You're 48 years old, and for the past few months, your body has been acting up. Sudden hot flashes hit you without warning, your sleep is chaotic, you're gaining weight without having changed your habits, and your periods are becoming unpredictable. Welcome to the world of menopause, this natural transition that all women will experience, but which is still not talked about enough. Menopause marks the end of the reproductive period and occurs on average around the age of 51 in France. It is often accompanied by various symptoms that can disrupt your daily life for several years. But rest assured, there are solutions to help you get through this period more serenely.
The main thing to remember
- Average age: 51 years old in France (normal between 45 and 55 years old)
- Definition: 12 consecutive months without periods marks menopause
- Main symptoms: hot flashes (70% of women), sleep disturbances, abdominal weight gain
- Duration: the transition (premenopause) lasts on average 2 to 4 years
- 15% of women do not experience any bothersome symptoms
Understanding Menopause: What's Happening in Your Body?
Menopause is not a disease, but a natural physiological stage marking the end of the reproductive period. To better understand it, you need to understand the mechanisms at play in your body.
The Hormonal Mechanism
At birth, every girl has a stock of about one million oocytes (eggs) in her ovaries. This number naturally drops to 600,000 or 700,000 at puberty, then gradually decreases with each menstrual cycle. Menopause occurs when this stock is depleted, with fewer than 1,000 oocytes remaining.
When there are no more ovarian follicles available, ovulation no longer occurs. The ovaries then stop producing the two main female hormones:
- Progesterone (which falls first during premenopause)
- Estrogens (the definitive decrease of which marks the onset of menopause)
It is this sudden hormonal drop that is responsible for the majority of the symptoms you experience.
The three phases of menopause
- Perimenopause (or premenopause) : transition period of 2 to 4 years before menopause, marked by irregular cycles and the appearance of the first symptoms (on average around 47 years old).
- Menopause : precise moment when periods stop permanently (diagnosed retrospectively after 12 months without menstruation)
- Postmenopause : period following menopause and lasting until the end of life
Average age in France: 51 years old. But be careful, the first symptoms can begin up to 10 years earlier, from 40-42 years old on average, during the premenopause phase.
Premature Menopause: A Special Case
Premature menopause (or premature ovarian failure) occurs when periods stop permanently before the age of 40. This condition affects approximately 1 in 100 women before the age of 40, 1 in 1,000 before the age of 30, and 1 in 10,000 before the age of 20.
Possible causes of early menopause
- Genetic factors : Turner syndrome, fragile X syndrome, family history
- Autoimmune diseases : Hashimoto's thyroiditis, Addison's disease
- Medical treatments : chemotherapy, radiotherapy
- Surgery : removal of both ovaries
- Smoking : advances the age of menopause by 1 to 2 years
- Cause unknown : in 75 to 90% of cases, no cause is identified
Important: Early menopause requires hormone replacement therapy until the average age of menopause (around 50-51 years) to avoid cardiovascular, bone, and cognitive complications. The risks of HRT do not apply to women under 50.
The First Signs: How to Recognize Menopause?
Menopause symptoms vary greatly from woman to woman. Some women experience menopause without much difficulty, while others experience a significant impact on their quality of life. However, 15% of women experience no bothersome symptoms.
Vasomotor Symptoms (Most Common)
Hot flashes and sweats
Affects 60 to 80% of postmenopausal women. These sudden sensations of intense heat rise from the chest to the face and neck, lasting from a few seconds to several minutes. They are often accompanied by redness, profuse sweating, and sometimes palpitations.
Duration: On average 6 months to 2 years, but can persist up to 7 years or more in some women (20%).
Common triggers: ambient heat, heavy meals, alcohol, strong emotions, stress, spicy foods.
Menstrual Cycle Disorders
This is often the first warning sign, which can begin up to 10 years before the final menopause:
- Irregular cycles (shorter or longer)
- Flow that varies (lighter or on the contrary hemorrhagic)
- Periods that skip several months and then return
- Bleeding between periods
Physical Symptoms
- Sleeping troubles : difficulty falling asleep, frequent night waking, night sweats that soak the sheets
- Vaginal and vulvar dryness : 25 to 70% of women, which can lead to painful sexual intercourse (dyspareunia)
- Urinary disorders : more frequent urinary tract infections, urgent urges, slight leaks
- Joint pain : all joints can be affected
- Weight gain and body shape changes : especially at the stomach level (we will come back to this)
- Skin changes : dryness, loss of elasticity, appearance of wrinkles
- Hair care : hair loss or excessive hairiness
Psychological and Cognitive Symptoms
Often underestimated but very impactful on a daily basis:
- Irritability and mood swings
- Anxiety, sometimes panic attacks
- Sadness, depressive tendency (affects up to 25% of women)
- Chronic fatigue, lack of energy
- Difficulty concentrating and remembering (“brain fog”)
- Decreased libido
Important note: These psychological symptoms are partly due to hormonal changes, but also to the domino effect of sleep disturbances caused by night sweats. Months of disrupted sleep naturally worsens mood, concentration, and energy levels.
