Menopause – symptoms and stages of the menopause. Everything you need to know

Menopause, also known as the change of life or the climacteric, is the permanent cessation of menstruation resulting from the natural decline in ovarian hormonal function. This process is associated with a drop in oestrogen and progesterone levels and, consequently, with the end of a woman’s reproductive capacity. The average age of onset of the menopause for women in Poland is 51 (it most commonly occurs between the ages of 45 and 55). However, the timing of its onset is an individual matter and depends on many factors, such as genetic predisposition, lifestyle and general health. As with puberty and the onset of the first period, for some women the menopause occurs earlier, for others later.

Symptoms associated with the decline in ovarian hormone function may occur long before the onset of menopause itself – during the perimenopausal period. The first stage of this is premenopause, during which irregularities in menstrual cycles are often observed. This is followed by perimenopause, the period immediately preceding menopause, characterised by an increase in symptoms resulting from the gradual decline in oestrogen and progesterone levels.

Menopause proper, as defined by the World Health Organisation (WHO), refers to the cessation of menstruation, followed by a period of 12 months without any bleeding from the genital tract. Although menopause is a physiological stage in a woman’s life, rather than a disease, its diagnosis should be confirmed by a gynaecologist. Diagnosis is based on a thorough medical history and tests such as transvaginal ultrasound or hormone level measurements, including FSH, LH and oestradiol.

The decline in ovarian function with age can disrupt the functioning of other bodily systems, leading, amongst other things, to hormonal changes and the unpleasant symptoms of the menopause, such as:

1. Vasomotor symptoms:

• hot flushes caused by hormonal changes,
• increased sweating (particularly at night).

2. Psychological symptoms:

• mood swings,
• tearfulness,
• irritability,
• nervousness,
• insomnia and other sleep disorders,
• difficulty concentrating,
• depressive episodes.

3. Physical symptoms:

• numbness and tingling in the limbs,
• heart rhythm disturbances,
• tension headaches, migraine,
• dizziness.

4 Atrophic symptoms:

• decreased libido,
• pain during intercourse,
• vaginal dryness,
• frequent genital infections.

How long do these symptoms last? It varies from person to person – every woman’s body reacts differently, which is why the course of the menopause can differ in terms of the type of symptoms, their severity and how long they last. However, in most cases, the symptoms of the menopause gradually subside within 5–7 years of the last period.

As we have already mentioned, the menopause is a natural process that occurs in every woman, linked to the body’s ageing. As a result of the decreasing number of ovarian follicles and the drop in sex hormone levels, the functions responsible for fertility gradually cease. However, some women notice worrying symptoms earlier than their peers. What could be the cause of premature menopause?

We can identify several factors:

• genetic predisposition – if women in the family have experienced early menopause;
• autoimmune diseases (including Hashimoto’s disease, coeliac disease, vitiligo and type 1 diabetes);
• a history of cancer treatment;
• viral infections;
• an unhealthy lifestyle, leading, amongst other things, to obesity;
• addictions, particularly smoking.

Menopause can be associated with a variety of symptoms and a reduced quality of life, but there are effective ways to alleviate its symptoms. Among the methods most frequently recommended by doctors are:

• Hormone replacement therapy (HRT)
  Hormone replacement therapy involves replenishing hormone deficiencies and restoring their balance in a woman’s body. Depending on test results and the patient’s individual needs, the doctor may recommend the use of oestrogens – sometimes in combination with progesterone. This therapy allows for significant relief, and in many cases even the complete resolution of menopausal symptoms. HRT should always be administered under strict medical supervision, following a prior assessment of indications and contraindications.

• Herbal medicine and supplementation during the menopause
  In cases of mild menopausal symptoms, or where a patient is unable or unwilling to take hormones, non-hormonal methods may be an alternative. Phytotherapy utilises, amongst other things, phytoestrogens – plant compounds with effects similar to those of oestrogens. Their natural sources include soya, beans, walnuts, sunflower seeds and linseed.Extracts from the leaves and flowers of red clover and black cohosh contain so-called phytoestrogens with clinically proven effects. These substances are frequently used in non-hormonal replacement therapy for women in the perimenopausal and postmenopausal periods, particularly to alleviate vasomotor symptoms such as hot flushes, excessive sweating and sleep disturbances.It is also worth ensuring an adequate intake of essential fatty acids (EFAs) and vitamin D. These components support the functioning of the endocrine system and have a beneficial effect on many of the body’s systems, including the nervous and cardiovascular systems. Regardless of whether supplementation is based on pharmaceutical preparations or natural sources of nutrients, its appropriateness and scope should be discussed with a doctor.

