‘menopausal’ period definition?

Women's Biz 💁‍♀️
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Continuing the discussion from How to Quit Antidepressants: Very Slowly, Doctors Say:

Totally off topic but not sure if it’s worthy of its own thread cos there’s so little info ‘out there’ on it, but It has been a burning issue with me for years now. I don’t suppose your neuro happened to mention either when that might occur, the ‘being past’ bit, or how ever you are supposed to know? All I’ve ever established is that medically women are classed as being ‘menopausal’ from the time their periods cease until Death. I’ve regularly seen mention that ‘menopause’ lasts for one year from date of last period which millions of women, me included, can contradict from personal experience. I’ve even read of GPs using the excuse for continuing to spread this fallacy as the fact that that was what they’d read in books at Medical School. As menopause is universal amongst women, and whales apparently, it’s surprising so little is known about it,

I suppose in connection to taking a MAV preventative I guess a neuro would be referring to cessation of menopausal symptoms if/when that happens. I’m convinced MAV women will all be much improved once it has. Many women find straight classic migraine stops at menopause and Dr Hain writes its highly unusual post 65 although I’m unsure quite how that relates to MAVers, Helen

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I have also wondered about this. I asked a gynaecologist acquaintance once. She said that what people usually call the menopause is actually the perimenopause (erratic periods, hot flushes, onset of migraine, brain fog, anxiety etc) and can start as much as 10 years before the menopause. The menopause, is as you said, a timespan of a year free from menstruation and with no further periods. So, you don’t actually know you are “going through” the menopause until you are at the end of it. After that you are post menopausal but can still have hot flushes etc for the rest of your life and a myriad of other symptoms from the drop in your hormones. This doctor runs “menopause clinics” but sees everyone from 30 year olds who think they are perimenopausal, young women who have had medically induced menopause and octogenarians. She feels the name of the clinic is a total misnomer. Women have lifelong issues around hormones adn our physiology that are not well understood.

I know a lady in her 80’s who still gets migraines (lifelong) and had been told by several doctors that she would be would be headache free post menopause and alarmingly also told she would probably “stroke out” early but is still here headaches and all, conversely my retired migraine specialist had chronic migraine since her teens controlled by propanalol, she took a large dose 240mg a day I think but the headaches stopped post menopause and she is having a lovely time going out to concerts etc. med and symptom free. I suppose her migraines must have been linked very strongly to hormones.

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From WebMD:
Natural menopause is not brought on by any type of medical or surgical treatment. The process is gradual and has three stages:

  • Perimenopause . This typically begins several years before menopause, when the ovaries gradually make less estrogen. Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last 1 to 2 years of perimenopause, the drop in estrogen quickens. At this stage, many women have menopause symptoms.

  • Menopause. This is the point when it’s been a year since a woman last had her last menstrual period. At this stage, the ovaries have stopped releasing eggs and making most of their estrogen.

  • Postmenopause. These are the years after menopause. During this stage, menopausal symptoms such as hot flashes ease for most women. But health risks related to the loss of estrogen rise as the woman ages.

From Mayo Clinic:
“Menopause is the time that marks the end of your menstrual cycles. It’s diagnosed after you’ve gone 12 months without a menstrual period. Menopause can happen in your 40s or 50s, but the average age is 51 in the United States.”

From medicinenet:
“Menopause is defined as the time when there has been no menstrual periods for 12 consecutive months and no other biological or physiological cause can be identified. It is the end of fertility, the end of the childbearing years.”

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I will echo the above. Most say menopause when they mean perimenopause. Menopause is defined as the cessation of periods for at least one year. But although hormones levels are very low after menopause, they can still fluctuate, causing symptoms. My grandmother had hot flashes into her 70s.
My Neuro kept saying my VM would probably end when I turned 50. I’m 51 and still have dizzy issues that come and go. I don’t know for sure if I’m in menopause cause I had hysterectomy at age 40. Regardless, I think that may be more true for women who had menstrual migraine when younger. That was not my case. I have also read that classic migraine not uncommonly converts to vestibular migraine during perimenopause. And also that there is a subset of women who get worse after menopause. So basically, anything’s possible!

