We could consider adulthood as our peak period, when we have come to know and value ourselves, to enjoy family, professional and social achievements.

But, for women, it also means the transition from active reproductive years to menopause, with all the physical and emotional changes that now happen.

This transition occurs between the ages of 45 and 55, when women go through the menopause. It is characterized by the gradual loss of ovarian follicular activity, which eventually leads to the permanent cessation of menstruation. Worldwide, the number of postmenopausal women is expected to reach 1.2 billion by 2030[1].

After normal reproductive life there are three stages: perimenopause, menopause and confirmed menopause (or postmenopause). This is a natural, progressive and very complex physiological process and is diagnosed retrospectively when amenorrhea (absence of menstruation) has been present for at least 12 months.

The first stage, called perimenopause

is a phase of hormonal disorders characterized by increased levels of FSH (follicle-stimulating hormone), while LH (luteinizing hormone) remains almost normal. This leads to irregular cycles and ultimately to anovulation (absence of ovulation).

Perimenopause sets in about five years before the final cessation of menstruation and can be divided into two phases of different durations:

• firstly, regular, shortened cycles, with a predominant hyperestrogenism whose symptoms are, among others, a premenstrual syndrome (PMS) -> water retention, rashes, breast tenderness, bloating, nausea, difficulty concentrating and sleeping, lack of energy, depression, fatigue, backache, lower abdominal pain and headaches[2].
• then menstrual irregularities, with a predominantly hypoestrogenic syndrome whose symptoms are -> hot flushes, night sweats, loss of libido, weight gain, headaches[3].

The second stage is therefore 'menopause' itself

corresponding to more or less severe estrogen deprivation, which causes hypersecretion in the hypothalamus and pituitary gland and triggers one of the most common symptoms, hot flushes.

Histologically, menopause is characterized by depletion of the follicular capital and a permanent deficiency of estrogen and progesterone.

At the biological level, the cessation of ovarian activity leads to the disappearance of the pituitary feedback on the secretion of gonadotropic hormones and FSH, which is observed during the cycle of non-menopausal women.

Finally, clinically, the main consequence is the disappearance of menstruation and the end of the reproductive period.

Finally, the third and last stage is 'confirmed menopause', or postmenopause, with estrogen deficiency

Menstruation has stopped for a year and the ovaries are atrophying and the central nervous system is starting to rebalance.

The hormonal disturbances of perimenopause and menopause affect the whole body: the genitals, the breasts, the neuromediators of the central nervous system and ultimately hormone-sensitive tissues such as the skin, eyes, bones and blood vessels.

This is the time when more severe diseases such as osteoporosis and cardiovascular disease, as well as diabetes and neurological disorders, appear.

In recent years, the market for solutions to relieve menopausal symptoms has grown considerably, while at the same time the need for informed choices based on individual specificities has increased. The specialist doctor, gynecologist or endocrinologist, is in the best position to determine a possible treatment, taking into account the patient's personal and family history, her gynecological and endocrinological assessment and the severity of the symptoms.

In the landscape of natural solutions to relieve menopausal symptoms is available in Romania gamma Manhaē Menopause, a natural supplement free of hormones and phytohormones and proven in clinical and consumer tests to be effective in providing significant relief from a wide range of menopausal symptoms. Manhaē Ménopause has 20 years of experience in this field and has become the market leader in France, its country of origin.

[1] Ilankoon I. M. M. P. S., Samarasinghe K., Elgán C. " Menopause is a natural stage of aging: a qualitative study ". BMC Womens Health [Online]. February 1, 2021. Vol. 21, p. 47. Available at:

[2] D. Haenggi-Bally, 'Premenstrual syndrome', p. 7

[3] B. Thompson, S. A. Hart, and D. Durno, "Menopausal Age and Symptomatology in a General Practice, J. Biosoc. Sci.Vol. 5, No^o 1, p. 71-82, Jan. 1973, doi: 10.1017/S0021932000008956.