Signs, Symptoms & What to Expect

Overview

What is postmenopause?

Postmenopause is a term to describe the time after someone has gone through menopause. When you’re in postmenopause, your menstrual period has been gone for longer than 12 consecutive months. At this stage in life, your reproductive years are behind you and you’re no longer ovulating (releasing eggs). The menopausal symptoms you’ve experienced in the past may become milder or go away completely. However, some people continue to experience menopausal symptoms for a decade or longer after menopause.

There are three stages of menopause: perimenopause, menopause and postmenopause.

• Perimenopause is the time leading up to menopause. It describes a time when hormones start to decline and menstrual cycles become erratic and irregular. You may start to experience side effects of menopause, like hot flashes or vaginal dryness.
• Menopause occurs when you’ve stopped producing the hormones that cause your menstrual period and have gone without a period for 12 months in a row. Once this has occurred, you enter postmenopause.
• Postmenopause is the time after menopause has occurred. Once this happens, you’re in postmenopause for the rest of your life. People in postmenopause are at an increased risk for certain health conditions like osteoporosis and heart disease.

How long does postmenopause last?

Once you enter postmenopause, you’re in this stage for the rest of your life. Your hormone levels will remain low and you’ll no longer have a monthly period. You can’t get pregnant because your ovaries have stopped releasing eggs.

What hormonal changes happen after menopause?

Your ovaries are making very little of both estrogen and progesterone by the time you’re in postmenopause. Some people still experience side effects from low hormone levels.

At what age are you considered postmenopausal?

There is not an age at which that you are automatically in postmenopause. Once your period has been absent for more than one year, you’re in postmenopause regardless of age. On average, people go through menopause around 51 years of age.

Symptoms and Causes

What are the symptoms of postmenopause?

Most people in postmenopause feel lingering symptoms from menopause. The symptoms are less intense. In some cases, they almost disappear. Lingering symptoms are caused by low levels of reproductive hormones.

People in postmenopause can feel symptoms such as:

If your symptoms become more intense or interfere with your daily life, talk with your healthcare provider. They may want to rule out any underlying condition causing these symptoms.

What causes postmenopausal bleeding?

Vaginal bleeding during postmenopause isn’t a normal side effect of decreasing hormone levels. In some cases, the dryness in your vagina could cause some light bleeding or spotting after sex. In other cases, it could indicate a condition like endometrial hyperplasia or uterine fibroids, infections like endometritis, or cancer. Contact your healthcare provider if you experience any vaginal bleeding so you can be evaluated.

Will my hot flashes stop after menopause?

Some people still experience hot flashes after menopause. Postmenopausal hot flashes are caused by decreased estrogen levels. It is not uncommon to experience a random hot flash for years after menopause. If your hot flashes are bothersome or intensify, speak with your healthcare provider to rule out other causes.

Diagnosis and Tests

How do you know you’re in postmenopause?

Your healthcare provider will be able to tell you if you’re in postmenopause based on your symptoms and how long it’s been since your last menstrual period. In some cases, your healthcare provider will take a blood sample and check your hormone levels to confirm you’ve gone through menopause. Remember, you’re not considered to be through menopause until it’s been over one year since you’ve had a period.

Management and Treatment

What medications are used to treat postmenopausal symptoms?

Hormone therapy could be an option, although healthcare providers often recommend using it for a short amount of time and in people under the age of 60. There are health risks associated with hormone therapy like blood clots and stroke. Some healthcare providers do not recommend using hormone therapy after menopause has ended or if you have certain medical conditions.

Some medications your healthcare provider may consider helping with postmenopausal symptoms are:

• Antidepressants for mood swings or depression.
• Vaginal creams for pain related to sexual intercourse and vaginal dryness.
• Gabapentin (Neurontin®) to relieve hot flashes.

Oftentimes your provider will recommend lifestyle changes to help manage your symptoms.

How do I manage symptoms of postmenopause on my own?

Certain lifestyle or at-home changes can help you manage symptoms of postmenopause. Some of these include:

• Using a water-based vaginal lubricant during sex to make it more pleasurable. Lubricating the vagina helps with dryness and pain.
• Regular exercise, meditation and other relaxing activities can help with depression and other side effects of postmenopause.
• Eating a diet rich in phytoestrogens (plant-based sources of estrogen) such as whole-grain cereals, flaxseed, chickpeas and legumes. Reducing caffeine and alcohol intake has also been shown to help.

Prevention

Are there any health risks associated with postmenopause?

People in postmenopause are at an increased risk for several conditions:

Cardiovascular disease

Estrogen helps protect against cardiovascular diseases like heart attack, heart disease and stroke. It is also common for people in postmenopause to become more sedentary, which contributes to high cholesterol and high blood pressure. These factors combined can increase a woman’s risk for cardiovascular diseases after menopause. A healthy diet, not smoking and getting regular exercise are your best options to prevent heart disease. Treating elevated blood pressure and diabetes as well as maintaining cholesterol levels are also ways to lower your risk.

Osteoporosis

People lose bone more rapidly after menopause due to decreased levels of estrogen. You may lose up to 25% of your bone density after menopause (approximately 1% to 2% per year). When too much bone is lost, it increases your risk of developing osteoporosis and bone fractures. The bones of the hip, wrist, and spine are most commonly affected. Bone mineral density testing, also called bone densitometry, can be done to see how much calcium you have in certain parts of your bones. The test is used to detect osteoporosis and osteopenia, a precursor to osteoporosis.

Vaginal atrophy

Decreased estrogen levels cause the tissues in your vagina to thin and deteriorate, making your vagina dry. People in postmenopause may continue to struggle with vaginal dryness for years after their last period. Using vaginal lubricants can help ease any discomfort caused by sex. Decreased estrogen levels can also impact the urinary tract and bladder and make leaking urine a problem for some people. Persistent dryness and painful intercourse should be evaluated by your healthcare provider to rule out other conditions. Using lubrication and topical creams or getting laser therapy to the vagina can help with vaginal dryness.

Mental health issues

Many people in postmenopause experience moodiness, anxiety and depression. This could be caused by stress, sexual tension or other life challenges that occur during this time. Some people feel sad that their reproductive years are over. Mood symptoms can also be caused by decreased hormone levels. It might help to talk with a therapist or counselor about what you are feeling.

What can I do to prevent osteoporosis?

