The idea that climacteric and menopause are not different things is common among women. Menopause is actually the second of three stages of climacteric, which is the event that marks the end of the reproductive period for women.
I'd like to suggest we review a bit of what happens in every woman's body during the various phases of the reproductive life cycle.
First, it's worth emphasizing that climacteric is not a disease, nor is menopause—they are phases that, yes, involve important changes, not all of them pleasant, but that doesn't mean there can't be good things too.
As we've seen, the reproductive cycle officially begins with the first menstruation, usually at the start of adolescence. But it all starts well before that.
A woman is born with her entire reserve of follicles that will give rise to eggs and that will be available until the end of her reproductive cycle—in other words, there's no way to replenish this reserve throughout life.
The egg develops with a single purpose: to be fertilized. When it's not used to give rise to a new being, this egg is discarded by the body, causing the common bleeding of menstruation. And this repeats every month, as we well know.
Over the years, the reserve decreases and, around age 45, a woman may begin to feel the effects of the transition from the reproductive to the non-reproductive period, noticing some differences in her body, such as menstrual periods becoming more spaced out than usual. This first phase of transition and entry into climacteric is called perimenopause.
Menopause, in turn, is an event: just as there is a first menstruation, all women will have their last one and, when that happens, the woman will definitively be in menopause. Some women spend up to 10 years living through perimenopause before menopause actually arrives.
Since this transition period causes menstruation to become irregular, diagnosing menopause requires the woman to have gone at least 12 months without menstruating.
The symptoms in the different stages of climacteric are basically the same, but with intensity levels that can vary. The closer the last menstruation approaches, the stronger the symptoms tend to be.
Five signs that menopause is approaching:
1 - Irregular menstruation This is the main sign that menopause is near. It may happen that your period doesn't come one month, goes months without coming, or comes twice in the same month. The hormonal decline prevents the uterus from preparing for a possible pregnancy, which directly interferes with menstruation. But there are exceptions! Some women may have a regular cycle until menopause.
2 - Hot flashes This is one of the most frequent symptoms, appearing unexpectedly and causing heat crises, mainly in the trunk, neck, and face. The face may become flushed and excessive sweating may appear. The sensation usually lasts from one to five minutes and can occur frequently for more than a year, or even more than five years for some women.
3 - Mood swings Sudden mood changes are also common. Besides everything this phase may represent psychologically for women, such as fear of aging, a feeling of uselessness, or emotional neediness, there is a main biological reason behind this: the fluctuation of sex hormones and their influence on the central nervous system, mainly estrogen and FSH (which stimulates the release of eggs). As a result, feelings of irritability, melancholy, anxiety, and crying are other symptoms that may manifest during this phase.
4 - Urogenital changes A series of urogenital changes accompany the transition and end of the reproductive period, including difficulty emptying the bladder, urinary incontinence, and infections that can become frequent, affecting the bladder and urethra. Additionally, there may be vaginal atrophy and a decrease in libido, with dryness and pain during sexual intercourse.
5 - Sleep disturbances Estrogen can also interfere with sleep regulation, so difficulty sleeping may appear. Hot flashes also have an important impact, as they can occur during sleep and cause awakenings. It's very important to take care of sleep during this phase, as it's conducive to insomnia becoming chronic.
There are other symptoms that many women experience and that manifest differently for each one, depending on a series of factors, from genetics to their own clinical and reproductive cycle history.
In addition to those already mentioned, other symptoms that may manifest include a physical sensation of restlessness, with palpitations, fatigue, headaches, skin changes, and weight gain, with increased abdominal and central fat in the trunk and neck, due to the lack of estrogen itself, which also ends up increasing women's risk of starting to snore and developing sleep apnea. This is more common after menopause has set in, in the third and final stage of climacteric, called post-menopause.
Fortunately, science has now discovered several strategies that can help us manage these symptoms, making the end of the reproductive cycle as comfortable as possible.
Still, yes, there may be moments when you feel you no longer recognize yourself, when you feel sadness or displeasure with your body, wondering deep down if you'll be able to feel desire again or feel desired, since one of the things that worries many women is the issue with libido, also linked to vaginal dryness and weight gain.
It's good that you're here, because the idea is to talk about all of this and think together about ways to deal with the avalanche of emotions that can come with climacteric in its different stages.