Lesson 2 of 7 · about 12 minutes
Words you’ll hear: a plain-language glossary
Midlife health comes with a lot of new vocabulary, and it can feel like everyone else got the dictionary first. They didn’t. These are the terms I use most when I explain perimenopause and menopause, written the way I’d say them across the table. Skim it now, and come back whenever a word in a later lesson (or at an appointment) trips you up.
Stages and timing
Perimenopause (menopause transition)
The years leading up to the final menstrual period, when hormone levels shift and cycles often change. Under the STRAW+10 staging system, the transition is described in two parts: early and late.
Early menopause transition
The point when cycle length starts to vary by 7 days or more, and/or menopause symptoms begin. For example, cycles that used to be steady at 28 days start landing anywhere from 22 to 35.
Late menopause transition
When periods begin to skip, with 60 days or more between them.
Final menstrual period (FMP)
The very last period. You only know which one it was in hindsight, after 12 months have passed with no bleeding.
Menopause
Defined as 12 consecutive months without a menstrual period. In the U.S. the average age is 52, per the Office on Women’s Health.
Postmenopause
Any time after menopause. This matters for your log: once you’re postmenopausal, any bleeding or spotting is something to contact your clinician about promptly.
STRAW+10
Short for the Stages of Reproductive Aging Workshop + 10. It’s the internationally used staging system, published in 2012, that defines the stages above using mainly menstrual cycle patterns. It’s one of the reasons your cycle dates are so useful to track.
Symptoms
Vasomotor symptoms (VMS)
The medical umbrella term for hot flashes and night sweats. “Vasomotor” refers to changes in blood vessels and body temperature control.
Hot flash
A sudden feeling of heat, usually in the upper body and face, that may come with flushing, sweating, or a racing heart. The Menopause Society notes episodes typically last 1 to 5 minutes and can range from mild to severe.
Night sweats
Hot flashes that happen during sleep, sometimes strong enough to soak sheets or wake you up. They’re one of the most common reasons sleep gets disrupted in midlife.
Genitourinary syndrome of menopause (GSM)
A group of changes in the vulva, vagina, and bladder linked to lower estrogen: dryness, burning, irritation, discomfort or pain with sex, urinary urgency, and sometimes repeated urinary tract infections. You may also hear the older terms “vaginal atrophy” or “atrophic vaginitis.” The Menopause Society notes GSM often worsens over time without treatment.
Brain fog
An everyday phrase for forgetfulness, trouble finding words, or difficulty concentrating. The Menopause Society notes 40 to 60% of midlife women report cognitive symptoms like these, and that sleep problems and mood changes can play a part.
Mood symptoms
Irritability, anxiety, low mood, or feeling less like yourself. These are real and common. When low mood, loss of interest, and sleep or concentration problems last most of the day, nearly every day, for two weeks or more, The Menopause Society recommends talking with a healthcare professional about possible depression.
Bleeding words
Spotting
Light bleeding that’s less than a typical period, sometimes just a few drops.
Abnormal bleeding (in perimenopause)
Some cycle changes are expected in perimenopause. ACOG lists these as not normal and worth discussing: bleeding or spotting between periods, after sex, heavy bleeding, bleeding that’s heavier or lasts longer than usual, and any bleeding after menopause.
Postmenopausal bleeding
Any bleeding or spotting after you’ve gone 12 months without a period. Always worth a prompt call to your clinician.
Treatment-conversation words
We’ll keep these at a general, educational level. Which option (if any) fits a person is a decision made with their own clinician.
Hormone therapy (HT, sometimes called MHT)
Prescription estrogen, sometimes combined with a progestogen. The Menopause Society’s 2022 position statement calls hormone therapy the most effective treatment for hot flashes and GSM. Risks differ depending on type, dose, how long it’s used, how it’s taken, when it’s started, and whether a progestogen is used.
Systemic vs. local (vaginal) estrogen
Systemic means it circulates through the whole body (for example, pills or skin patches). Local or vaginal estrogen is used in the vagina in low doses mainly to treat GSM. The 2022 statement notes that low-dose vaginal estrogen or other non-estrogen therapies can be used for bothersome GSM that over-the-counter products haven’t relieved.
Progestogen
A general word for progesterone and similar medicines. Whether a progestogen is used is one of the factors The Menopause Society says affects the risks of hormone therapy, and the FDA keeps a boxed warning about endometrial (uterine lining) cancer for systemic estrogen-alone products. Your clinician can explain how this applies to you.
Nonhormone therapy
Options for hot flashes that don’t use hormones. The Menopause Society’s 2023 nonhormone position statement reviewed both medicines and non-medicine approaches; we’ll look at what it found in Lesson 3.
Contraindication
A health reason a particular treatment may not be a safe fit for someone, for example a history of certain cancers or cardiovascular disease.
Shared decision-making
A conversation where you and your clinician weigh the evidence together alongside your symptoms, history, and personal preferences. The Menopause Society specifically recommends this approach for hormone therapy decisions, with periodic check-ins about whether to continue.
Symptom log (or symptom diary)
A simple, regular record of what you notice: bleeding, hot flashes, sleep, mood, and anything else that matters to you. It’s the heart of this course.
Quick self-check (about 5 minutes)
Cover the definitions and see if you can explain each of these in your own words, as if to a friend:
- What’s the difference between perimenopause and menopause?
- What does “12 consecutive months” have to do with menopause?
- What does VMS stand for, and what two symptoms does it include?
- Why is any bleeding after menopause worth a prompt call?
- What’s the difference between systemic and vaginal estrogen?
If one is fuzzy, that’s a great word to circle and bring up at your next visit. Asking “Can you explain what you mean by that?” is always a fair question.
Sources
- Executive summary of the Stages of Reproductive Aging Workshop + 10 (Harlow et al., 2012)
- Definition and Stages (Canadian Menopause Society)
- Perimenopause (The Menopause Society)
- Symptoms (The Menopause Society)
- Mental Health (The Menopause Society)
- Perimenopausal Bleeding and Bleeding After Menopause (ACOG FAQ)
- Menopause basics (Office on Women’s Health, HHS)
- The 2022 hormone therapy position statement of The North American Menopause Society
- The 2023 nonhormone therapy position statement of The North American Menopause Society
These definitions are for general learning and aren’t meant to describe or diagnose anyone’s individual situation.
Something here not seem right? Report a concern privately to the Poéma team.