Osteoporosis isn’t entirely preventable, but you can take steps to strengthen your bones. Eating foods high in calcium like cheese, yogurt, spinach or fortified cereals can help boost calcium intake. Adding a calcium supplement can also help. Some people also need a vitamin D supplement because it helps their body absorb calcium.

What can I do to prevent cardiovascular disease after menopause?

The best ways to prevent cardiovascular diseases are to eat a healthy diet, exercise regularly and avoid smoking. Conditions such as high cholesterol, high blood pressure and having obesity are usually related to poor diets and lack of physical activity.

Outlook / Prognosis

Can you get pregnant after menopause?

Once your menstrual period has been absent for over a year, you are unlikely to get pregnant. Until your healthcare provider has confirmed you are no longer ovulating and can’t get pregnant, continue to use birth control if you don’t want to become pregnant.

Do people in postmenopause lose interest in sex?

No, not all people lose interest in sex after menopause. Vaginal dryness and discomfort during sex can make sex less pleasurable. Using a vaginal lubricant can help with dryness. Some people are less interested in sex because of other symptoms like depression or feeling tired. If your feelings about sex have changed, ask your healthcare provider for help.

Living With

How often do I need to see my doctor after menopause?

You should still see your healthcare provider for routine gynecological care even though you aren’t menstruating. This includes Pap tests, pelvic exams, breast exams and mammograms. You should continue to schedule annual wellness appointments. Since you are at an increased risk for osteoporosis, providers usually recommend bone density screenings as well. Talk to your healthcare provider to determine how often you should make check-up appointments based on your health history.

When should I call my doctor?

If any of your postmenopause symptoms bother you or prevent you from living your daily life, contact your healthcare provider to discuss possible treatment. They can confirm you have completed menopause and are in postmenopause.

Some questions you might ask are:

• Are these symptoms normal for people in postmenopause?
• Is there treatment for my symptoms?
• Is hormone therapy still an option?
• What can I do to feel better?

If you experience any vaginal bleeding during postmenopause, contact your healthcare provider to rule out a serious medical condition.

Frequently Asked Questions

How should you feel after menopause?

Some people continue to feel symptoms of menopause for years after their last menstrual period. It’s common to have hot flashes or feel depressed about getting older. Speak with your health care provider if you are still suffering from symptoms so they can offer support or treatment.

How do I stay healthy after menopause?

It is important to maintain a healthy lifestyle, especially as you age and your risk for certain medical conditions increases. Some ways for people in postmenopause to stay healthy include:

• Exercising regularly. Walking, doing yoga or strength training can help lower your risk for many medical conditions.
• Weight-bearing exercises can strengthen your bones and muscles.
• Eating a healthy diet. Foods like fruits, vegetables, lean meats and whole grains should make up the bulk of your diet. Avoid lots of salt or sugar and limit your consumption of alcohol.

A note from Cleveland Clinic

Going through menopause can be uncomfortable and present new challenges and health concerns. Speak with your healthcare provider about any symptoms you feel or questions you have. They can help make sure you are supported through this time and get the care you need.

Irregular Periods in Your 40s — Is It Perimenopause or Something Else?

Irregular Periods in Your 40s — Is It Perimenopause or Something Else?

If you’re in your mid- to late 40s and your periods are becoming irregular, you may be in the menopausal transition, or “perimenopause.” This is the natural stage your body goes through as you approach menopause.

This stage lasts about four years on average, although some women may experience only a few months or many more years of symptoms. It is characterized by fluctuations in hormones as your ovaries are nearly out of eggs. Your estrogen levels drop and you may have markedly irregular menstrual cycles. On top of irregular periods, hormonal changes can lead to weight gain, hot flashes, trouble sleeping, vaginal dryness, mood changes, and depression.

Perimenopause ends with menopause, at which point you have not had a period for 12 months.

When Can You Expect Perimenopause?

Chances are, if you’re between the ages of 45-50, your irregular periods are a sign of perimenopause. The average age a woman starts the menopausal transition is 47.

While we cannot predict when this will occur for you, the age your mother began to experience symptoms may be a good indicator. Smokers tend to reach menopause earlier than non smokers as well.

Should You Get Tested for Perimenopause?

The short answer: No.

The blood tests that measure your ovarian reserve are rarely accurate during perimenopause. FSH and estrogen change by the day and throughout the day so they are generally not helpful.

We do consider testing these hormones if you experience perimenopausal symptoms under the age of 45. We generally will also check other pituitary hormones, like TSH and prolactin, if you are experiencing these symptoms prematurely.

Keeping a menstrual diary is generally the best “test” you can do. This will give you and your OBGYN insight into what your body is doing and for how long.

Any time you experience abnormal uterine bleeding (i.e., changes in the amount of blood, frequency of bleeding, and length of bleeding), checking in with your doctor is a good idea to make sure it is normal and that no other work-up is needed.

Stages of Perimenopause

Women typically go through the menopausal transition in two phases: early and late.

Signs of Early Perimenopause

• More frequent menstrual cycles
• Unpredictable menstrual cycles
• Heavier or lighter bleeding

Signs of Late Perimenopause

• Hot flashes or mood changes
• Less frequent menstrual periods
• Heavier or lighter bleeding

What to Expect During Perimenopause

Just as every woman’s period is different, the way you experience perimenopause will be different. The intensity of symptoms varies from one woman to the next, but they follow a typical progression until you have reached menopause and do not have a period for 12 months.

Irregular Periods

This is the hallmark of perimenopause. The frustrating part is the unpredictability. Periods may change gradually from one cycle to the next, or you may notice more abrupt changes.

Hot Flashes & Night Sweats

Hot flashes and night sweats are common symptoms of perimenopause and menopause, with over 85% of women reporting hot flashes. Hormone changes affect your body’s “internal thermostat.” A hot flash feels like a wave or sensation of heat across your face, neck, and chest. It can last for several minutes. Hot flashes can happen a few times a day, a few times a week, or less often.

Hot flashes that happen at night are called night sweats, which can cause women to wake up drenched in sweat and disturb sleep.  Women are more likely to report hot flashes at night.

Trouble Sleeping

When hot flashes wake you up, it can be hard to fall back to sleep. You may feel like you are in “fight or flight” mode.  In addition, mood trouble can often make sleep tricky.

Irritability & Depression

Perimenopause increases the risk of depression by about 30%. The rise in depression may come from the changes and lack of control over what’s happening to your body, sleeplessness, and other life events that typically occur at this point as we age. There is good news! Studies have shown that the risk of depression decreases after menopause.

