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Menopause Myths, Measures, and Moments...
10/17/2022

How Long Does Menopause Last? Take a room filled with women over 45. How many of them have them have the same menopause? The answer is… 0. Nada. None. Zilch.

Menopause is unique to an individual, and her hormone make up, genetics, epigenetics, diet, stress levels, and even her culture. BUT (there’s always a but), there are some generalizations that can be made to help us understand this transitional phase a little better.

Peri-menopause - the time meaning before menopause - can begin as early as 40, and for some, can continue well into their 50’s. Whilst the ‘symptoms’ of peri-menopause can vary, the underlying similarity is that the hormone secretion from our ovaries begins to change.

Let’s Talk About Periods

During regularly scheduled programming (a.k.a period through childbirth years) our ovaries pump out estrogen during the first half of the cycle and then, after ovulation at mid-month, they pump out progesterone for the second half. Towards day 26-27 progesterone levels drop quickly and this sudden drop triggers a period as the uterine lining sheds. The estrogen makes the uterine lining grow and plump up. The progesterone stops that growth and allows the uterine lining to strengthen and mature.

If we don’t ovulate – we still get that surge of estrogen in the first half of the cycle but don’t get the surge of progesterone in the second half. This can mean that periods get longer, or shorter. Longer periods happen when estrogen just keeps on growing the uterine lining and we get bloated, and we gain weight. When the uterine lining eventually sheds, that’s a lot of mass that needs to detach and drain away. We get cramps as this happens and a heavy period that lasts for all of eternity.

For some women, cycles start to get shorter. Estrogen still builds the uterine lining during the first half of the month, but without that progesterone to signal the uterine lining to mature, it can shed early. Women can then have cycles that last 25, 22, even 19 days long. Periods are often light, but without progesterone, mood swings, depression and general miserableness are common.

Perimenopause Perception

When these changes happen each cycle – that’s what we call perimenopause. We still get cycles, but they have gone all wackadoodle. This is when the most intense symptoms of perimenopause often start including depression, anxiety, brain fog, changes to skin and hair, joint pain, hot flashes. We still make some estrogen – but it’s not balanced by progesterone and it’s the lack of progesterone that creates symptoms of estrogen dominance.

[Perimenopause Formula - {Too much estrogen} + {not enough progesterone} = crazy brain, sore boobs, heavy periods]

Then What?

Over time, the length of time between periods gets longer and longer, 3 months to 6 months, 9 months and so on. This is what we can call being in Menopause…because those menses are pausing. For some women this can last 4-5 years, others this can be 1-2 years. For most women, this happens somewhere between age 48 and 52, although it can happen earlier or later. Now it’s time for more symptoms - thinning skin, vaginal dryness, MORE hot flashes, lost car key syndrome, lost purse syndrome (it was in the grocery store and customer service had it, thank goodness).

Timeline of hormone transitions

Howlongdoesmenopauselast.png

Averages noted by darker shades

A woman is finally Post-Menopausal when she hasn’t had a period for 12 consecutive months. Her ovaries no longer make estrogen (or at least, not enough to grow a uterine lining) and they have long given up the ghost of making progesterone.

There can be several years where the ovaries make estrogen but no progesterone. This is the time of life that can be most miserable: hot flashes, mood swings, tender breasts, bloating, weight gain, weepiness, furious rage, massive periods. This is the time when progesterone can be extremely helpful to replace what is no longer made and balancing the estrogen still made in the ovaries.

Hormone Supplementation

The general supplementation guidelines look a little like this:

Hormonal Phase

Which Hormone

When Used

Early Menopause

Progesterone

Days 15-28 of the cycle

Late Menopause

Progesterone

Progesterone days 8-28 of the cycle

Menopause Transition

Progesterone

Estradiol

Estriol

5 days out of 7

5 days out of 7

2-3 times weekly for vaginal dryness

Post Menopause

Progesterone

Estriol

Estradiol

Every other day

2-3 times weekly for vaginal dryness

Per doctor recommendations

Too often the medical profession equates hormone symptoms with changes in estrogen. While estrogen is very important for so many more functions than just making a uterine lining grow, it kind of misses the point. Progesterone levels drop WAY before estrogen levels do. It is the lack of progesterone that means estrogen is unbalanced which causes most of the perimenopausal and menopause symptoms.

For women who start to supplement with progesterone in their mid to late 40’s, the menopause transition can be significantly easier. While it is super helpful, progesterone is not a magic ingredient - making sure your body gets enough clean water, vitamins, minerals, exercise, stress management, makes a huge difference too.

There will likely come a point when adding estrogen is the next step to make sure your body and brain has the key resources to stay healthy and well. Estriol is in Silky Peach Cream and is used by thousands for women for vaginal dryness and urinary incontinence. Sometimes a stronger estrogen is needed and a doctor can help with that, making sure any estradiol is balanced by progesterone.

Most menopausal symptoms will eventually subside after an average of 7 to 9 years, but about a third of women will have symptoms for a decade or longer.