Menopause: complaints and causes

In Germany about eight million women are between 45 and 60 years old. You are just before, in the middle or just after the menopause. Although menopause is not a disease, up to 80 percent of them have climacteric symptoms. Every third woman in this age group suffers so severely that she can only deal with everyday life without treatment.


Menopause, also known medically as the climacteric, is divided into three individual phases, all of which refer to the menopause, ie the time of the last menstrual period.

  • The premenopause is the time before the menopause and affects mostly women between the 40th and the 50th year of life. The secretion of follicle stimulating hormone (FSH) increases slightly. The production of the luteal hormone progesterone, however, decreases. This can cause the periods between two bleeding to shorten. The period still occurs regularly. Because estrogen levels are often elevated, individual bleeding may be more intense and last longer.
  • The "high phase" of menopause is the perimenopause. It lasts on average six to seven years. This usually leads to significant irregularities in the cycle up to the complete absence of the menstrual period. The formation of progestogens decreases faster than that of estrogens, so that the concentration ratio between progesterone and estrogens varies greatly. Those affected may experience hot flashes, tachycardia, mood swings or increased nervousness.
  • Postmenopause begins one year after the last period and lasts until the hormone balance reaches a new stable level. The menopausal symptoms subsided. The end of the postmenopause and thus the end of the menopause is different from woman to woman and depends next to the hormonal changes of the subjective experience of the symptoms.

On average, women are 51 years old at their last menstrual period. The exact time of menopause can only be defined retroactively, if no further menstruation has occurred for one year. Overall, the period of menopause can last about ten to 15 years.

Because of the significant increase in life expectancy, women today often spend more than a third of their life after menopause. For them it is therefore crucial how they come through the menopause. For many, this phase is a chance to change and begin a new phase of life in which they see themselves as independent personalities and not just as nesters for the family.

Complaints and their medical causes

Menopause is a physiological process of change. The massive fluctuations in estrogen levels often manifest as irregularities in temperature regulation and are perceived as hot flashes, sweats, or redness.

In addition, vegetative changes can occur, ie changes in the nervous system, which is not deliberately controlled and regulates vital functions such as heartbeat, respiration, digestion and metabolism. Progesterone and estrogens have an opposite effect on the autonomic nervous system.

Frequency of menopausal symptoms in women between the ages of 45 and 54 yearspercent
Nervousness, irritability90%
Fatigue, lethargy, performance decline80%
Hot flashes, sweats70%
Depressed mood, wine cramps70%
a headache70%
Forgetfulness, lack of concentration65%
increase in weight60%
sleep disorders50%
Joint and muscle pain50%
heart problems40%
Libido loss (decreased sexual desire)30%
Paresthesia (sensory disturbances such as tingling or numbness)25%

For many women, the ever-changing concentration ratio of hormones is associated with palpitations, increased nervousness, sleep disturbances or mood swings. The true symptoms of estrogen deficiency only appear in the postmenopause. They affect the female reproductive organs, the main target organs of estrogens and can show as a dry vagina, bladder weakness and altered sexuality. The frequency of menopausal symptoms is shown in Table 1.

Non-medical changes in middle age

The characteristic menopausal symptoms are not only hormonal to explain. Although mood swings actually reflect the upsurge of hormone levels, the causes are more diverse. Individual constitution, family situation, but also life history and socio-economic factors are determining how women individually experience and manage the climacteric transitional phase.

In addition to the physical changes that are often associated with a particular emotional sensitivity, the phase of menopause is a time in which many cuts are made in the personal and family environment. Some examples are:

  • The children are leaving the house (empty nest syndrome)
  • Parents become ill, in need of care or die
  • Crises in the partnership
  • Problems when returning to work (change / further development of the job)
  • "Age-related" difficulties in changing jobs

The fact that such factors have an effect on mental health is confirmed by the inability to work statistics: whereas for all other types of illness the days off (AU) days are decreasing, these increase in the case of diseases affecting the psyche - in 2004 almost by comparison with 1994 Half to 144.7 percent. It has been proven that mental illnesses are more common in women (rank 3 of the AU days) than in men (rank 6).

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