Treating Perimenopausal Symptoms

Perimenopause itself does not need to be treated. It is a natural, normal transition as you move to the next stage of your life.

Treating perimenopausal symptoms, however, is definitely possible. A discussion with your OBGYN will help you determine the best path for you.

• Birth control pills that contain low doses of estrogen can be used to help control the uncomfortable symptoms of perimenopause by regulating your body’s fluctuating hormones.
• Antidepressants can be prescribed to help with depression. They can also help treat hot flashes.
• Supplements, such as multi-vitamins, support your overall health. Herbal and hormonal therapies, however, are not recommended. Studies consistently show they are as equally effective as a placebo at managing symptoms and some are associated with risks.
• Mindfulness and meditation are tools that you can learn to use to manage irritability, depression, and anxiety.
• Counseling can help you learn how to cope with the changes your body and life are experiencing.
• Exercise (strength training, cardiovascular routines, yoga) is beneficial throughout perimenopause as it can help you maintain a healthy weight, improve your mood, strengthen your bones, and reduce your risk of cardiovascular and other diseases.

Frequently Asked Questions about Perimenopause

Q. Can I still get pregnant during perimenopause?

1. The chance that you could become pregnant in your mid- to late-40s is very low. However, as long as you are menstruating, it is certainly possible that you could get pregnant. We recommend contraception into your 40s if you do not want to become pregnant.

Q. When should I stop taking my birth control?

1. Birth control can mask the transition to menopause, which is why it is used for treating symptoms such as hot flashes and irregular bleeding. Birth control also makes lab tests for perimenopause unreliable. We recommend stopping birth control around age 50-51 and then monitoring your symptoms.

Q. What can I do about perimenopausal weight gain?

1. As you age, your metabolism naturally slows down. You may also lose muscle mass and gain unwanted fat. It’s important to maintain a healthy diet and shoot for 30 minutes of exercise each day. Carrying excess weight increases your risks of heart disease, Type 2 diabetes, and even various types of cancers. Talk to your doctor about ways you can obtain (and maintain) a healthy body weight.

Q. When should I call a doctor about my perimenopausal symptoms?

1. If you are experiencing hot flashes and night sweats under the age of 45, contact your OBGYN to see what else might be causing them. When you have abnormal uterine bleeding, it is important to alert us regardless of age as we may recommend an ultrasound or endometrial biopsy to rule out abnormal changes in the uterus.

If you have not had a period for 12 months and then experience vaginal bleeding, contact your doctor. It is not normal for bleeding to recur after this period of time. Read our article about when you should see your OBGYN.

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Remember, perimenopause and menopause are natural and normal transitions, but they can be stressful. Many symptoms can be managed which can help you regain a sense of control, well-being, and confidence to thrive in your next stage of life.

We want you to feel supported, heard, and cared for as you go through this change.

Sometimes, the biggest help is simply confirmation that what you’re experiencing is normal!

Dr. Ashley Durward has been providing healthcare to women in Madison since 2015 and joined Madison Women’s Health in 2019, specializing in high and low risk obstetrics, contraception and preconception counseling, management of abnormal uterine bleeding, pelvic floor disorders, and minimally invasive gynecologic surgery.

Hot Flashes, Other Menopause Signs May Last for Decades

En español | Here’s a news flash about hot flashes: They and other menopause symptoms can last for years … and years … and years.

A major new study by the Mayo Clinic found that a large portion of women experience hot flashes, night sweats and other symptoms not only in midlife but also into their 60s, 70s and 80s. The study, published in Menopause: The Journal of the North American Menopause Society, collected data from nearly 5,000 women. When asked whether they experienced any symptoms related to menopause, a significant percentage reported having symptoms long after the natural age of menopause.

Women typically experience menopause in their 40s or 50s, with the average age being 51 in the United States.

The researchers found that women 60 and older who reported moderate to severe hot flashes were likely to be married or in a committed relationship. They were less likely, though, to self-report their health as “excellent.” Caffeine appeared to boost the chances of menopausal symptoms in women older than 70. In addition, the study found that women who used hormone therapy were less likely to report moderate or severe hot flashes. But this was to be expected.

Researchers say the study shines a light on what may be an unmet medical need for women over 60.

“With increased awareness, clinicians can identify these distressing symptoms and review treatment options with women, which can lead to improved quality of life,” said Paru David, M. D., a menopause specialist at the Mayo Clinic campus in Arizona and a study coauthor, in a press release.

Juliana Kling, M.D., another menopause specialist at the Mayo Clinic in Arizona and study coauthor, echoed David’s emphasis on the need for more physician engagement.

“Women in their 60s, 70s and 80s who are still experiencing menopause symptoms should talk with their doctors to find a treatment plan — and relief — that can improve their quality of life,” Kling said in a press release.

To alleviate hot flashes and other symptoms, experts say there’s growing evidence that an active lifestyle with regular exercise can lead not only to fewer symptoms but also to a better mood.

Signs of Early Menopause | SELF

We’ve all heard about The Change and associate it with getting older, no longer being able to have kids, and never having to worry about a period again (silver lining). But for some women, menopause happens much earlier than they would have expected, completely taking them by surprise and derailing plans for a growing family.

“Premature menopause is relatively uncommon,” Alan B. Copperman, M.D., director of the division of reproductive endocrinology and infertility at Mount Sinai Hospital and medical director of Reproductive Medicine Associates of New York, tells SELF. Yet for women who were planning to have children toward the end of their reproductive years, it can be devastating.

The average age a woman hits menopause is 51. Perimenopause, or the period of natural decline in reproductive hormones, usually starts in a woman’s 40s, but can happen mid-30s, too. It’s marked by symptoms like an irregular menstrual cycle and those hallmark hot flashes. You’ve officially reached menopause after being period-free for 12 straight months.

Some women, though, reach menopause before they even turn 40. This is referred to as premature or early menopause, and is preempted by premature ovarian failure (POF), a condition where a woman’s ovaries stop working before she turns 40. About 1 percent of women are affected by POF. For some of these women, POF can develop as early as their teenage years, and for others, it happens in their 20s or 30s.

Oftentimes, premature menopause and POF are used interchangeably, Copperman says. The key difference, though, is that POF can be intermittent, according to the American Society of Reproductive Medicine. A woman experiencing POF can still possibly get pregnant through assisted reproductive technologies like IVF—an estimated 10 percent of women with POF become pregnant using their own eggs, with or without an assisted technology.

