2 When does the menopause happen?

Menopause will happen to everyone who has a menstrual cycle. And many people find exactly that – it just happens to them, often bringing about changes that they have possibly never thought about before, far less anticipated. For some, menopause is a gradual process that occurs as they end their fertile years. But for others, the transition happens almost overnight, where menopause is ‘induced’ or accelerated by the sudden reduction of hormones that occur as a result of surgery (e.g. hysterectomy), or medical interventions, such as some types of treatment for cancer (Hillard et al., 2017).

A ‘natural menopause’ occurs as a part of the expected transition of the body from being fertile and able to produce children to being no longer capable of becoming pregnant (Northrup, 2012). This occurs as the levels of hormones gradually change, with a substantial fall over time in the production of oestrogen. For some people, this process might last for perhaps 4–5 years, while for others, it can take up to 12–13 years (Newson, 2019; Northrup, 2012). The following figure shows how oestrogen levels fall across the lifespan.

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A diagram of 8 outlines of bodies, going from left to right. The title of the image is: ESTROGEN HORMONE LEVEL. The bodies are coloured in two shades of pink, the lighter shade representing Estrogen deficiency and the darker shade representing Estrogen level. Going from left to right, the bodies each represent the ages of 20, 30, 35, 40, 50, 60, 70, 80. Between the ages of 40 and 70, menopause is highlighted as a stage. At the age of 20, Estrogen level is approximately 75% of the body shaded, with Estrogen deficiency taking up 25% of the body. At the age of 30, this is even less, with Estrogen level taking up approximately 90% of the body shading. At age 35, the whole body is Estrogen level. At 40, it is similar to 30, but with a bit less Estrogen deficiency. 50 has increased Estrogen deficiency, approximately 20% Estrogen deficiency and 80% Estrogen level. At 60 Estrogen deficiency maps about 50% of the body with Estrogen level taking up the other half. At 70, Estrogen deficiency takes up about 75% of the body and then at 80, its up 90% of the body, with Estrogen level taking up the final 10% of the body.

You can see there is a significant decline in oestrogen between the ages of 50 and 60 where symptoms such as low mood, brain fog and increased anxiety accompany this reduction.