The definition of menopause is when there is no menstruation over a 12-month period – when the periods actually cease permanently. The average age for menopause is around 51 years old but there are certain lifestyle and diet changes that we can make prior to this to ensure we are very prepared when it comes.
As a woman enters menopause, the ovaries prepare to end reproductive functions, and in the process of doing so, the number and quality of ovarian follicles diminishes. As this happens hormone levels begin to shift erratically as fewer ovulations, occur and the common menopausal symptoms begin to arise. It’s so crucial to check in with ourselves and do what we can feel our best at this time.
Symptoms can vary but most common are Irregular periods or non-existent periods, hot flashes, night sweats, cognitive decline/problems (memory loss), sleep problems/insomnia, mood changes, weight gain especially around the middle and slowed metabolism, thinning hair and dry skin all over, loss of breast fullness.
Typically, the cease of menstrual periods accompanied by the above symptoms and your age will determine the diagnosis of menopause, but various tests can be done to further confirm this if you are feeling unsure. Often, elevated follicle-stimulating hormone (FSH) levels are measured to confirm that a woman has got there. When a FSH blood level is consistently elevated to 30 mIU/mL or higher, and she has not had a menstrual period for a year or more it is generally accepted that she has reached menopause combined with the various symptoms.  Oestrogen and progesterone decrease significantly at menopause, and testosterone levels gradually decrease with age this is why some women will not notice any symptoms as levels start to drop and others though may be more sensitive to the changes. That’s when symptoms will show up and you may experience lack of sexual desire, low mood, depression, low energy and impaired focus and concentration.
The perimenopause is the transition period prior to menopause when your hormone levels start to change, but before your periods stop for good. It can be hard as it can cause a wide range of symptoms, both physically and mentally.  
Blood tests aren’t normally done to diagnose peri menopause as they can show up as unreliable due to a change in hormone levels daily. Treatments and diagnosis are normally done on an understanding of symptoms paired with a woman’s age/lifestyle/diet etc. However, you may be offered HRT which is hormone replacement therapy, however my suggestion would be to look at diet, supplements and lifestyle changes first as menopause hasn’t been reached yet.
Symptoms can include- Loss of confidence, insecurity, anxiety, depression, mood swings, panic attacks, irritability, chronic exhaustion, insomnia and difficulty falling asleep, loss of libido, bloating and changes in digestion, heart palpitations, hair loss and dry skin.
Important to include phytoestrogens in the diet such as legumes, beans, flaxseed and fermented organic soy like tempeh.  These foods can actually mimic the role of estrogen and have mild estrogenic effects.  I would highly recommend 1-2 Tbsp. flax daily. 
Eliminate/reduce refined sugars, coffee, alcohol – these reek havoc with hormones and can exacerbate symptoms
Fibre is important for healthy bowel elimination and clearance of toxins/excess hormones as well as keeping blood sugar levels balanced
Sage- In one study sage tablets were shown to reduce hot sweats in 50% within 4 weeks and by 64% within 8 weeks. The average total number of hot flushes per day decreased significantly each week from week 1 to 8. You can also drink fresh sage in tea form and sip throughout the day. It’s an acquired taste but take comfort in the fact that it’s doing you a whole lot of good!
Consume healthy fats to help balance hormone levels, reduce inflammation and promote stable blood sugar levels.