However, once your period is gone for a full year, you’ve officially entered menopause—and menopause is for good.

What causes early menopause?

Early menopause can either happen on its own or be caused by certain medical treatments, though many times the cause is unknown. Chromosome defects, like Turner’s syndrome, can affect ovary formation and cause someone to experience very early menopause. An autoimmune disease that cause the immune system to mistakenly attack the ovaries is another potential cause, as is genetics. “If your mom had menopause in her 20s or 30s, that can be hereditary,” Copperman says.

Cancer treatments like chemotherapy and radiation therapy can damage the ovaries and cause POF. Some women may find that a portion of their ovarian function returns naturally over time, while others may simply continue into menopause. Women who undergo surgery to remove their ovaries—like Angelina Jolie, who elected to have her ovaries and fallopian tubes removed along with undergoing a double mastectomy after learning she had the BRCA1 mutation—will experience menopause immediately after.

Though early menopause is uncommon, every woman will start to see her ovarian function decline with age, no matter what. “There’s only one direction the ovaries go,” Copperman says. “It’s inevitable that there will be reproductive aging,” meaning the quantity and quality of your eggs will slowly and steadily diminish over time. So if you’re planning to have children later in life, it’s not a bad idea to visit a reproductive specialist and get a full fertility workup to assess your current reproductive health. Having all the information will help you make the best decision possible.

How can you tell if you’re starting to go through menopause early?

The signs of early menopause are essentially the same as the signs of menopause, prompted by the hormonal changes you go through as your reproductive organs prepare to call it quits. Here are the symptoms that may signal a decline in ovarian function. (Note that they can also signal a number of other fixable health problems. “We can frequently reassure women that their ovaries look fine and we need to look elsewhere to find the cause of their symptoms,” Copperman says. “Just because your period is irregular or you have hormonally related changes doesn’t mean that the ovaries are failing.”)

What’s the Average Age of Menopause?

Can someone please tell me what the average of menopause is? Your face is heating up. Your periods are going haywire. And you’ve just cried in the line at the post office. And here you are searching up questions like Is 47 too early for menopause?

Weird that for all the billions of women on this planet who have gone through menopause, we still don’t seem to feel like it’s something we can talk about. The result is that we land up stumbling through it alone without the support we need.

We think it’s time that changed—so let’s have the conversation.

When does menopause start (on average)?

The average age of menopause is 51.

But there are so many different experiences of this life phase that even the idea of a “normal age for menopause” feels like it leaves a lot of the story out. The reality is, there’s no one “menopause age”.

Learn more on when does menopause start.

How do you know when menopause starts?

Menopause is the time 12 months after you have your last period. Your period stops because your ovaries stop releasing eggs.

While menopause is technically a moment in time, it’s better understood as a phase where your body goes through a transition from one life stage to another.

Before you hit menopause, you go through what’s called perimenopause. Over this period, your body goes through a major hormonal shift. Hence all the crazy symptoms. Because you no longer need estrogen and progesterone to help out with your menstrual cycle, your ovaries stop producing these hormones—and this change can have all sorts of interesting effects on your body.

But the fascinating thing is, while some women go through a whole lot over this time, others don’t really experience anything at all.

Perimenopause often begins in your 40s, a year or two before you stop having your period for good. But it can start much earlier and/or go on for much longer.

About 1% of women go through menopause before they hit 40. This is called early menopause and it can put you at greater risk for health complications like osteoporosis. (Basically, you spend more time without the benefits that estrogen brings.)

While we don’t always know for sure what causes early menopause, there are some risk factors that may make it more of a likelihood:

• Genetic factors. If your mama went through early menopause, you might too
• Undergoing chemotherapy
• Having ovarian surgery
• Autoimmune diseases
• Epilepsy
• Smoking. Various studies have revealed a link between exposure to smoke and menopause.

If you think you are going through early menopause, talk to your doctor to see if treatments such as Hormone Replacement Therapy (HRT) are right for you.

What are the top 10 signs of menopause?

While different women have different experiences, here are the more common menopause symptoms:

1. Hot flashes. Yes, this is the poster child for menopause symptoms
2. Periods that are irregular, heavy, and/or longer than usual
3. Bone loss
4. Quick changes in mood
5. Vaginal dryness
6. Loss of libido
7. Fatigue
8. Night sweats
9. Thinning hair (and hair that grows in new places)
10. Tender or sore breasts. They may also start morphing into a new shape.

Symptoms may last until after you have hit menopause (recap: 12 months after your last period) but some women continue to experience them for a few years. There’s just no one way to have this experience.

The more we talk about menopause, the less isolating the experience is for all of us. Chat to your Peanut community. Talk to your friends and family about what you’re experiencing. Book a session with a counselor.

You just don’t have to go through this alone.

📚 More on menopause:
Introducing, Peanut Menopause
What Happens During Menopause?
How to Deal With Menopause
When Does Menopause Start?
Painful Sex After Menopause? What to Know
Hot Flashes: Causes, Symptoms, and What to Do
What to Know About Menopause Joint Pain
Unusual Menopause Symptoms You Might Not Know
Why Are My Breasts Getting Bigger After Menopause?

You Asked: How will I know I’m in menopause?

You knew it was bound to happen someday, but so soon?! You’re not even 50 years old yet. A mood swing here, a few missed periods there…and is it warm in here? You start to wonder if you are going through menopause.

Perimenopause and symptoms

If you find yourself googling this question, then you are most likely transitioning to menopause. This transition period is called perimenopause, the period of time when the ovaries gradually produce less and less estrogen.

This reduction in estrogen most commonly manifests through unpredictable menstruation and can last for several years, which ultimately leads up to your last period. “You need to go a year without your period to be considered menopausal,” said Sharon Dormire, PhD, MSN, professor at the Texas A&M College of Nursing. “It is diagnosed retrospectively.”

During perimenopause, all women notice significant changes to their monthly cycles. They may notice their periods getting shorter or longer, or they experience inconsistent periods—whether it is a period every two months or every nine months—and they will likely not be able to predict their bleeding. Many women, but not all, will also experience mood swings as well as hot flashes and night sweats during the transition to menopause.

“One possible symptom that provides frustration during perimenopause is veryheavy periods,” Dormire said. “As you age, your ovaries are less responsive to the monthly cycle, so your brain releases a specific hormone to trigger egg production. As a result of this hormone, the ovary can release more than one egg in a given month, which ultimately produces more blood.” She noted this is why twins are more common for mothers at this age.

