Understanding premenopause, perimenopause, and menopause
Women’s hormonal journey is marked by natural stages which, although normal, represent major turning points for their health and well-being. Between the ages of 40 and 55, the transition to menopause is accompanied by physical, psychological, and metabolic changes that can sometimes be profound.
These hormonal transition phases, long dismissed as trivial, nevertheless have a real impact on quality of life. Recent data is unequivocal: 87% of women are affected by at least one symptom and 67% suffer from genitourinary disorders (GEMVi study, 2022). One in four women even experience symptoms that are described as “severe.”
Today, the medical approach has evolved to offer effective, safe, and personalized solutions tailored to each individual’s specific needs.
1. Define the steps: What exactly are we talking about?
It is essential to clearly distinguish between these three phases to better identify care needs:
- Premenopause: This is the phase during which ovarian function begins to decline subtly. Menstrual cycles remain regular, but subtle hormonal fluctuations may occur.
- Perimenopause: This is the “turbulent zone.” It begins when menstrual cycles become irregular. Variations in estrogen and progesterone levels are most pronounced during this phase.
- Menopause : It is clinically confirmed after 12 consecutive months without menstruation or by a hormonal assessment, and marks the permanent cessation of ovarian hormone production.
2. Why does the body change?
The ovaries gradually produce less estrogen and progesterone. These hormones act like keys on multiple receptors located throughout your body: brain, bones, heart, skin, and urogenital system. It is their deficiency, and especially their sudden fluctuations, that explain the diversity of symptoms observed.
3. Symptoms and consequences: an overall impact on health
The symptoms of menopause are not simply temporary inconveniences, but reflect a profound metabolic change that affects both immediate comfort and long-term health.
Skin aging: The drop in estrogen leads to a 30% loss of skin collagen five years after menopause. This causes thinning of the skin, loss of firmness, and increased dryness, accelerating aging, particularly of the face.
Metabolic risks, cardiovasculars and neurovasculars: Beyond aesthetics and comfort, a hormone deficiency causes a significant change in a woman’s risk profile. The decline in estrogen increases the risk of developing cardiovascular disease and bone density loss (osteoporosis). In addition, the cessation of menstrual cycles is accompanied by a decrease in metabolism and, often, weight gain.
A major study published in the Journal of the American Heart Association (El Khoudary et al., 2020) highlights that menopause is a vulnerable period during which there is an acceleration in visceral fat deposition and an alteration in the lipid profile, significantly increasing the risk of atherosclerosis and coronary heart disease.
Intimate health and sexuality
Genitourinary syndrome of menopause (GSM) affects nearly two out of three women. Without treatment, the following two symptoms gradually worsen:
- Vaginal dryness and dyspareunia: Atrophy of the mucous membrane causes burning and pain during sexual intercourse.
Decreased libido (sexual desire)
4. Bioidentical hormone therapy: a proven solution
Bioidentical hormone therapy aims to replace hormones that the body stops producing. It is a cornerstone of anti-aging medicine for women. It has now been conclusively proven that it does not increase the risk of breast cancer.
- Eliminate debilitating symptoms (hot flashes, sleep disturbances, brain fog).
- Protect cardiovascular and bone health, thereby reducing the risk of long-term complications.
- Restore intimate comfort and prevent genitourinary syndrome.
