How can you tell if you're on the cusp of menopause, and what lies ahead?

After 12 uninterrupted months without menstruation , science declares the stage of life in which a woman can conceive a child to be complete. Or, to put it another way, it is the definitive test that certifies the diagnosis of menopause . According to the Spanish Association for the Study of Menopause , this phase can occur between the ages of 40 and 50, with the average age being 51.

Now, chances are, before a woman stops buying feminine hygiene products like pads or tampons, her periods will start to become irregular , which is just the tip of the iceberg for the rest of the symptoms of perimenopause, the period that precedes the final disappearance of menstrual bleeding.

Among the numerous premenopausal signs, "the first and most obvious is the alteration of menstrual cycles," says Dr. Silvia P. González , a gynecologist with a master's degree in menopause and climacteric, medical director of Menoclínica, and President-Elect of the Spanish Association for the Study of Menopause. "These variations occur by at least seven days in the periodicity of early perimenopause, while in late perimenopause, menstruation can disappear for more than 60 days ," she points out.

This change in the functioning of a woman's menstrual pattern "is due to hormonal fluctuations that, in turn, can cause symptoms," the doctor points out, reminding us that "although this alteration is very characteristic, in some cases, especially in younger women, other causes must be ruled out ."

"It's a unique process for each woman. I often say it's like a fingerprint."

In addition to the disruption in menstrual frequency, it is common to also experience hot flashes , mood swings, fatigue and insomnia.

In any case, "it's a unique process for each woman; I often say it's like a fingerprint. In addition, there are external factors, such as lifestyle habits and other family members, that can influence it, and it's not possible to predict exactly what will happen to each woman."

Almost a decade of warning

All of the symptoms mentioned above usually occur after the age of 40 , "and the entire perimenopause usually lasts between two and eight years , although it can last more than a decade," says the gynecologist.

During this time, there are two particularly significant changes: weight gain and loss of muscle and bone mass. Many women watch, bewildered, as their bodies transform inexorably and for no apparent reason starting in their 40s, and even more so in the following decade.

As for weight gain, the truth is that it's not a process exclusive to women, since "both men and women experience it due to age," the specialist points out. What happens is that "with menopause There is a change in body composition that tends more toward fat accumulation , especially in the waist and hips," explains the expert, who warns that, although attempts can be made to reduce this increase through diet and exercise, "the trend will continue to exist."

Decreased estrogen levels

On the other hand, "the loss of muscle mass ( sarcopenia ) and muscle strength (dynamopenia), as well as the decrease in bone mass (osteopenia and osteoporosis ) also occur after menopause, which is related to the hormonal decline , especially of estrogen, but also, in part, to androgens (male hormones)," the expert points out.

Detecting symptoms early helps establish preventive strategies

In this case, "low-impact strength training combined with a proper diet rich in protein and minerals such as calcium, phosphorus, and magnesium, as well as appropriate supplementation, can help," he adds.

The mind is also altered

In addition to hot flashes, weight gain, and loss of bone and muscle mass, there are also psycho-emotional symptoms. "Hormonal fluctuations cause many women to experience symptoms such as irritability, sudden mood swings (emotional lability), and a tendency toward low mood," she explains. However, "this is also strongly influenced by personal, family, and work-related factors," she clarifies.

In addition to emotions, cognitive abilities can also be affected. In this regard, "many women also suffer from brain fog, that is, difficulty concentrating, paying attention, and having memory problems during this period."

Although it's not possible to avoid the aforementioned symptoms, what you can do is "observe changes and detect symptoms early so you can seek medical attention. This way," the doctor emphasizes, "it's possible to establish preventive and therapeutic strategies as soon as possible."

Furthermore, she reminds us that healthy lifestyles— those that include a balanced diet, regular exercise, and proper sleep hygiene—"are recommended both during menopause and at all stages of life, although with slight nuances during this period, so the sooner they are implemented, the better."