Menopause indicators

Some women experience a lot of symptoms during perimenopause, and some women experience very few. So how can you know you are getting close to menopause? Again, the only true indicator of menopause is that you have not had your period for 12 months.

Typically, in the United States, the average age for a woman’s last menstrual cycle is 52.4 years old. Women can experience these symptoms for up to four years before they actually experience their last menstrual cycle.

Symptoms after menopause

Women can also experience potentially uncomfortable symptoms like hot flashes, mood swings and vaginal dryness after their last period. “For one to two years after menopause, hot flashes are typically worse than before the last menstrual cycle,” Dormire said.

Ways to manage symptoms of menopause

Many of the menopause symptoms like mood swings and hot flashes have to do with the changing levels of estrogen in your body. Hormone therapy is a common treatment for menopause, but it is recommended you speak to your health care provider, as hormone therapy is not recommended for everyone, including women with a history of breast cancer.

Also, women may have different triggers for their hot flashes. Some common triggers are alcohol, caffeine, stress and tight clothing.

Dormire recommends having an honest and upfront conversation with your health care provider about your symptoms and possible treatments. “There are a lot of options that we did not have a few years ago. Hormone therapy is not just taking a pill anymore,” she said. “There are even vaginal creams and patches that are hormonally based, which limit the impact administered hormones have on the rest of the body.”

Women have also found success with using nonhormonal medication to treat hot flashes. Medicine usually given for pain or seizures as well as some antidepressants often offer relief.

No one way to treat menopause is better than the other. Because the symptoms vary so greatly from woman to woman, do not be afraid to try different management techniques. Speak with your health care provider to make a plan that is customized to you. If you are experiencing symptoms of menopause, do not feel helpless. There are plenty of ways to manage your symptoms and find relief.

— Mary Leigh Meyer

What Is Menopause & When Does It Start? Your Menopause Questions Answered

The angst that often arises during a woman’s puberty may rear its head again when menopause rolls around.

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Much of that emotion could be fueled by uncertainty. Menopause affects each woman differently — symptoms and timing vary by individual.

Knowing the facts about menopause can help make the transition less frightening.

Carrie Bell, M.D., an OB-GYN at the University of Michigan Von Voigtlander Women’s Hospital, answered key questions about menopause that all women should know.

What is menopause?

Menopause is a natural biological process in which the menstrual cycle stops. The ovaries are functioning less and no longer releasing eggs, which is related to a drop in estrogen and progesterone levels in the body.

Medically, the designation is confirmed when a year passes without a period or any spotting. “It’s a transition in a woman’s life,” Bell says. “Puberty starts a phase in a person’s life in which she will have periods and a biologic family. The transition into menopause is a movement away from that phase of life.”

There is no way to prevent menopause, she notes.

The body slowly enters menopause, often with several years of signals preceding it. This is known as perimenopause. Those signals include irregular periods, heavier or lighter flows and weight gain.

The average age for menopause in the United States is 52, according to the Department of Health and Human Services. Perimenopause may begin as early as 10 years prior, but it averages four years before the transition.

Still, some women have a family history of early menopause. Others are ushered into it medically. Women who have their ovaries surgically removed or undergo cancer treatments may experience early menopause. Women who smoke traditionally experience menopause two years earlier than nonsmokers.

In addition, “certain medicines tell the ovaries to not make hormones and tell the brain that you are menopausal,” Bell says.

What are the symptoms of menopause?

Before you realize your period has stopped, you may notice other symptoms associated with menopause and perimenopause. They include:

• Hot flashes

• Night sweats

• Low sex drive

• Dry eyes, skin and mouth

• Vaginal dryness or pain

• Emotional changes (irritability, depression and mood swings)

• Fatigue

• Insomnia

• Urinary trouble (frequency or incontinence)

• Hair loss

• Memory problems

Should you see a doctor for menopause?

The range of symptoms, depending on severity, might compel a woman to see a doctor to rule out disease or other ailments. Other patients may hardly notice them.

“Some women transition beautifully into menopause,” Bell says. “When a period stops, women feel OK and they don’t need a doctor to diagnose menopause. ”

But women may struggle with symptoms because they interfere with their daily lives. That’s when they should consult a gynecologist.

Bell cautions that women younger than 40 who experience symptoms seemingly related to menopause should make a doctor’s appointment to rule out any other condition, including primary ovarian insufficiency, which occurs when the ovaries stop producing enough reproductive hormones.

What treatments help menopause?

Treatments vary by symptom, Bell says. Using birth control during perimenopause may eliminate irregularity or heavy flow. It could also improve hot flashes, vaginal dryness and moodiness.

SEE ALSO: 5 Tips for Better Sleep (Counting Sheep Not Required)

Another route to consider is hormonal therapies. Estrogen therapy can reduce hot flashes and improve vaginal dryness. The therapy is available in a pill, cream, gel or patch.

But hormone use warrants a discussion as the impact of using hormones continues to evolve, Bell says. A recent study in the journal Menopause found that the risk of cardiac and stroke death increases in the first year after discontinuing hormone therapy.

“Those who can take hormones are determined on a case-by-case basis,” Bell says.

The therapy also can clash with other health conditions. Women should avoid hormone therapy if they have high cholesterol and triglycerides, liver disease, gallbladder disease, blood clots or a family or personal history of breast cancer.

Nonhormonal therapies such as gabapentin and venlafaxine can reduce the symptoms of hot flashes, night sweats and mood changes. And water-based vaginal lubricants may help minimize vaginal dryness.

“A person should talk with her provider if she wants to explore complementary or alternative treatment options for menopausal symptoms,” Bell says.

What are the complications of menopause?

Menopause changes the body. The low levels of estrogen and progesterone raise the risk of certain health concerns, including heart disease, stroke and osteoporosis, Bell says.

Women should see a doctor each year not only to monitor for those conditions but also to look at their lifestyle choices — and kick any bad habits.

“When you enter this life phase, hormones and metabolism shift,” she says, noting that a healthy lifestyle can ease the transition into menopause. “It’s the time to assess individual behaviors like smoking, diet and exercise level, as optimization of these can help with the menopause change.”

90,000 ᐉ What are the first signs of menopause in women: the main symptoms

What is menopause and when does it start?