Weight Gain and Bloated Belly: Why and How to Avoid It?
This is one of the major concerns of menopausal women. Studies show that on average, women gain 2 to 2,5 kg during this period, with an average weight gain of 0,8 kg per year between the ages of 42 and 50 (and up to 1,5 kg per year for 20% of women).
Why Do We Gain Weight Around Our Belly?
1. Change in fat distribution
Before menopause, the silhouette is called "gynoid": fat is stored on the hips, thighs, and buttocks. After menopause, it becomes "android": fat migrates to the stomach and abdomen. This redistribution is caused by the drop in estrogen and progesterone.
2. Increased visceral fat
Before menopause, female hormones inhibit the activity of an enzyme responsible for visceral fat (deep fat around the organs). When these hormones drop, this enzyme is no longer controlled and visceral fat accumulates. This is the most dangerous type of fat for cardiovascular health.
3. Slowing of metabolism
With age, muscle mass decreases in favor of fat mass. Muscle burns more calories at rest than fat. As a result, basal metabolism slows, and the body burns fewer calories, even without changing its habits.
Bloated Belly: Not Just Fat
A swollen belly during menopause isn't always due to actual weight gain. Three factors can explain it:
- Water retention : the drop in estrogen disrupts water balance and the nervous system, promoting water retention in the abdomen
- Digestive bloating : hormonal changes modify the intestinal microbiota, slow down transit and promote bloating
- Fat accumulation : as explained above
Concrete Solutions to Limit Weight Gain
Adapt your diet
- Increase protein to preserve muscle mass
- Favor foods with a low glycemic index
- Reduce salt to limit water retention (max 5g per day)
- Increase fiber to improve transit
- Limit alcohol (high in calories and promotes hot flashes)
- Eat foods rich in potassium (lentils, almonds, avocados) to combat bloating.
Move regularly
- 30 minutes of moderate activity 5 times a week minimum
- Weight training twice a week to maintain muscle mass
- Brisk walking, swimming, cycling, yoga
- Exercise also helps reduce hot flashes and improves sleep.
Manage stress
Chronic stress increases cortisol, which promotes abdominal fat storage. Practice meditation, yoga, cardiac coherence, or any calming activity.
Treatments: Medical and Natural Options
There are several approaches to dealing with menopause symptoms. The choice depends on the severity of your symptoms, your medical history, and your personal preferences.
Menopause Hormone Therapy (MHT)
Long called HRT (Hormone Replacement Therapy), the THM remains the most effective treatment to alleviate the symptoms of menopause.
Its operation is based on the combination of two hormones:
- Estrogens (estradiol): administered by cutaneous route (patch, gel) preferably
- Progestin (micronized natural progesterone or dydrogesterone): at least 12 days per month to protect the endometrium
Women who have had a hysterectomy take only estrogen.
Benefits of THM
- Very effective against hot flashes (reduction within 1 month)
- Improves sleep, fatigue, mood
- Treats vaginal dryness
- Prevents osteoporosis and reduces the risk of fractures by 30 to 40%
- Cardiovascular protective effect if started within 10 years of menopause
- No weight gain linked to treatment if minimal dose and limited duration
Risks of THM
The main risks identified (which increase with the duration of treatment):
- Breast cancer : moderate excess risk that increases with duration (especially beyond 5 years). The risk decreases after stopping treatment. The French regimen (estradiol patch + natural progesterone) limits this risk.
- Thromboembolic risk : especially the first year. Almost non-existent with cutaneous estrogen (patch) associated with natural progesterone.
- CVA : increased risk, especially with oral estrogens
- Endometrial cancer : only if estrogen alone without progestin in women who still have their uterus
Who can take THM?
HRT is indicated when menopausal symptoms significantly impair quality of life, provided that:
- Menopause less than 10 years ago (therapeutic window of opportunity)
- You are under 60 years old
- No contraindications (see box below)
Absolute contraindications to HRT
- History of breast cancer
- History of heart attack or stroke
- Coronary disease
- Current or past venous thrombosis
- Undiagnosed vaginal bleeding
Medical monitoring : MHT requires annual reassessment with your doctor to ensure the benefit continues to outweigh the risk. Treatment should be taken at the lowest effective dose and for the shortest duration necessary.