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Hi Helen, so my neuro since my first visit 18 months ago after going through my headache history is convinced it’s hormones that tipped me into chronic migrane along with stress and ridiculous pace of life. He told me on my first visit that I was typical type of patient, mid 40s, developed menstrual migrane after the birth of my kiddies.
At my last visit a few weeks ago, now we can see some improvement with effexor it’s also highlighting where my worst days fall ie ovulation and especially periods. As part of a discussion about how we manage my migranes as I get towards meno, he told me that he would expect my migrane symptoms to settle after meno and he said he’d hope to see this from around the age of 57, and this is based on what he sees happen in cases like mine. He did say he has exceptions of women who don’t get this brake in chronic migrane symptoms, but based on the fact hormones are my primary trigger, he’s hopeful for me. To be honest, I feel he’s trying to give me hope when he tells me this, as some one said above anything can happen with meno and migraines so I don’t dwell too much on it and I’m certainly not going to set a timer to countdown the next 10 years :grin:… Time will tell I guess but for the next few years I’ll hold onto his hopeful view and who knows :crossed_fingers:

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Nin, were you able to reduce the stress and hectic pace of life? I suspect this would help me immensely, as I’m in a very stressful job and commuting, but I don’t see a way out of that at present. Just curious if you were able to make some changes, and if they helped.

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I think it’s safe for me to say I know Nin’s answers will be yes to both your questions but no doubt she’ll elucidate in due course. I only forestall her because from everything I‘ve read and my own personal experience I just had to post to say I think it’s essential to reduce any/all triggers as part of a recovery programme. Public transport/commuting is one for many. Just ask @jojo65 about the difference making changes to her travelling arrangements. The only consistent MAV management advice I’ve ever had was Trigger Avoidance. That came from every medic involved. So I’d say it’s as important as meds and caffeine reduction. Helen

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Hi. From what I’ve read of hormone pattern type MAV, your history certainly fits a pattern whereby it may well disappear completely at/post menopause and I most sincerely hope for you that it does. Yours sounds very very hormone dependent. Mine’s different in that, mine previously stopped at menarche completely (so presumably my normal 28 day cycle didn’t bother it) only to return in different form at menopause but I’m hoping it’s just ‘extreme hormones fluctuations’ with me and that once menopausal symptoms subside and levels set to some new norm, mine might disappear too. As you infer. Tis better to travel in hope. Helen

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Hmm. Interesting thread . I have been having hot flushes and night sweats since being in the perimanopause stage which makes it about 20 years altogether. I am 12 years into the post menopause stage and think that I am going to be one of those who have hot flushes for ever! I am convinced that the menopause symptoms - flushes, insomnia, anxiety etc contributed to me succumbing to the MVBD. Working full-time and looking after an elderly mum in law often at the same time as baby sitting the grandchildren when you haven’t slept properly all takes its toll. Sadly at the time no one was particularly interested - at least they weren’t at my GP surgery.
I reckon that MAV/MVBD also cause hot flushes and I wonder if some of our male sufferers would be able to confirm that? Jan xx

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You, and me both. I read somewhere the other day of a 92 year old lady still having them so we got a way to go yet!

Really. I wouldn’t have thought so. Anxiety can. The last twelve months since my 24/7 dizziness ceased I’ve noticed I get dizzy now when I have a hot flush and on days wgen hot flushes are prevalent i always have far more MAV Symptoms and feel more disequilibrium than on days I don’t have as many/or any hot flushes but I’ve always thought both MAV and hot flushes are caused by fluctuating hormones in my own case at least, Helen

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Hey napagirl, yes I had too. When chronic mav happened 3 years ago this june, I was out of work ill for almost 6 months and during this time with the help of family, hubbie and a supportive gp I had a mirror placed in front of me and to be honest I knew that my pace of life was unsustainable. I’m someone who is driven towards perfection in all I do, I am restless in that my head knew no rest I was always on the go, always planning a project at work or at home and been an anxious girl on top of all that.

So I knew 6 months into this I had to remove a big toxin or stressor for me which was work. The stumbling block was financial in that it I earned a nice few Bob with great benefits. With support from doctors I returned to work part time on reduced hours and started my plan to financially save and plan for my departure at work. It took almost a year and honestly there were days it nearly broke me in spirit and mentally I found it so hard and my symptoms were flaring up terribly so I’d get home from work and go lie down so my kids had no time with me, but I kept my end goal in sight to keep me going.

The best sleep I ever had was on the night I resigned. It took me months after to mentally unwind and create capacity in my head to start healing. At that point a good friend had given me the name of a neuro and I got to see him and now on meds which are helping but removing a massive trigger like a stressful work environment has been a huge enabler. It’s also helped restore a calmer home for my family and everyday I’m grateful that I can do this. Some days dare I say it, mav may have given me a silver lining, it may have saved me from something worse.

