Within menopause, there are three different stages: premenopause, menopause, and postmenopause.
In Spain, the average age of menopause is around 51 years. Early menopause, although rare, occurs before the age of 40. There can also be cases of women aged 54-56 who continue to have their regular periods, but beyond that age, it is not usual.
In this sense, three different stages are distinguished within menopause: premenopause, menopause, and postmenopause. According to Dr. Clotilde Vázquez, head of the Endocrinology and Nutrition Service of the Fundación Jiménez Díaz University Hospital, ” premenopause is characterized by the beginning of the decline in the production of ovarian hormones and by the beginning of upward oscillations of hormones hypothalamus-pituitary glands that regulate the entire process of the ovulatory cycle”.
Women in this phase may experience delayed periods, irritability, more pronounced premenopausal syndrome, or, conversely, significant bleeding to the point of anemia. Sleep may begin to be disturbed and they may experience some flushing or headache.
In Spain, the average age of menopause is around 51 years
On the other hand, menopause begins when you no longer have periods. The symptoms described above can be aggravated: difficulty sleeping, morning joint pain or stiffness, daytime and/or nighttime hot flashes, quality of sleep, and different emotional disorders ranging from emotional instability to marked irritability or sadness that can become intense or even go into depression.
In addition, the expert details, “it is very common to begin to gain fat in the trunk area, around the waist and a tendency to hypertension and an increase in cholesterol levels can be verified. The skin and hair lose smoothness and vaginal dryness and infections and pain in sexual intercourse begin. The main cause of these symptoms is estrogen deficiency, whose blood levels become almost undetectable. This period can last between 5 and 10 years”.
Finally, postmenopause will be the late period, after 10 years without a period. If hormone replacement therapy has not been received, in this phase the late consequences of the decrease in estrogen predominate in the organs: both in the bones (osteopenia/osteoporosis) and in the joints (arthritis, osteoarthritis), but above all in the genitourinary system: atrophy of the vaginal epithelium, incontinence and in some women uterine prolapse. Fat gain, the tendency to hypertension, and dyslipidemia can continue to worsen. Some women with a genetic predisposition develop type 2 diabetes at this stage.
STARTING AGE IN EACH PHASE AND DIFFERENCES
”The first phase is between 45 and 50 years; the average age of menopause, that is, of the complete cessation of cycles and menstruation, is 50 years; and we would place postmenopause around the age of 60”, says Dr. Clotilde Vázquez.
On the differences in each of the stages, the specialist comments that the instability of hormonal levels is key in the first phase. In turn, the absence of estrogen and progesterone secretion by the ovary and the permanent elevation of pituitary hormones are characteristics of the second phase. Finally, the appearance of the consequences of estrogen deficiency in the metabolic, bone vascular, and urogenital systems would be the characteristics of the third phase.
