The menopause: It starts in your late 30s, but it's not so bad

The menopause, climacteric, menopause: terms for one and the same phenomenon that most of us associate with one thought: getting old. Plus hot flushes, less desire for sex and mood swings ... No, thanks! But the change does not have to hang over women's heads like a sword of Damocles. We asked two gynaecologists what women can expect in the new phase of life and how they can enjoy it.

This is what happens when the body goes through a change (for the second time)

. No woman needs to fear the change, because she has already experienced a serious hormonal change once in her life: during puberty. Gynaecologist Doris Maria Gruber explains: "With the help of the brain, the conductor, the hormone orchestra is tuned during puberty." One after the other, the hormones are brought into position, which takes around four to six years. It's no different later in menopause: here, too, the brain gives the command - with the difference that this time it tells one hormone after another when to stop working.

On average, women experience the menopause around the age of fifty, says gynaecologist Silke Bartens. But the range is wide: "There are also those who no longer have periods in their early 40s, as well as women who are still menstruating at 55." The good news is that some women don't suffer; about a third of women have no symptoms at all during the menopause. A third have mild symptoms and a third have very severe symptoms. Spoiler: Menopausal symptoms can vary from phase to phase!

Menopause: symptoms and discomfort

. What happens in any case: The menstrual cycle changes. Bleeding cycles become irregular, periods longer or shorter, stronger or weaker. Reducing the menopause to just sweats, dry vagina and decreased libido falls short. There is a huge spectrum of symptoms that can affect women, but don't have to. "The problem is: hardly any doctor looks at the symptoms as a whole and concludes that it is the menopause," says Gruber. If a woman has joint pain, she usually goes to an orthopaedic practice; if she has psychological problems, she goes to a psychiatric practice. Moreover, the individual phases of the menopause are usually only touched on in medical training. "We have to look at the symptoms more holistically and not break them down to one organ," says Gruber. Her advice: Be brave and ask the doctor directly if it could be the menopause.

Our bodies make the menopause.

Our body doesn't make it easy for us to deduce from one to the other, because the symptoms also vary during the change. In the beginning, women often experience symptoms that they do not associate with the menopause at all: Joint pain, headaches, depression. In the next phase, the symptoms can continue: Mood swings, swollen joints, breast pain, menstrual irregularities, poor sleep and weight gain, dry eyes.

Do you think it's menopause?

If the woman is in the middle of menopause, classics can occur such as: Hot flushes, night sweats, dry, burning or itchy vagina, pain during sex, decreased libido. But that's not all: if you leaf through the guide "Woman on fire" by Dr. Sheila de Liz, you'll be served a long list of - possible - symptoms: Depression, anxiety, anger attacks, hair loss, difficulty thinking and remembering, hair loss, skin problems, migraines, heart arrhythmias, frequent bladder infections, night urination, tinnitus/hearing loss, severe PMS, incontinence ... . The following applies: every woman experiences her change individually. And, once again, it can happen without any symptoms at all. Gynaecologist Gruber puts it in a nutshell: "No one suffers like another!" Just like back then, during puberty.

Cause hormones: oestrogen and progesterone

Why all this? What happens in the body when women go through the menopause? "Hormone production from the ovaries and other organs decreases," says expert Bartens. The hormones oestrogen and progesterone play a particularly important role. Their production begins to decline in the late 30s and early 40s - the female body is gradually being reorganised. Even if women still get their periods regularly and can even become pregnant, the hormone balance changes. This can cause some women to experience slight changes in their state of mind. That is, when they are far from thinking about the change.

By then, a lot has already happened in a woman's body over decades: girls are born with a fixed number of follicles or egg follicles, from which the eggs are later formed. Initially, there are several million follicles, but during puberty the number decreases to between 100,000 and 400,000 and diminishes with each ovulation. At around 50 years of age, all the follicles are used up. As a result, the production of oestrogen, for which the follicles are responsible, decreases more and more. As a result, the last menstrual bleeding eventually sets in, the menopause.

You probably thought the term menopause meant the whole process, including hot flushes. Wrong: Menopause is exactly and only the duration of the very last period.

Peri-, pre- and post-menopause: the menopause occurs in phases

. What we call the menopause, on the other hand, is actually called the perimenopause: the phase around the age of 50 when hot flushes, cycle irregularities, dry eyes and co. strike. "By the way, it's not always menopause, sometimes it's just weeks or months," Bartens knows.

The time before the actual change is called premenopause. During this time, women often feel the first physical changes, some in the menstrual cycle, others - see above - in other places that have nothing to do with the female organs. When the spook is finally over and the last bleeding has stopped, we move on to the postmenopause: the body's hormones are readjusted, and symptoms gradually subside. But new symptoms can also arise, such as intolerance to lactose or cosmetics, problems with the thyroid gland, and so on. It is therefore all the more important to have good medical support during this time, which takes the complaints seriously and treats them if necessary.

Sexuality and contraception in alternation

No more periods, no more desire for sex? Many women are afraid of this. But it's not that simple. "Problems like loss of libido, dryness and other symptoms used to be taboo. Today people talk about it," says gynaecologist Bartens. No desire for sex can be related to the change. But it doesn't have to be. Possible causes for a reduced libido are also the relationship with the partner or the attitude towards one's own body. She advises: "You can discuss your complaints with your gynaecologist and think about possible ways to help.

But it is also a fact that some women really blossom sexually after the change. Earlier worries such as unwanted pregnancy, cellulite dimples or flab on the belly disappear with the change. Now only one thing counts for them: the pleasure of pleasure. (If the mucous membrane of the vagina hurts during sex because it has become thinner due to the hormone change, an ointment containing oestrogen can help) . When to stop using contraception is best discussed with your gynaecologist. As a general rule, if it has been at least a year since your last period, contraception is usually no longer necessary.

Other benefits: Making this the best time of your life

. Many menopausal symptoms have been shown to improve with exercise. Taking small breaks and getting plenty of rest also help to relieve symptoms. One thing is certain: the menopause is not a monster that takes away your fertility and turns you into a dried-up sultana. "It offers the chance to change some things," says Bartens.

This chance is even offered to you by your own body, because: The many provider hormones that women produced in the first half of life now play only a secondary role. We no longer care so much about the needs of others.

With this, a change of perspective is imminent. Once the hormonal fog has cleared, many women ask themselves again for the first time since puberty: what do I want to do for myself?

If you want to get through the change well, Gruber advises: "Find a gynaecologist who specialises in the menopause." Unfortunately, the menopause is only touched on in specialist training, not taught in depth. That's why gynaecologists often don't know enough about this special time in every woman's life. It's best to ask your gynaecologist if he or she has undergone any special training, or do some research on the internet to find a menopause specialist.

The most important tip is to take care of yourself and seek help if you get stuck. Gruber says: "Only a healthy soul can grow old healthily.