Menopause (menopause) is a period in a woman’s life, which is characterized by a decrease in estrogen production and a gradual fading of fertility. This process is natural and not a disease. This shortage may not only be age related. Although, according to statistics, the onset of menopause is associated precisely with the woman’s age and varies from 45 to 55 years. Early menopause is a sign of illness. Perhaps it is also a hereditary factor, that is, a physiological feature of the body that is transmitted through the female line from generation to generation. The causes of early menopause can also include diseases of the nervous system, and as a result – chronic diseases of organs and body systems. Then the menopause can begin at the age of 35. This makes it impossible for women to become pregnant in their prime of life and years. Therefore, it is dangerous to delay contacting a doctor, because it is not known what caused the cessation of menstruation.After all, there is such a symptom even in oncology – when a tumor of both benign and malignant character occurs.

Signs and symptoms

So how do you know that your menopause has begun? The most basic and first sign is the absence of menstruation for more than six months. But it is not yet a fact that the menopause has begun. For more than six months, there may be no menstruation for other gynecological diseases, for example, ovarian dysfunction. Therefore, in order to identify your illness in the absence of menstruation for a long time, it is better to contact your gynecologist.He will accurately diagnose after diagnostic tests.

In addition to this main symptom of menopause, there are a number of symptoms:

1. Hot flashes;
2. Sudden chills;
3. Increased perspiration;
4. Redness of the skin of the face, neck, décolleté;
5. Headache;
6. Specific odor;
7. Dizziness;
8. Tingling of the skin of the face, shoulders and other parts of the body;
9. Decreased libido (sexual desire) and dryness of the intimate area.
10. Short-term and long-term loss of consciousness, and so on.

Who is to blame and what to do?

When the symptoms of menopause appear, there is no need to look for the guilty ones – either it is age, or a disease that provoked the premature loss of the functions of the reproductive system. In any case, you need a consultation with a gynecologist-endocrinologist. He will also determine the treatment program, which may include both hormones – in severe cases, and phytotherapy methods – in milder forms.

In any case, only a doctor will prescribe therapy. It is better not to self-medicate and not diagnose yourself. Today, any clinic has unique equipment that will help you pinpoint the cause of your illness.

It must be remembered that only laboratory and clinical diagnostics will help to make a diagnosis. After all, the signs with menopause are very similar to the symptoms of other diseases, including gynecological, vascular, endocrine systems.Therefore, it is necessary to be treated only as prescribed by a doctor, so as not to harm yourself, your beloved.

Autumn of women’s life

Doctors say: menopause is not the end of life, but the beginning of a new stage for a woman, the passage of which largely depends on herself

Natural process

In the life of every woman there comes a time associated with the natural hormonal changes in the body. This is a physiological period during which, against the background of general age-related changes in the body, processes in the reproductive system, characterized by the cessation of first reproductive and then menstrual functions, prevail.This period is called menopause, or menopause, and it is divided into three main stages.
Premenopause – begins on average at 45 years of age. At this time, a gradual extinction of ovarian function occurs, conception becomes problematic, but the risk of unwanted pregnancy still exists. There is a gradual increase in the intervals between menstruation, a reduction in their duration and a decrease in blood loss. Premenopause lasts from the onset of irregular periods until the last menstrual period.
Menopause is the year following the last period.On average, menopause occurs at the age of 50-53.
Postmenopause is the period of life after menopause.
Heralds of climax
Against the background of a progressive deficiency of sex hormones, the following three groups of symptoms arise:
1) Early symptoms of menopause are vasomotor: hot flashes, increased sweating, headaches, hypotension or hypertension, chills, palpitations; emotional and mental: irritability, insomnia, drowsiness, weakness, anxiety, depression, forgetfulness, decreased libido.
2) Medium-term symptoms occur 3-5 years after the onset of menopause and manifest themselves in the form of urogenital disorders – vaginal dryness, pain during intercourse, itching and burning in the genital area, cystalgia, urinary incontinence. The condition of the skin and its appendages changes, wrinkles, brittle nails, hair loss appear.
3) Late symptoms of menopause – metabolic disorders: osteoporosis (leaching of calcium from bones, leading to an increase in their fragility and, as a result, joint pain, fractures, curvature of the spine), cardiovascular diseases, Al’s disease zheimer.
Menopause is not the same for all women. The course of menopause is influenced by the conditions of life, the nature of work, the state of somatic and gynecological health, the emotional mood of a woman. If in your youth you were faced with a violation of the cycle, pre-menstrual syndrome, infertility, be prepared for the fact that your menopause may be difficult to pass. Smoking brings menopause closer. This conclusion was made by a group of American doctors, who, in particular, found that smoking more than 15 cigarettes a day reduces reproductive age by about 2 years.Early menopause can also be promoted by poor quality and (attention to ladies, constantly dieting!) Insufficient nutrition. But if a woman has been using hormonal contraceptives for a long time, then menopause, on the contrary, occurs somewhat later.

A doctor will help you

In whatever form the menopause proceeds, you should not focus your attention on unpleasant sensations. It must be remembered that menopause is not a disease, it is a completely natural physiological process, moreover, temporary, and painful manifestations can not only be weakened, but in some cases completely eliminated with the help of a gynecologist.
Depending on the severity of climacteric symptoms, the gynecologist selects an individual complex therapy for each woman. Methods for the treatment of climacteric syndrome include hormonal, non-hormonal and non-pharmacological agents.
Menopausal hormone therapy (MHT) is the main most effective treatment. The modern pharmaceutical industry produces drugs for MHT in the form of tablets, skin patches and gels, vaginal suppositories and creams.Drugs that are correctly selected with the help of a doctor actively counteract the aging process, allowing you to maintain health and performance. Naturally, all this will increase the quality of life of a modern woman in adulthood.
For the appointment of MHT, the gynecologist conducts the specification of personal and family anamnesis, general, clinical and laboratory examination (blood clotting test, lipidogram, cytological examination of smears, ultrasound of the pelvic organs, mammography), gynecological examination.The choice of the drug requires a thorough assessment by the doctor of the indications and contraindications for the appointment of MHT, an individual approach to each patient.
Hormonal drugs should not be taken: for breast cancer; endometrial cancer, vaginal bleeding of unknown etiology; acute thrombosis and thromboembolic conditions; uncontrolled arterial hypertension; acute hepatitis; intolerance to the components of the drug, cutaneous porphyria.
If there are contraindications to MHT or refusal to use hormonal drugs, the gynecologist will offer alternative ways to correct symptoms, including drugs, herbal preparations containing phytoestrogens, acupuncture, psychotherapy.

