painful if the lining of the vagina becomes inflamed, dry and rough.

• Increase in facial hair and thinning of hair on scalp

The most common cause of hair loss is low thyroid function, which is common among menopausal women. Other causes include, but are not limited to, changes in hormone levels, increased testosterone, increased stress (physical or emotional), various medications, scalp/dermatological issues and heredity.

Once hormones have levelled off, most of the symptoms experienced during perimenopause will disappear -- although some women have occasional hot flashes, anxiety, bouts of depression, etc, for a few years after they become postmenopausal.