Non-Hormonal Treatments
For women who cannot or do not wish to take HRT, other options exist.
Drug treatments
- Antidepressants (SSRIs, SNRIs): can reduce hot flashes by 50%
- Gabapentin : effective on hot flashes
- Local treatment : estrogen in ovule or vaginal cream for dryness (minimal absorption, almost zero risk)
- Vaginal lubricants and moisturizers : to improve sexual comfort
Natural approaches
Note: The lack of scientific evidence doesn't necessarily mean ineffectiveness. Some women experience benefits from these approaches, likely due to the placebo effect (which is not insignificant) or mechanisms that are still poorly understood. The important thing is that the treatment is right for you and doesn't pose any risks.
Long-Term Health Effects
Beyond the immediate symptoms, estrogen deficiency increases certain health risks. This is why regular medical monitoring is important after menopause.
Increased cardiovascular risk
Before menopause, estrogen protects the cardiovascular system. After menopause, the risk of hypertension, atherosclerosis, heart attacks, and strokes increases. Cardiovascular disease becomes the leading cause of death in women, ahead of breast cancer. This risk is even higher in cases of early menopause.
osteoporosis
Bone loss accelerates after menopause. Osteoporosis affects 1 in 4 postmenopausal women, increasing the risk of fractures (wrist, femoral neck, vertebral compression fractures).
Cognitive decline
Women who experience early menopause or menopause before age 45 have an increased risk of cognitive decline and neurodegenerative diseases compared to women who experience menopause around age 50.
Adopt the right reflexes
- Regular physical activity : protects the heart and bones
- Balanced diet : rich in calcium and vitamin D for bones
- Sun exposure : 15-30 minutes a day for vitamin D
- Stop smoking : reduces all risks
- Blood pressure monitoring
- Regular screenings : mammography, bone densitometry according to risk factors
Living Through Menopause with Peace
Menopause isn't an illness to be endured, but a transition to be navigated. Here are some tips for managing this period and fully enjoying this new stage of life.
Get Accompanied
Consult a healthcare professional (general practitioner, gynecologist, or midwife) for a consultation dedicated to menopause, ideally at the first signs. This consultation allows for personalized support integrating gynecological, cardiovascular, and osteoarticular dimensions.
In France, a preventive check-up between the ages of 45 and 50 helps address the difficulties and symptoms associated with perimenopause. It can be performed by a doctor, midwife, nurse, or pharmacist.
Staying Calm During Your Period (Yes, It's Possible!)
During premenopause, the periods become unpredictableSome flows may be heavy, others very light. This chaotic period adds stress to an already difficult time.
Reliable protection to help you get through premenopause with peace of mind
Period Panties provide up to 12 hours of leak-free protection, even for heavy flows typical of premenopause. No more stress about unpredictable leaks and changing your protection every 2 hours.
Breaking the Taboo
In France, menopause remains a taboo subject. 48% of women under 50 find it difficult to talk about, 46% of premenopausal women have never spoken to their partner about it, and 38% don't know who to talk to. However, talking with other women, your partner, or a professional can be a huge help in getting through this stage.
What to Remember
Menopause is a natural stage that affects all women, generally around the age of 51. It marks the definitive cessation of reproductive function and is often accompanied by symptoms (hot flashes, sleep disturbances, weight gain) due to the drop in female hormones. But their intensity varies enormously from one woman to another, and 15% of women go through this period without bothersome symptoms.
Solutions exist, from hormone therapy to natural approaches. A healthy lifestyle (appropriate diet, physical activity, stress management) can significantly help manage this transition.
Menopause isn't the end of your life, but simply a new phase in your life, with its challenges and benefits (no more periods, no more risk of unwanted pregnancy!). With the right support and strategies, you can get through this period with peace of mind and continue to thrive.
Sources & Scientific References
- INSERM. Menopause. DOI
- Ministry of Health and Solidarity. Menopause: Learn and Talk About It. May 2025. Product
- Health Insurance (Ameli). Menopause: definition, symptoms and diagnosis. Product
- French National Health Authority. Hormonal treatments for menopause. 2014. Product
- Hamidovic A, et al. (2020). Higher Circulating Cortisol in the Follicular vs. Luteal Phase of the Menstrual Cycle: A Meta-Analysis. Frontiers in Endocrinology, 11, 311. DOI
- World Health Organization (WHO). Menopause. October 2024. Product
- Study of Women's Health Across the Nation (SWAN). Epidemiological study, 1994-present.
Medical Warning: This article is intended for informational purposes only and is not a substitute for professional medical advice. If you experience persistent or unusual symptoms, consult a healthcare professional.
