Menopause

What is menopause?

Technically speaking, a woman experiences menopause when it has been one full year since her last period. Leading up to this event, a woman may experience regular periods followed by irregular periods, and eventually, her periods will stop altogether. Once a woman passes this one-year threshold, she is now post-menopausal. While it’s important to understand the distinction, you’ll commonly hear post-menopause simply referred to as “being in menopause.”

A woman is in menopause when her ovaries are no longer producing the sex hormones they have produced throughout her life, especially since puberty. This means estrogen, testosterone, and progesterone levels diminish by about 95% by the time menopause occurs. Since the ovary is no longer abundantly producing these vital hormones, the aging process begins to go into overdrive.

For many years, the average age of menopause has been reported to be 51, but anecdotally it appears women are going through this transition at younger and younger ages.

How do I know if I’m in menopause?

As mentioned above, once a full year has passed with no bleeding, it’s safe to say menopause is official. But what about women who’ve had a uterine ablation, an IUD, or a hysterectomy but kept their ovaries? These women won’t have the obvious lack of bleeding as an indication of menopausal status. This is when lab values can be helpful for diagnosing whether or not a woman may or may not be in menopause.

Lab values such as follicle-stimulating hormone, or FSH and estradiol levels are the most common things that doctors will look at to get an indication of menopausal status and if the ovaries are still trying to produce sex hormones. FSH levels go up in an effort to have the ovary make enough estrogen to produce a follicle (which houses an egg) and when the ovary becomes non-responsive the FSH levels go up even more. Therefore, in the presence of very high FSH levels and very low estrogen levels your doctor can likely conclude you’ve reached post-menopause. These two lab values are not the end all be all, and your doctor may need to check some other tests. It’s important to visit with a doctor specializing in menopausal hormones as they can help navigate the nuances of lab value changes that may be seen around the time of menopause.

At AgeWell, we can walk with you through the ups and downs of menopause. The providers at AgeWell have tailored training to help you carefully make decisions about handling this midlife transition that can often come with lots of questions and concerns.