MENOPAUSE OR PERIMENOPAUSE?

​You will often have heard the terms “menopause” and perimenopause” banded around, but do you know if they mean different things or are they the same term but given a modern slant?
 
The term “menopause” has been around for a very long time. It comes from the Greek words “men” meaning month and “pauein” meaning to stop.  In fact Aristotle referred to menopause at 40 years, but a French physician, Charles-Pierre-Louis de Gardanne, started to use the term menopause in 1821.  Interest in the menopause started to increase during the mid-19th century and it was in the 1930s where it was described as a deficiency disease. In 1899 the American pharmaceutical company, Merck, started selling Ovariin, derived from dried and pulverised bovine ovaries, but it was only in 1942 that the first modern commercial prescription drug Premarin (made from pregnant horse’s urine) came onto the market, and it was only used as a short term remedy. However, it took until the 1970s for menopause to be recognised as a medical condition requiring use of regular medication to reduce symptoms. This was when hormone replacement therapy (HRT) was branded as “the ultimate liberation of middle aged women”!
 
Throughout history there has been a belief that there was a link between the womb and the brain, so women were considered to be more likely to become insane, particularly those in menopause.  So many were locked up in asylums!!  In Victorian times, a woman’s ovaries “were the seat of feminine essence and all that was virtuous in women sprang from them.” Therefore if ovaries failed either through disease or menopause, then the woman was considered to not be “of sound mind”.  The ovaries would be removed as doctors believed this would make the woman more compliant, docile and harder working! I’m so glad that attitudes have moved on a bit since then, as I would definitely be lacking ovaries and in an asylum!!
 
So back to my original question of “what is the difference between menopause and perimenopause”? 
 
Menopause is the process that a woman goes through that causes her periods to end.  I would absolutely stress that it is a turning point, not a disease!  But it can have a big impact on a woman’s well-being.  Although menopause can bring physical discomfort (hot flushes/night sweats etc), it can also be the start of a new and rewarding phase of your life, and a golden opportunity to guard against major health risks like heart disease and osteoporosis.
 
Age it the leading cause of menopause, but it can be brought about by surgical/medical intervention such as hysterectomy and removal of ovaries, chemotherapy, or pelvic radiation treatment.  As we get older, there are fewer eggs in our ovaries to be released causing lower levels of oestrogen to be produced, until eventually our periods stop.  I wrote about the role of hormones and our reproductive cycles in earlier blogs, so feel free to go back and have a refresher on this.  Our bodies are complicated machines!
 
Menopause is classed as the time when a woman has not had a period for 12 consecutive months and it technically only lasts a day.  I do feel we should have a celebration with cards, balloons, wine and cake on this day!! The day after, we become post-menopausal. The average age of menopause is 51 years but this is only a guide and can happen earlier or later.  There is no proven way to predict menopausal age, but it is often worth a conversation with your mum to see when she went through menopause. 
 
So, the period of time that used to be referred to as menopause, is now referred to as perimenopause.  This is the time prior to menopause when our periods and ovulation become irregular.  This can last 8-10 years before menopause, and is when we experience the symptoms attributed to lowering hormonal levels.  It usually begins in the mid-40s but can begin as early as a woman’s 20s or 30s.  If it occurs before the age of 40 it is referred to as an early menopause or primary ovarian insufficiency (POI).  Statistics show that this occurs in 1:100 under the age of 40 and 1:1000 under the age of 30. 
 
I hope this explains the terms around menopause that you will have heard.  In future blogs I will be looking at the symptoms you may be experiencing in perimenopause, why they happen, available treatments, but also how my love of reflexology can help you manage your symptoms.