June 10

Naming Women’s Midlife

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By Professor Jerilynn C. Prior BA, MD, FRCPC

(Editor’s note: There’s a lot of confusion around names relating to the change that comes in midlife for anyone born with ovaries. This can also differ between countries. In this article Professor Jerilynn Prior seeks to clarify terminology.)

Why do specific names matter? 

Because then two people can talk about something and each will know what the other means. 

Today, the word “Menopause” is used in three different ways:

1. Ask just about any woman and she is likely to say:

“Menopause is all that is changing and negative about getting old.

2. Ask a gynecologist, however and they will assert:

Menopause is the final menstrual period.”

3. Ask an epidemiologist and they will explain (as does the WHO) that:

“MENOPAUSE is a woman’s final life phase that begins a year after the last menstruation.”

The official meaning of MENOPAUSE is the final life phase (for a person born with ovaries) that begins a year following the last menstrual flow.

(Editor’s note: This differs in some places however. In the UK, we tend to describe this life phase as post-menopause – causing further confusion as this could mean after the end of the final life phase of menopause, therefore after death!)

How do we know that the last flow was truly final?

That is based on statistical probabilities. In a large, long-term study starting with women university students, researchers learned that after 1-year without a further period, 90% of women older than 45 years were unlikely to have another.

That means 10% of women who reach menopause at a normal age have to restart the 1-year menopause clock. Also, younger women had a 20% chance of further menstrual flow. This was confirmed by a prospective randomly selected, population-based study.

What do we call the the time before the 1-year ‘menopause clock’ runs out?

“Climacteric” is old-fashioned and vague; “early menopause transition,” and “late menopause transition” are currently used. But the official Medical Subject Heading (MeSH for literature searches) that is all-encompassing is PERIMENOPAUSE (it became official in 1995).

Download the INFOGRAPHIC here.


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