The Menopause officially marks the end of the female reproduction.1 It occurs when you stop menstruating for 12 months in a row and you are over 50 years old.1 Although this life stage is well known, there are different stages within menopause that are important to recognize and understand. Although Pre-Menopause and Menopause are both part of the same overall life transition, they have different symptoms and treatment options.1
Menopause is not a disease; therefore, it cannot be diagnosed as such. Women will need to see a gynecologist only, if relieve for symptoms is needed. However, if a woman is having menopausal symptoms before the age of 45 years, it will be necessary to see a gynecologist.2
Pre-Menopause is a transitional phase and called as such because it happens right before menopause. This phase can last up to 10 years and usually starts when women are in their 40s. The menstrual cycles become erratic and irregular, sometimes there are heavy bleedings. Gain of weight is no symptom of menopause.3
Moreover, women in pre-menopause should consider that they can still get pregnant.3
The following symptoms are typical for the pre-menopause:
Menopause occurs when a woman that is over 50 years old stops menstruating for 12 months in a row.1 Alternatively, the period of a woman could also stop permanently as the result of a surgical treatment, which is the removal of the ovaries (surgical menopause). At this point, the ovaries no longer release eggs and no longer release estrogens, and pregnancy is no longer possible.4
In this phase of life, women are more exposed to cardiovascular diseases1 and osteoporosis.5 It will also have a psychological impact as women can experience mood changes and depression. Women should also consider talking to a gynecologist regarding their sexual life, vaginal dryness and similar problems.1
The Post-Menopause are the years of a woman’s life after menopause occurs.6 In this phase, menopausal symptoms, such as hot flashes etc., get milder or disappear.6 Women in Post-Menopause have an increased risk for osteoporosis and heart diseases. Medication or healthy lifestyle changes may reduce the risk of these conditions.6
Yearly visits of the gynecologist are still necessary during Post-Menopause, in order to exclude pelvic and breast cancer. Especially if bleeding occurs during this phase, a gynecologist must be seen to exclude cancer.6 A PAP test should be performed up to the age of 65 years.7
1. Takahashi TA, Johnson KM. Menopause. Med Clin North Am. 2015 May;99(3):521-34. doi: 10.1016/j.mcna.2015.01.006. PMID: 25841598.
2. Kingsberg SA, Larkin LC, Liu JH. Clinical Effects of Early or Surgical Menopause. Obstet Gynecol. 2020 Apr;135(4):853-868. doi: 10.1097/AOG.0000000000003729. PMID: 32168205.
3. Perimenopause: Age, Stages, Signs, Symptoms & Treatment. (2021). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21608-perimenopause
4. Surgical Menopause - Australasian Menopause Society. (2017). Surgical Menopause. https://www.menopause.org.au/hp/information-sheets/surgical-menopause
5. Endocrine Society. (2022, January 24). Menopause and Bone Loss. https://www.endocrine.org/patient-engagement/endocrine-library/menopause-and-bone-loss
6. Postmenopause: Signs, Symptoms & What to Expect. (2021, October 5). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21837-postmenopause
7. Pap Smear After Menopause. (2002, October 7). WebMD. https://www.webmd.com/menopause/guide/menopause-pap-smear