Prevention primarily

Timely “prevention” of inevitable age-related changes can alleviate a number of negative symptoms, and often completely save women from them. Here are some recommendations that will help you to “survive” menopause with the least difficulty:
– regularly check the level of cholesterol in the blood – this will help reduce the risk of developing cardiovascular diseases, often occurring or exacerbated during this period;
– for the same purpose, regularly (at least once a week) measure blood pressure in the morning and evening;
– make a blood test for sugar content to establish if you have latent diabetes;
– undergo a study of bone density in order to detect osteoporosis at an early stage;
– visit a gynecologist for a general examination and ultrasound examination of the reproductive organs;
– make a mammogram and monthly independently monitor the condition of the mammary glands;
– Watch your weight. It is necessary to abandon the rather widespread idea of ​​losing weight, remembering that the fat layer plays a major role in the production of estrone, providing the prevention of many menopausal disorders. It is advisable to consume legumes, bread with whole grains of wheat, sunflower seeds, berries, soy products rich in phytoestrogens. The diet should include a sufficient amount of vegetables, fruits, dairy products, vegetable fats, lean chicken, turkey, fish. These products provide the body’s need for vitamins, hormones and trace elements (calcium, phosphorus).A woman should not abuse alcohol, coffee, hot food spices;
Stop smoking. If you cannot do this, then at least limit the number of cigarettes smoked;
– if you haven’t played sports so far, it’s time to start. However, teach that the loads should be very dosed. The first time classes are best carried out under the supervision of a specialist. Swimming, walking, massage will be of great benefit.
Do not lose your mood
The psychological state during menopause is no less important than the physical one. At this age, many serious changes take place – from a sharp increase in the external signs of aging to a violation of the usual way of life (a typical example: children grow up and leave the parental home), which can be difficult to accept. Alas, all this is inevitable, and we will not fix anything, constantly thinking about what happened and lamenting what we have lost. Moreover, the general condition may even worsen. It is necessary to “correct” life attitudes and try to accept the ongoing changes. After all, menopause is not the end of life.Yes, we are deprived of many privileges of youth, but we also gain a lot: life experience, wisdom, adequacy of perception, finally, time free from household worries and worries – after all, children have already grown up, and we have the opportunity to take care of ourselves and fulfill old desires and dreams. In a word, whether the autumn of our life will be truly golden depends only on us!

Yu.A. KISELEVA, obstetrician-gynecologist

Material published in the newspaper “Tambov Courier”

Analyzes for hormones during menopause

Analyzes for hormones during menopause help the doctor determine the stage of age-related changes and choose replacement therapy for the patient. The onset of menopause is indicated by the following manifestations:

• absence of menses for more than three months,
• hot flashes, sweating,
• emotional instability,
• weight gain,
• deterioration of skin and hair condition,
• decreased sex drive,
• vaginal dryness.

These symptoms usually appear in a woman between 45 and 55 years of age. Early onset of menopause may be associated with:

• ovarian emaciation or tumor,
• malfunctioning of the thyroid gland,
• chemotherapy or radiation.

With timely diagnosis, early, or artificial, menopause is reversible. Taking sex hormone analogues allows you to normalize ovarian function and the menstrual cycle.

Women over 35 years old with a delay in menstruation for more than 3 months, the appearance of hot flashes, it is necessary to take a blood test for FSH. The level of this substance increases several times with the onset of menopause. The FSH test will rule out artificial or early menopause.

Selection of therapy

Hormone replacement therapy will help to normalize the state of health during menopause.Doses of biologically active substances for each patient are selected by the gynecologist individually and only based on the results of a comprehensive examination. During the course, a woman must regularly be tested for hormones. This will help the doctor to adjust the prescriptions in a timely manner.

For the selection of HRT, studies are carried out on:

• FSG,
• LG,
• TTG,
• prolactin,
• estradiol,
• calcitonin.

In addition to being tested for hormones during menopause, a woman should also have regular tests for lipid metabolism, calcium, phosphorus and liver enzymes.The concentration of these substances in the body directly depends on the hormonal background. For example, calcium absorption decreases with estrogen deficiency. Signs of this are hair loss, increased brittle nails, deterioration of the condition of the teeth. Taking synthetic analogs of female sex hormones normalizes metabolism and eliminates unpleasant symptoms of menopause.

To study the hormonal background for one or several indicators, you need to take a blood test from a vein. If the woman still has menstruation, tests are carried out on the 5-7th day of the cycle.The optimal day for the examination can only be determined by your attending physician.

To get tested for sex hormones during menopause, select a laboratory and make an appointment. You can check the rules for preparing for the examination with our administrators.

All articles

Menopause

Gerasimova Elena Vladimirovna

Obstetrician-gynecologist

April 23, 2021

Menopause is in simple words a natural stage in the life of a woman over 45 years old, which is the starting point of the beginning of the period of menopause – the transition from reproductive to non-reproductive life . ..The onset of menopause is determined from the last spontaneous menstrual period.

Usually, the physiological process of preparing for menopause, as part of evolutionary natural aging, occurs 3-5 years before the first symptoms of menopause appear in women. Such restructuring causes multicomponent changes that require good adaptive capabilities of the organism. Hormonal changes are often accompanied by clinical manifestations: disturbance of the menstrual rhythm, the occurrence of abnormal uterine bleeding, functional ovarian cysts.

Many women are concerned about the question: menopause at what age usually begins. The time of its onset is a genetically determined period, but there are a number of factors that can speed up this process. Among them are a sedentary lifestyle, bad habits, stressful situations, physical and emotional stress, poor ecology, infectious and oncological diseases of the genital organs, surgical interventions in the pelvic organs.

The average age of menopause in women is 51 years. The date of natural menopause is set retrospectively: 12 months after the last menstrual period. Depending on how many years menopause begins in women, there are:

• Premature menopause – the period of onset from 30 to 40 years;
• Early – from 41 to 45 years old;
• “Timely”, average age – 45-50 years;
• Late – after 50-55 years.

Life expectancy is steadily increasing, and more and more women are entering peri- and menopause.According to demographers’ forecasts, by 2050, the average life expectancy will be 85 years, the number of elderly people will approach 2 billion, and most of them are women in transition from menopause and menopause.

Classification of menopausal disorders

According to the time of occurrence and the nature of manifestations, menopausal disorders are usually considered in three main groups:

Group I – early symptoms.

