Your menopause doula, reporting for service! After sharing much of my menopause journey in the last article, it’s time to turn the spotlight to YOU. This article is all about getting the basics straight. Together, we’ll get on the same page about what menopause really means, the unique experiences that come with it, and why tracking your periods should be at the top of your to-do list…starting now.

What is menopause?

Surprisingly, menopause itself is just one day in a person’s life. It’s the day when someone has gone a full year without having a period. Think of it as an anniversary! Everything before that day is called premenopause, and everything after it is postmenopause.

The years leading up to menopause—when periods stop and fertility ends—are marked by big hormonal shifts, especially in estrogen and progesterone. This phase, known as perimenopause, usually starts about 4–6 years before your final period. On average, most European women hit menopause (again, that one-year mark after the last period) around age 51. This means perimenopause often starts around 44–45. Of course, these are just averages. Some people start perimenopause 10 years earlier, and for others, it’s only 2 years before menopause.

Before perimenopause, estrogen and progesterone keep a relatively steady balance. But during this transition, they start to spike and dip wildly. If this all sounds familiar, it should! The hormonal rollercoaster of perimenopause is actually pretty similar to what happens in our teenage years—that is why some people call it a “second adolescence.” This is what causes those well-known signs like hot flushes, mood swings, trouble sleeping, and irregular bleeding. And no, this doesn’t stop the day you hit menopause. Hormones take time to stabilize, usually 1–2 years afterward, as your body adjusts to a new, lower level. While the ovaries stop producing large amounts of hormones, other glands (like your adrenal glands) pick up the slack and produce just enough for what your body needs.

Natural vs. Non-Natural Menopause

In all of this, I’m referring to what’s called “natural menopause.” However, there are also “non-natural” menopauses. These include premature ovarian insufficiency (POI) (like yours truly), medically induced menopause, and surgical menopause, which happens when the ovaries are removed. Menopause can also result from treatments for certain diseases, such as cancer.

It’s estimated that 1 in 100 women (though recent studies suggest it might be closer to 4 in 100) will experience POI. Sadly, we have very little data about the other types of non-natural menopause, even though we know the numbers are on the rise. Women experiencing non-natural menopause may face stronger and more debilitating symptoms, compounded by the mental and emotional load of navigating menopause outside the “typical” age range and dealing with the sudden loss of fertility. This adds an extra layer of complexity to their journey, requiring even greater awareness, empathy, and tailored support.

Let’s clear something up…

People often refer to this whole process as “menopause,” but that’s not technically correct. It’s better to call it the menopause transition, which includes perimenopause, menopause, and postmenopause. And let’s be clear: this transition is normal—it’s not a disease. That’s why I prefer to talk about “signs” or “experiences” rather than “symptoms,” which makes it sound like something’s wrong.

Most of us know about the “big” signs like hot flushes, but there are actually over 35 possible experiences during this time. Some of them are pretty unexpected, like dry eyes or dental issues. Please google “menopause symptom tracker”, download one that you like and get familiar with it! My goal isn’t to scare anyone or make menopause sound awful. Not all these things happen to everyone, and certainly not all at once. Every menopause journey is completely unique.

Here’s how it breaks down:

• About one-third of women experience no signs or very mild ones.
• Another third have mild to moderate signs.
• The remaining third have more severe experiences, and for 5–10% of them, these can seriously impact their quality of life—comparable to living with a chronic illness or disability.

This huge variation is why it’s so hard to talk about menopause in a one-size-fits-all way. It’s a complex experience shaped by individual factors like your age, health, diet, the type of menopause you have (natural, induced, or premature), your cultural background, your job and even whether you’ve faced racism. These things can either make menopause easier or much harder.

Is it menopause or just getting older?

That’s a tricky question. Menopause symptoms overlap a lot with the natural aging process. But here’s where gender and sexism come in. Women’s bodies have been historically pathologized and treated as “defective.” Even the language we use reflects this—outdated terms like “ovarian failure” or “vaginal atrophy” (yes, really) make it sound like our bodies are broken. This is one reason I hesitate to present a long list of menopause “symptoms” as inevitable.

That said, I’m sharing this info for two important reasons:

1. Awareness is power. Many women have no idea what to expect during perimenopause, which leaves them feeling confused, scared, and isolated. It’s easy to think, “What’s wrong with me?” instead of realizing, “Oh, this is just a normal part of the process.”
2. Doctors aren’t always helpful. In some places (like Germany), there’s a real lack of knowledge about menopause in the medical community. Women are often misdiagnosed (with things like burnout or depression) or told there’s nothing wrong and sent home to “just deal with it.” This is a gender and political issue! The personal is political! So here’s how you can advocate for yourself:

Right now, perimenopause is “diagnosed” (meaning recognised by doctors) based on self-reported signs and whether your age matches the typical range. That’s why it’s so important to:

• Learn about perimenopause so you know what to look out for.
• Track your periods and “symptoms”—what happens, when, how long it lasts, and how intense it is. There are plenty of apps and printable templates to help with this. Again, google “menopause symptom tracker” and take your pick.

Tracking doesn’t just help your doctor in case you need some medical support—it helps you. Paying attention to your body builds a connection with it. The more we understand what’s happening, the more empowered we feel. Even if you decide you do not need medical support, knowledge about your experience is key to navigating it well.

It’s not all doom and gloom.

I want women to feel strong and powerful coming out of this transition. Menopause isn’t the beginning of the end—it’s a time to refocus on yourself. Those subtle changes your body is sending you? They’re a signal that it’s time to slow down, listen, and make adjustments that support your well-being.

In my next article, I’ll share some tips to help you navigate this time with ease and confidence. Stay tuned!

Illustrations by Nadezhda Moryak on Pexels