• Non-hormonal pharmacotherapy
  In recent years, new treatments for symptoms associated with the perimenopausal and menopausal periods have been developed, including non-hormonal therapies that target the neurobiological mechanisms responsible for temperature regulation.Fezolinetant is a new drug used to treat moderate to severe vasomotor symptoms of the menopause, such as hot flushes and night sweats. It acts as a neurokinin 3 (NK3) receptor antagonist in the hypothalamus, thereby stabilising the body’s temperature regulation, which is disrupted during the menopause.

• Lifestyle changes
  An appropriate lifestyle is also a key element in alleviating the symptoms of the menopause. Diet, levels of physical activity and sleep quality have a real impact on the body’s functioning and hormonal balance. If you feel unwell, it is worth not only undergoing the recommended tests but also taking a look at your daily habits.
  The following are particularly important:
  • a balanced diet rich in nutrients;
  • eating 4–5 meals a day, preferably at regular times;
  • limiting stimulants, sweets and highly processed foods, and reducing sugar and salt in favour of natural spices and herbs;
  • replacing animal fats with plant-based fats, e.g. olive oil;
  • drinking around 2 litres of water a day;
  • regular physical activity – even a short, daily walk can be beneficial;
  • a consistent bedtime and at least 7 hours of rest each night.

Menopause is a stage in a woman’s life during which the body undergoes numerous hormonal and metabolic changes. This is precisely why regular preventive check-ups are so important, as they enable the early detection of any potential health issues. What signs and conditions should you pay particular attention to during this period?

• Osteoporosis
  One of the most common conditions during the menopause is osteoporosis, which is a gradual decrease in bone mineral density. If left undiagnosed and untreated, the condition significantly increases the risk of fractures — even from minor injuries — and can lead to serious complications affecting the skeletal system.
• Overweight and obesity
  Women going through the menopause are also more prone to weight gain, including becoming overweight or obese. Hormonal changes can contribute to an increased appetite and a slower metabolism, leading to the accumulation of body fat. Abdominal obesity is particularly dangerous, as it increases the risk of developing type 2 diabetes, as well as cardiovascular diseases such as stroke or heart attack.
• Urinary incontinence
  Women with reduced physical activity may experience muscle weakness, including in the pelvic floor muscles. As a result, stress urinary incontinence may occur, for example when coughing, laughing or during physical activity. This is a common problem during the menopause, but it can be effectively treated and managed with appropriate therapy and regular exercise.
• Decreased libido
  One of the most commonly reported symptoms of the menopause is a decrease in libido, which can affect intimate and emotional relationships within a partnership. During this time, open communication with your partner is particularly important — talking about needs, difficulties and emotions. Consciously nurturing the relationship can also be helpful, for example by spending time together or seeking couples’ therapy.

The NAMI Medical Resort and Clinic is part of the INVICTA European Family Centre and extends the care offered at INVICTA Clinics, where specialists have been supporting women’s health – including during the menopause – for over 25 years. Supplementing this care with a spa programme allows us to provide patients with comprehensive, long-term health support.

The medical programmes offered at NAMI combine a stay at the centre with diagnostics, specialist consultations and the planning of preventive measures. The process involves, amongst others, doctors, orthopaedic and urogynaecological physiotherapists, dieticians and naturopathic specialists. At the same time, the programmes support the body’s recovery and help restore psychophysical balance.

Based on the results of tests and consultations, a personalised treatment plan is drawn up, which can be continued even after the end of the stay. Patients have the option of remaining under the care of the INVICTA team – either through online consultations or in-person visits at their nearest clinic.

An integral part of the health programmes is a dietary consultation, including a body composition analysis. A dietitian helps to plan a diet that supports hormonal balance and is tailored to the body’s current needs.

At NAMI, we support women going through the menopause in a safe, informed and structured way – with a focus on health at this stage of life and in the years to come

NAMI Medical Resort and Clinic exclusively offers medical programs.