Menopause: A Journey of Change

​Marilyn Erickson, MSN, APRN

“In the dance of life, a new phase begins,
A journey of change, where the old world thins,
Menopause arrives with quiet force,
Bringing wisdom and grace on its sacred course.”
—Dixie Lincoln Nichols
 
So menopause presses forward whether or not women are ready for it. But knowing and understanding what is happening during this process of menopause can give women some sense of readiness and maybe even a little control. I will start you on this knowledge journey by describing some of the distinguishing features of the menopausal stages. 
 
Perimenopause: the beginning of the end of ovarian function. During this transitional stage, fluctuations in hormone levels are beginning. The hormones affected are progesterone and estrogen. Our periods become irregular and may be shorter or longer in duration. It may begin sometime in our 40s and more rarely, in the mid-30s. It may last anywhere between 2 and 10 years. 
 
Hormone levels fluctuate crazily during this stage and no one-time hormone test can diagnose it. But your provider can start menopausal hormone therapy (MRT) as symptoms emerge. The symptoms that are known to benefit from MRT are hot flashes, night sweats, menstrual irregularities, decrease in sexual feelings, fat gain in your abdominal wall and internal organs, hair loss, low muscle mass and bone loss. 
 
Once fertile grounds now lay sacred and bare,
Yet within this stillness, a power to share,
No longer defined by cycles of the moon,
A deeper essence begins to bloom.
—Dixie Lincoln Nichols
 
Menopause: Occurs when you have not had a period for 12 months. It marks the end of a woman’s menstrual cycle and reproductive capabilities. It is really defined by a date on the calendar rather than by a list of symptoms. The average age of menopause is 51. Early menopause occurs before age 45 and premature menopause occurs before the age of 40. 
 
Postmenopause brings a woman to a new phase of her life. It lasts the rest of one’s life and is really a time to be kinder, more loving and giving to oneself. It may present with more hot flashes, heart palpitations, and sweating. The average duration of these symptoms is extremely variable. 
 
Because the changes in a woman’s life during this transition brings with it many changes of aging, it is important to pay attention to any symptoms that occur that could indicate that one is going through the perimenopausal stage. MRT started early on can be very beneficial and support a higher quality of life. 
 
A woman does not need to feel defeated or dismissed during this transition. As the poetry cited suggests, it is a time for growth, wisdom, and power.

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