Intimate symptoms during menopause: what to expect and how to

It’s a fact… If you’re a woman, you’ll go through menopause at some point in your life.

In Belgium, there are 370,000 women in perimenopause and 310,000 women in menopause. Understanding what to expect, what the symptoms are, and how to manage them will help you feel good about yourself during this phase of your life so that you can be #menoproud.

What's going on?

At birth, the ovaries contain an average of one to two million eggs; by the time of menopause, only 1,000 remain. If there are not enough eggs, ovulation ceases and a woman is no longer fertile. In addition, the production of estrogen and progesterone declines starting at age 40. These two hormones, which were previously in balance, become imbalanced, causing a variety of symptoms.

The stages of menopause

These are the different stages a woman goes through, from her fertile period—characterized by regular cycles and monthly menstruation—to a state of ovarian depletion, in which the number of eggs decreases dramatically and hormone production is significantly reduced.

Phase 1: Perimenopause (ages 46–51)

This phase precedes "actual" menopause. It is the "transitional phase" between the "fertile" period and the complete cessation of menstruation.

During this phase, there is a significant decline in the number of eggs, and periods of high and low hormone levels follow one another in rapid succession. This results in irregular cycles (shorter, longer, heavier bleeding, little to no bleeding, etc.), symptoms caused by hormonal deficiencies (poor sleep, hot flashes, mood swings…), and symptoms caused by excess hormones (heavy bleeding, breast tenderness…). This phase can last for years.

Stage 2: Menopause (average age 52)

When a woman has not had a period for twelve months, with no other explanation, this is referred to as menopause. The average age at the time of the last menstrual period is 51. The average age at menopause is 52.

This is the phase that marks the end of menstruation and, consequently, fertility. During this phase, the body tries to adjust to the low hormone levels, which for many women is accompanied by symptoms. Approximately 80% of women experience these symptoms.

Common complaints include:

• Hot flashes (60%–70% of women)
• Sleep disorders and mood swings
• Weight gain
• Vaginal dryness (30%–50% of women)
• Urinary tract infections and incontinence

Stage 3: Postmenopause (ages 52–54)

Postmenopause is the period following the onset of menopause. For many women, menopausal symptoms will subside after a while.

During this phase, hormone levels continue to decline gradually until they stabilize. The body becomes increasingly accustomed to this new reality, and for most women, symptoms decrease drastically between the ages of 54 and 60. What does not disappear, however, is the aging of the skin and mucous membranes. Throughout the body, the lipid barrier that protects us from dehydration becomes less effective, leading to irritation and itching, including in the intimate area. In addition, the reduced estrogen level results in drying of the vaginal mucosa. This is the cause of vulvovaginal atrophy, with its well-known symptoms such as vaginal dryness, itching, burning, and often painful intercourse (dyspareunia).

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