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[KarineT]

Hello everyone,

I find it all very confusing about perimenopause, menopause and postmenopause but I think I've begun to understand.

After speaking to a menopause specialist this morning this is how I interprete all three stages of the menopause but correct me if I'm wrong.

Perimenopause is when the hormones fluctuate so much but at the same time they start declining. This is when one notices the first symptoms.

In menopause the hormones probably still fluctuate but they decline even more and more symptoms can crop up.  I automatically assumed that when a lady enters the menopause that's when she starts the 12 months process withoiut a period otherwise she's stil perimenopausal.

As for postmenopause is when one hasn't had a period for at least 12 consecutive months and therefore the menopause has been reached.

This means that in my own case I could already have entered the menopause, i.e. going through it, even though there's a possibility that I could have more periods in the future despite the fact that I haven't had one since January this year and, in this case,  it would no longer make me perimenopausal. But it looks like the transition  between the perimenopause and the menopause cannot be distiguished unlike postmenopause.

When I asked the specialist about HRT this morning, he told me that one of his patients is 80 years of age and she can't live without HRT.  I was shocked but he said that there are only a small percentage of ladies who have that problem though.  I do hope I won't be one of them.



 

[Tc]

Hiya karine.

 As I see it there are only 2 phases.  Peri menopausal which means "around menopause" and post menopausal..I dont think there is an in between. I think "menopausal" is often used as another word for peri.

in peri, the fluctuations can become more pronounced as it goes from its early stages to late and at times estradiol levels fall lower than they would have before. .   This continues until levels fall and stay down and periods cease permanently . You are post menopause from that point on but we only know this with hindsight of 12 months period free because during the late stages of peri periods can be months apart.   It's highly individualised. Some women find once they start skipping a couple of months   they then stop but other women  may have no period for 11 months and then have one. In which case the countdown to post meno starts again.  To this end it's worth noting that women under 50 are advised to continue contraception for 2 years after last period.  Women over 50 it's one year. 

The exception to this is surgical menopause where we know there will be no further ovulation. you are immediately post menopause and dont have to wait 12 months. 

So. You are still peri menopause. You havent had a period since January.  If you dont have another one before next jan/Feb then you will be post menopause from then on. But until then you are peri.  If you have a period before then you have to restart the 12 month countdown from then. 

you can ask for HRT in peri if you wish.
X

[CLKD]

Why worry how long you need to take HRT?  If you were diabetic or had a heart condition ? 

Menopause literally means cessation of periods.  12 months from the last without a bleed or smudge of brown discharge.  Some ladies do get periods after this time which needs investigation via a GP to check the womb lining.

Peri means the journey into menopause.  Some don't notice much other than lack of periods which then stop, which is what happened to me.  No flushes but skin has been itchy due to a drop in oestrogen and I have ovestin for vaginal atrophy which began years after periods stopped.  Now I have to work out how old I was  , I think I was late 40s.  It as 2002 anyway.  VA popped up 5 years ago.  Hindsight and I wonder if I was peri for several years which I put down to other issues. 

Some ladies have horrendous hormonal upheaval and require HRT for a long time.  As well as anti-depressant and anti-anxiety medications.  It's about making informed choices and deciding which symptom needs easing. 

Clear as mud ain't it  . It does help to keep a mood/symptom/food diary.

[KarineT]

I have a diary and record all the symptoms that I get.  In terms of diet I don't eat spicy foods, I don't drink alcohol or coffee and I don't smoke.  But I do like sugary foods.  I have started cutting down on these.

[KarineT]

Then in my case I haven't yet reached menopause as I haven't gone 12 months without a period.

[CLKD]

Seems like it.  Enjoy being period free 

[Tc]

Correct karine.  Once 12 months,have passed without a period you will be post menopause. If you have a period tommorow you have to start counting 12 months again.  Once you are post meno eastrogen levels,will remain low  compared to previous years. 

[Mogster71]

This is a big part of the problem I think....we are vastly under-educated when it comes to the menopause. I didn't even know about perimenopause until I was about 43 or 44 and (what I now know) going through it...I'm nearly 49 now. There's this term "menopause" which seems to encompass the whole thing! In my mind's eye I see the menopause itself as being a bit of a line drawn in the sand which you can't draw until you have gone 12 months without a period.

In peri our hormones are fluctuating like mad while they have their last "ta-da" moment. My GP was fab and his explanation was that because levels are falling they have to push really hard to make things happen, which is why we have these intense surges and dips. It all made sense to me. I try not to get too hung up on the whys and whens really as on HRT now I've upped the dose I do feel better. Once I had found the HRT which suited me I had about 6 months on it working well then the next 3 having a headache all day long on most days of the month. Almost instantly since increasing it I've had just a few buzzy head feelings here and there in the second half of the pack. I'll take that over feeling cr*ppy thank you My mood is calmer and energy levels higher, my body responded almost instantly.

As CLKD has said above, if you were in pain you'd have medication or a thyroid/insulin deficiency you'd take medication to help you feel better. I realise that ovarian failure is a natural event and that for centuries women had to endure it naturally but if you have options to take something which can really ease things if you're having a rough time then is it worth a try? If it works you'll feel better and if it doesn't you can always stop taking it?