From uncertainty to renewed strength

What are the menopausal years?

The menopausal years are a natural phase in every woman's life that marks the transition from the fertile to the non-fertile stage. Medically, this is referred to as the climacteric. It covers the period during which ovarian hormone production gradually declines. In this process, the secretion of the hormones estrogen and progesterone in particular decreases, so menstrual bleeding first becomes irregular and eventually stops altogether.

This adjustment does not happen suddenly, but rather gradually over several years. As early as the mid-40s the body can begin to produce fewer sex hormones. This initially shows up as menstrual cycles that become shorter, longer or more irregular, until fertility finally ends. Menopause — the last menstrual period — marks the end of the fertile phase.

What happens during the menopausal years?

During the menopausal years a woman's body undergoes a number of profound changes that occur in different phases. The start is marked by the premenopause, which typically begins around age 40. In this early phase progesterone falls first while estrogen levels remain largely stable. This hormonal shift causes the cycle to become irregular, bleeding may be heavier or lighter, and spotting can occur.

The years immediately before and after the last period are known as the perimenopause. This is the actual transition when menstruation becomes irregular and then stops altogether. Only in retrospect can it be clearly determined when menopause — the last period — has occurred. This phase is often characterised by a particularly intense hormonal adjustment that affects both body and mind.

Afterwards comes the postmenopause. The fertile time then ends for good and the hormonal balance settles at a permanently lower level. In this phase many typical accompanying symptoms of the menopausal transition subside or disappear entirely, while others related to low estrogen production may become more noticeable. These include changes to the skin, mucous membranes or muscles influenced by the hormonal shift.

For some women this process begins significantly earlier, even before the age of 40. In that case specialists speak of premature menopause, which is often a major emotional burden for those affected.

What complaints occur during the menopausal years?

The menopausal years can be accompanied by a variety of physical and psychological complaints that differ by phase. At the outset, changes in the menstrual cycle are often noticeable as bleeding becomes irregular in duration and intensity. At the same time, vasomotor symptoms frequently occur: hot flashes, felt as a sudden rush of heat in the upper body and face and often followed by flushing and heavy sweating. Many women experience these at night as well, which can severely disrupt sleep.

As hormone production declines further, other changes occur. The mucous membranes in the genital area dry out, which can make sexual intercourse painful and increase the risk of urinary tract infections. Dry eyes or bladder problems are also possible. In addition, pelvic floor stability decreases, which can lead to incontinence. At the same time, chronic estrogen deficiency causes bone density to fall and raises the risk of osteoporosis. Joint and muscle pains are further possible complaints.

Alongside the physical changes there are also psychological effects. Mood swings, irritability and an increased susceptibility to depressive moods are among the commonly reported symptoms. For many women sexuality also changes during this time, whether due to pain, reduced desire or difficulty reaching orgasm. In addition, metabolism slows down, which can encourage weight gain.

Can diet influence the menopausal years?

Diet can indeed have a noticeable influence on how women experience menopause and when it begins. Studies indicate that certain eating habits are associated with an earlier or later onset of menopause. For example, a diet high in foods that cause large blood sugar spikes has been shown to advance menopause by more than a year on average. Adequate intake of nutrients such as vitamin B6, vitamin D and zinc, and regular consumption of legumes and fatty fish, can on the other hand delay its onset.

Furthermore, the hormonal balance can be influenced by everyday diet. Plant foods such as soybeans, yams, flaxseed or legumes contain phytohormones that may help the body compensate for natural hormonal fluctuations. These substances act similarly to endogenous hormones and can help reduce symptoms such as hot flashes or cycle variability.

Is it possible to become pregnant during the menopausal years?

Pregnancy in the menopausal years is less frequent but still possible. Because the ovaries work irregularly at this time, ovulation can occur despite declining fertility. This makes it difficult to assess with certainty whether conception can still occur.

Medically, the likelihood can be estimated using blood tests and imaging. For example, the FSH level — which does fluctuate — provides hints about how active the ovaries still are. An ultrasound can additionally show how many follicles are still present and roughly estimate remaining fertility.

However, because no method is considered definitively reliable, some uncertainty remains. Specialists therefore recommend continuing contraception for up to one to two years after the last period, depending on whether menopause occurred before or after age 50. Those seeking clarity about their personal situation should consult a doctor.

Do men have a menopause too?

The question whether men really go through a menopause is often asked. While testosterone levels in men also decline with age, they fall much more slowly and less abruptlythan the hormonal decline in women. For that reason the term “male menopause” is viewed critically by science and is not clearly recognised.

The term “andropause” describes the gradual decline of male sex hormones, mainly testosterone. This process typically begins in middle adulthood and can lead to various changes. Unlike in women, hormone levels often remain within the normal range, so not every man develops noticeable complaints.

Nevertheless some men report symptoms associated with this hormonal shift, such as reduced energy, decreased libido or changes in mood and body composition. Because it is a gradual and very individual process, andropause cannot be equated with the menopausal transition in women. Clinically it is therefore more accurate to speak of a partial androgen deficiency of the aging man, affecting only some men.

What can help against menopausal complaints: practical tips

• Incorporate movement into your daily routine. Regular activity strengthens muscles and bones and has a positive effect on mood. Even walks, cycling or light exercise can improve well-being and help prevent weight gain.
• Cross-country skiing trains the heart and circulation as well as the muscles and also reduces stress. Start slowly and increase intensity step by step.
• Make sure you get enough calcium. About 1'000 mg daily protect the bones. Suitable foods include dairy products, broccoli, arugula and nuts.
• Also ensure sufficient vitamin D. Since the body produces it only with sun exposure, spend plenty of time outdoors from April to October. In winter, supplements can be useful.
• Structure your diet to be rich in fibre. Whole grains, legumes, vegetables and nuts promote digestion and prevent constipation. The goal is around 30 grams of fibre per day.
• Prefer plant-based protein. Soy, legumes or tofu support the maintenance of muscle mass, which declines during the menopausal years.
• Reduce sugar and white flour products. Simple carbohydrates cause blood sugar to fluctuate and promote weight gain. Instead, choose whole-grain alternatives.
• Observe what triggers hot flashes. Coffee, black tea, spicy foods and alcohol can worsen symptoms. Herbal teas and mild foods are generally better tolerated.
• Dress in layers, as several thin layers allow you to react quickly to hot flashes. Breathable fabrics are especially helpful.
• You can also use cold as immediate relief. Cool water on the wrists or alternating showers soothe hot flashes and train temperature regulation.
• Look after your adrenal health, because prolonged stress can reduce production of important hormones such as estrogen and progesterone. Support your hormonal balance by getting enough sleep, eating healthily and integrating relaxation techniques into your daily routine.
• Methods like yoga, meditation or breathing exercises can relieve the nervous system and effectively alleviate sleep problems, inner restlessness and mood swings.
• Also consider herbal preparations. For example, black cohosh can relieve hot flashes and yam may support hormones through its diosgenin.
• For severe symptoms, hormone therapy may be considered. It is often effective but requires medical supervision and regular checks, as risks such as an increased breast cancer risk exist.

The menopausal years are certainly challenging, but they also offer a chance to rediscover your body. With mindfulness and targeted measures you can ease your symptoms and move through this life phase feeling stronger.