Characterized by: hot flashes, increased sweating, headaches, hypotension or hypertension, chills, palpitations.

During hot flashes, peripheral vascular expansion appears in the forehead, chest, shoulders, back, and thighs. There are also their nocturnal counterparts – sweating attacks.

A decline in the quality of life is far from the only negative consequence of hot flashes. They are accompanied by dysfunction of the vascular endothelium, which leads to the development of hypertension and are an independent factor in the development of cardiovascular diseases. At the time of the tide, there is a sharp decrease in blood flow in certain areas of the brain, including those responsible for memory mechanisms.Episodes of ischemia can become the basis for the development of degenerative processes in the brain. The presence of hot flashes is associated with an outcome in dementia and Alzheimer’s disease. Therefore, in some cases, severe climacteric syndrome requires an appeal to a cardiologist, neurologist, therapist, psychologist.

Group II – delayed medium-term symptoms.

Characterized by: urogenital complaints – dryness in the vagina, pain during sexual intercourse, itching, burning, urinary disorder.

The prevalence of urogenital symptoms among the female population is very high – 30-70%, and only increases with age.Women rarely turn to specialists with such a problem, considering this condition to be natural.

Meanwhile, urogenital atrophy is the cause of frequent recurrences of inflammatory diseases of the lower urinary tract. Loss of tone of the ligaments and pelvic muscles predisposes to prolapse and prolapse of the vagina and uterus.

Estrogen deficiency leads to a decrease in the collagen content in the dermis and the development of atrophy, which is manifested by a decrease in elasticity, a deterioration in the blood supply to the skin and mucous membranes, a decrease in the function of the sebaceous and sweat glands, an increase in dry skin, peeling, itching, and increased cold sensitivity.Wrinkles appear, brittle nails increase, hair loss increases. The relative predominance of male sex hormones over female in some women cause androgen-dependent dermopathies: hirsutism, seborrhea, alopecia, acne.

Group III – late (metabolic).

Typical: metabolic disorders – osteoporosis, cardiovascular diseases.

Osteoporosis is a systemic disease of the skeleton that leads to a decrease in bone strength and an increased risk of fractures.Normally, bone resorption begins at the age of 35, 10-15 years before menopause. Bone loss accelerates during the menopausal period. Women suffer from osteoporotic fractures more often than stroke, myocardial infarction and breast cancer combined. Fracture of the femoral neck causes disability or death in 26% of cases.

Treatment and relief of symptoms of climacteric syndrome

Moderate or severe climacteric syndromes are the main indications for menopausal hormone therapy (MHT).

The optimal time to start MHT is the changeopause – the transition period until the last menstruation. During this period, when the signs of menopause in women have not yet appeared, the intake of hormones provides the most effective prevention of diseases of the cardiovascular system and osteoporosis. In urogenital disorders, local estrogen therapy is usually recommended.

However, MHT has a number of contraindications and limitations, which served as an incentive for the development of alternative therapy for menopausal disorders.Herbal preparations – biologically active additives (BAA), containing phytoestrogens – have become especially popular all over the world.

If you find signs of menopause, do not try to diagnose yourself or take hormonal medications. This can only be done under constant medical supervision. The best solution is to see a gynecologist. At the reception, the doctor will conduct a full examination, consisting of examination, history taking and tests. And given the fact that menopause in women proceeds depending on the individual characteristics of the body, the gynecologist will prescribe a special therapy.

How to understand that menopause is coming, is it possible to delay menopause with food and sports – doctor’s advice – Healthy lifestyle and health

Hot flashes, tearfulness, irregularities in the cycle – these are not always symptoms of the onset of menopause. In addition, the climax can be postponed, exactly how – in the material

Menopause occurs at 45-55 years old, but menopause can be postponed / Photo: Collage: Today

Even if you are over 40 or even over 50 and all the symptoms of menopause are “present”, menopause can be confirmed only with the help of laboratory diagnostics.What other symptoms of menopause, at what age does menopause occur? and is it possible to slow it down – said the candidate of medical sciences, our permanent expert, gynecologist-endocrinologist Anna Shargorodskaya.

Anna Shargorodskaya / Photo: press service

So at what age is the onset of menopause the norm?

The age of a modern woman at which natural menopause occurs is 45-55 years . And genetics plays a leading role in exactly when you start menopause.Ask your mother and other relatives on her side, at what age they started menopause and stopped regular menstruation.

Read also:

Early menopause: how many years it can begin

Also external factors affect the time of menopause, such as habits, lifestyle in general, nutrition, existing and previous diseases. Even the fact of how your mom’s pregnancy went. Menopause can be:

• early, if it comes before the age of 45,
• premature – if up to 40 years old,
• late – when the woman is over 55 years old.

Both early and late menopause are caused by genetic factors, pathologies of pregnancy in the mother, autoimmune diseases, surgeries on the uterus and ovaries, cancer therapy (radiation and “chemotherapy”). And “classic” symptoms are not always a confirmation of that a woman has started menopause.

And how to understand that it is menopause?

Shortening of the menstrual cycle, mood swings from aggression to tearfulness, excessive sweating (hot flashes), dry mucous membranes – these signs really appear during the approach of menopause. But also the same symptoms appear with PMS, against the background of various diseases or general fatigue, and in a woman at the age of 25-30.

Therefore, if you are over 40 and have begun to worry about the above symptoms, and your muscles have lost their tone, you start to get tired faster, your skin has become less elastic – do not rush to diagnose yourself with menopause.

You can calculate ovulation yourself or use the mobile application / Photo: freepik.com

In addition to hot flashes, sleep disturbances and irritability, with menopause there is a persistent absence of menstruation throughout the year .And only diagnostics can confirm with 100% certainty that you have menopause.

Moreover, the extinction of reproductive functions and a decrease in the production of sex hormones in a woman occurs long before the complete cessation of menstruation. This is a natural process that cannot be avoided. But it is quite possible to slow down and “slow down” the onset of menopause.

How to make menopause come later

We cannot change genetics, but we can do the influence of external factors and lifestyle on the female body.And there is no secret: for women’s health, good sleep, physical activity, high-quality regular sex (but not promiscuous sexual intercourse), getting rid of accumulated stress are important. You can look young at 55, already being a grandmother.

Important! All “gears” from this chain help to prolong youth and delay menopause. The less stress – the better digestion, mood and more energy. Accordingly, energy and youth keep you healthy and menopause comes later.