1. Understanding Menopause Basics

Menopause consists of three stages, perimenopause, menopause and post-menopause.

Perimenopause also known as the menopause transition, is the transition between the initial symptoms of menopause and the actual cessation of menses, which generally takes happens between 36-45 years of age. This time in a woman’s life can last up to 10 years but usually lasts from 4-6 years. During this time estrogen increases relative to progesterone and can lead to estrogen dominance. Perimenopause is usually determined by a symptoms score and towards the later stages of perimenopause - closer to menopause, can be indicated by higher levels of Follicle stimulating hormone (FSH) and Luteinizing hormone (LH).

Menopause is one specific point in time marking the cessation of menstruation and it is specifically after 12 months of no menstruation. The average age of women is between 45 and 50. Premature menopause can occur from the ages of 40 onwards. In addition to the cessation of menses, menopause can be determined through TSH, LH and estrogen with Pico AMH (anti-mullerian hormone) tests in addition to a symptoms score. Pico AMH tests are used to determine fertility to see how viable the ovaries are.

Postmenopause is the stage when menopause is complete and the menstrual cycle has stopped. It is a woman’s new biological state for the rest of her life. Estradiol (E2) is low, Estrone (E1) is active but it is 10x weaker than normal estrogen. As such it doesn’t have the same effects and is reactive instead of proactive.