Symptoms

In clinical terms, ‘Menopause’ (big ‘M’) refers to a specific event, cessation of menstruation (periods). In everyday conversation, ‘menopause’ (little ‘m’) is also used to mark the transition from the reproductive phase to the non-reproductive state.

There appears little agreement regarding the age range for this transitory process, including Menopause. However, it is generally accepted that this process starts several years before and continues several years after Menopause itself. All studies examined agreed that the average onset of ‘Menopause’ in the West is 51 years.

According to Hoga et al. (2015) systematic review of 24 menopause worldwide studies, those experiencing transition ranged between 40 and 65 years. More recently, Gordon et al. (2019) have defined menopause transition as between 42 and 55 years

The diagram, below, shows the possible extent of The Menopause Years. As previously stated, menopause is universal to women but individually experienced, and therefore The Menopause Years as defined here serves merely as a guide.

         The Menopause Years

Note. The age at which a woman transitions and reaches menopause varies substantially. The same applies for symptoms.
1. Based on Stages Of Ageing Workshop (Straw) Park City UT USA, Jul 2001, J Women’s Health Gend Based Med. 2001 Nov; 10(9): 843-8
2. McKinley S M, Brambilia D J, Posner J G. The normal menopause transitions. Maturitas. 2008 Sep – Oct; 61 (1-2): 4-16

Sue’s research carried out with women experiencing The Menopause Years identified the following symptoms, shown in the image below, as the most prevalent amongst participants:

Burden of psychological and physiological suffering
(Image adapted from van Dijk et al., 2014, data from First in the Queue, 2020)

Alongside psychological and physiological symptoms, social and cultural context also influences how women approach and experience The Menopause Years. (Ayers et al., 2010). Hofmeier et al., 2017 qualitative study captures the thoughts, feelings and attitudes of 1,849 women over 50 towards their menopause transition. It emphasises the ‘daunting task’ participants have, managing both cognitive and physical changes. In the analysis, four primary themes emerge, namely:

• The physical and psychological experience of ageing
• The challenges of ageing itself including the injustices, the inequalities
• The importance of self-care
• The need for recognition as an individual who has a contributory role in society

It concludes that the realities of this time of life for a woman need to be widely acknowledged alongside the provision of proper support as women navigate their way through this significant change in life. Approximately 45% of women in the Nuffield study (2017) identified that they often have little understanding of menopause and were ill-prepared, with symptoms not attributed to this change in life. In many cases, women seek little or no help.

What is certain is that The Menopause Years is a significant stage in women’s lives that can be experienced in many ways. Such experience can also be viewed within how each woman perceives menopause, both positive and negative. Those with negative attitudes reported more symptoms during these years (Ayers, 2010). In contrast, those with an optimistic approach show lower levels of depression and a more positive body image (Ebril, 2018).