I honestly know how making a big life change relating to work can be and it’s not easy, but perhaps you can build out a plan to remove some stressor on the work front over the next 9 to 12 months, this is such a hard thing to do but I found the benefit of doing this mentally empowering. Doing something in this space even as small as working a few less hours can open a place for healing.

The material side of our lives have changed and we’ve had to cut our cloth to fit our new lives. At a future point I will return to work but I will carefully think thru what I can do that keeps me well too.

I really hope options emerge for you that can reduce the stressor for you in work, sending you a virtual hug in the meantime xx

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If @turnitaround decides to revive the ‘post of the month’ I’d vote for this one Nin. Full of sense and so well written. I think far too much emphasis on here, by very site’s nature, goes on meds tried and failed (all very important and necessary stuff I appreciate) that the necessity for Trigger Reduction/Avoidance which I feel must exacerbate symptoms for so many is under estimated. Helen

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Nin, thank you for that! That was very well sad, and I plan to re-read it several times. I suspected it would be true. I know my job and commuting are a huge stress factor, and I feel so utterly trapped. My management is actually trying to push me into more hours and travel :rage: I am saying NO, but they may push, such that I may have to insist on help from my doctors. Thing is, through all of this, NONE of my Dr’s has said stay off work awhile. It’s like they are paranoid of putting someone on temporary disability or something. They say “take the meds, you’ll be fine.” And “be careful”. There were mornings I would just cry and hope I’d actually make it to work. Then hold the walls to walk when I get there. Being the only woman in my group, I hear things like “it’s just menopause” ugh- no support or understanding. I have tried to find a role part time, but that is not looking possible. Losing/leaving my job would mean losing our house, and having to leave the greater area due to cost, which would create different stress for various family reasons. I’m def in a sticky situation! But if I can hold on for a few more years, I can retire early with pension intact. It’s those few years I worry about!

I need a creative solution, and believe me, I’ve been trying to come up with one!

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Hey there, I completely and utterly understand the dilemma you face and most importantly the need to retain your family home, that’s an essential priority for you all and it has to be done.

Knowing that you only have a few, maybe 3 years? to work until early retirement with full pension is certainly a positive ryy of light at the end of the work tunnel.

I think your strategy to get through the next few years is to minimise what and how you work and maximise opportunities for time out for healing and recovery knowing that you need to pace out carefully the next 3 years.

A few thoughts and sorry if you’ve already thought these out…

  1. If part time role is not available, is there any hope of a job share position?

  2. If not, could you go and talk to your doctor or neuro and share the burden you are carrying in terms of work load and expectations of travel increased hours etc… The key point here is to make them understand how it’s impacting your condition and quality of life.

There are two outcomes here…
A. They recognise you medically need time off even if its a matter of months and you are signed off. I’d encourage you to push this, if you are holding onto a wall walking into work, I don’t think you should be there. From an employer perspective, if they knew this, perhaps they would be more open to options. Do you have a hr department or company doctor?

B. If they are reluctant to sign you off could you create a letter from them with their approval into your company stating that whilst you don’t necessarily want to go out on disability you have a medical condition that sets boundaries for you ie travel, hours etc…

Failing the above, then you need a game plan…

Break down the next 3 years into 6 or 12 month windows and see…

  • can you insert blocks of holidays to simply reduce the time at work?
  • can you start to put some money away to look for a sabbatical maybe next year?
  • is there anyway you could work from home even one day a week?

I think what’s super important is your mental approach to the next few years, so that you stay away from feeling like a victim of circumstances and instead reach for the role of a conqueror!!!

I suspect you are strong and have an inner steeliness to you, so maybe this coming weekend, grab an hour and map out all the ways you could make it work. I know it’s so hard when you feel so crap but one day at a time, one week at a time etc… Just remember whilst our homes are important and essential, you are too to your family so keep thinking creative options xxx

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Well said, and it applies to all of us. It’s such a relentless persistent condition it’s so easy to end up feeling defeated. Helen

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Nin, you are the best! I am at work now, and quickly read your response. I plan to reread later. You should be a life coach!! I am going to do exactly what you say- come up with a plan and outline, breaking it down- with contingencies. This is all great advice. Maybe you should look into becoming a life coach. Not only do you have great advice, you have a way of breaking things down, and communicating so effectively.
Thank you :heart:

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Ah thanks so much for the kind words, it’s made my evening :grin:. Really pleased the advice can be of help to you x

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