Most women experience a period of irregular menstrual cycles before menopause: some cycles become longer and the flow decreases, while others become shorter and the flow lasts longer.
The most common pattern is a pause in menstruation for 2-3 months or half a year, followed by a sudden return of menstruation 1-2 times, or continuous bleeding for more than 10 days, or even over a month. Menopause can only be confirmed after 12 months of amenorrhea and when the woman is over 40 years old. The stage from the start of menstrual changes to the final menopause is called the perimenopausal transition period, which lasts an average of 4-5 years.
The excessive influence of estrogen on the overgrown endometrium during menopause often leads to irregular vaginal bleeding. As the endometrium does not fully shed and lacks a regular renewal process, menstruation can sometimes last for several months or be absent for a period and then followed by heavy bleeding. In some cases, after a considerable period of time, a follicle matures and ovulation occurs, causing the entire endometrium to naturally shed and form a normal menstrual cycle, often with a heavier flow.
The chance of ovulation decreases during the perimenopausal period, and menstruation becomes less frequent until it eventually stops and menopause occurs. This is the opposite of the mechanism during puberty where menstrual cycles become regular as the follicles mature. Menstruation during menopause is the inevitable result of follicular decline.
In conclusion, the perimenopausal period can manifest in various ways. If menstruation does not occur for one year, it can generally be assumed that the follicles have lost the ability to respond to the large amount of follicle-stimulating hormone secreted by the pituitary gland and menopause has occurred. The length of the perimenopausal period varies and is influenced by factors such as genetics, occupation, nutritional status, and health level. For each individual, the type or pattern of menopause is unpredictable and can only be confirmed after one year of amenorrhea.
The age at which menopause occurs varies greatly among women and is mainly related to the level of estrogen in the body. The reported natural age of menopause in North America, Europe, and Asia is 49-51 years old. According to a survey of 5000 women aged 40-65 in Beijing in 1990, the average age of natural menopause was 48.4 years, similar to reports from other countries. In 1996, the average life expectancy for women in China was 73.04 years, and in Shanghai, it was 78.21 years, which means that women spend about 30 years after menopause.
Therefore, the health care issues of women during the perimenopausal period or after menopause are becoming increasingly important and have received attention. Women should also have a correct understanding of the arrival of menopause and happily and joyfully spend the second half of their lives.
