Reference

The glossary: menopause terms, defined properly

The vocabulary of menopause is where a lot of women get lost — and where a lot get dismissed. Here is each term defined plainly enough to use in a GP's office and precisely enough to trust: the staging framework, the stages, the clinical terms, the treatments, and the Malta-specific system words you'll meet nowhere else. Each definition stands on its own.

Last verified: 10 July 2026 · clinical terms per STRAW+10 & NICE; Malta terms per primary Maltese sources · re-verified quarterly

The staging framework

STRAW+10

The Stages of Reproductive Aging Workshop +10 system (Harlow et al., 2012) — the internationally accepted clinical framework that divides reproductive life into stages, from reproductive through the menopausal transition to postmenopause. It uses menstrual pattern as the primary staging criterion, supported by hormone markers rather than led by them. Women of Malta's 7 user-facing stages map directly onto STRAW+10.

FMP — final menstrual period

The last natural period a woman ever has. It can only be identified in hindsight, once 12 period-free months confirm it was the last. The FMP is the anchor for staging: everything before it is perimenopause, and the clock into postmenopause counts from it.

The states, in plain terms

Premenopause

The reproductive years before the transition begins — regular cycles, stable hormones, typically before the mid-40s. It is not a diagnosis or a menopause "pre-stage"; it's the baseline. Symptoms here are usually cycle-bound rather than menopause-driven, which is why thyroid, iron and other causes are checked first. See premenopause in Malta.

Perimenopause

The menopausal transition — the years when ovarian hormones become erratic and periods change, before they stop for good. Marked by variable cycle length and new symptoms (hot flushes, sleep disruption, mood change). In women over 45 it's diagnosed clinically from symptoms and cycle change, without a blood test. It ends 12 months after the FMP.

Menopause

Technically a single point in time: the day 12 consecutive months have passed since the final period, with no other cause. It's diagnosed retrospectively, once those months are complete. In everyday speech the word also names the wider transition, but clinically it's that one milestone. Mean age is around 51 internationally; no peer-reviewed Maltese cohort has been published.

Postmenopause

Life from 12 months after the FMP onward. Estradiol settles into a stable low, FSH into a stable high. Hot flushes may persist for years, while bone, heart and genitourinary health move to the front. Any bleeding in postmenopause is not normal — see a doctor promptly.

POI — premature ovarian insufficiency

Loss of normal ovarian function before age 40, causing absent or irregular periods and low estrogen. Diagnosed with two FSH readings above roughly 25 IU/L at least four weeks apart, plus symptoms. POI is not early menopause turned down — guidance treats hormone replacement as the default until the natural age of menopause, and it needs prompt specialist workup, not watchful waiting. See early menopause and POI in Malta.

Early menopause

Menopause between 40 and 45 — earlier than typical, but distinguished from POI, which is before 40. Like POI, it shifts the HRT calculation toward treatment, because more of life is spent without estrogen's protective effects on bone and heart. Under 45, a blood test is more likely to be part of the assessment.

The clinical terms

GSM — genitourinary syndrome of menopause

The collective term for the genital, sexual and urinary effects of low estrogen: vaginal dryness, irritation, painful sex, recurrent urinary symptoms or infections. Unlike hot flushes, GSM tends to be progressive and does not resolve on its own. It's the most consistently under-treated menopause symptom, and it responds well to local vaginal estrogen. See GSM and vaginal dryness in Malta.

Vasomotor symptoms (hot flushes and night sweats)

The sudden heat, flushing and sweating — and their night-time form. The mechanism is a narrowed thermoneutral zone: as estrogen falls, temperature-regulating neurons in the hypothalamus over-react to small rises in core temperature. Vasomotor symptoms affect up to 80% of women and last a median of around 7 years. They are the classic target of hormone therapy and of newer non-hormonal drugs.

The treatments

HRT / MHT — the same thing

Hormone replacement therapy (HRT) and menopausal hormone therapy (MHT) are two names for one treatment: replacing the estrogen — and usually progesterone — the ovaries stop making. "MHT" is the term many clinicians and guidelines now prefer; "HRT" remains common, especially in the UK and Malta. NICE recognises HRT as first-line for vasomotor symptoms in suitable women. See HRT in Malta.

Body-identical vs bioidentical

Body-identical hormones are regulated, pharmaceutical-grade preparations whose molecules are structurally identical to the body's own — for example transdermal estradiol and micronised progesterone. Bioidentical, in the compounded sense, means custom-mixed preparations made by some pharmacies without the same regulatory testing; guideline bodies advise against these. Regulated body-identical HRT is evidence-supported; compounded "bioidentical" products are not.

Micronised progesterone

A body-identical progesterone (processed into fine particles for absorption) given alongside estrogen in women who still have a uterus, to protect the womb lining from unopposed estrogen. It's the modern European default progestogen, with a more favourable profile than older synthetic progestins. It is one of the products not currently on Malta's Government Formulary.

Tibolone

A synthetic steroid taken as one daily tablet that acts on estrogen, progesterone and androgen receptors — an alternative form of hormone therapy for some postmenopausal women, useful for vasomotor symptoms, mood and libido. In Malta it is not listed on the Government Formulary, so it's bought privately when prescribed.

The Malta system terms

POYC — Pharmacy of Your Choice

Malta's scheme for dispensing free government medicines through a community pharmacy you choose. It supplies only medicines on the Government Formulary List. Because menopausal HRT isn't on that list as of June 2026, POYC doesn't dispense it free — which is why HRT for menopause is bought out-of-pocket in Malta. See what menopause care costs in Malta.

Government Formulary List

The official list of medicines the Maltese state provides free at point of access through POYC. On the list for a qualifying condition means free; off it means private pay. As of the June 2026 list, hormones are covered only for named conditions (Turner syndrome, hypogonadism, malignant disease and others) — not menopause — and first-line HRT products aren't listed at all.

EMT — Exceptional Medicinal Treatment (named-patient route)

Malta's formal route for obtaining a medicine not marketed locally. A medical consultant submits an EMT Request Form to the Directorate for Pharmaceutical Affairs (legal basis: L.N. 58 of 2018). It's consultant-initiated — a patient can't file it alone — but it's the mechanism that can bring in a specific product a pharmacist otherwise "can't get in Malta".

Mater Dei GOP — Gynae Outpatients

The Gynae Outpatients clinic at Mater Dei Hospital, Msida — the public secondary-care entry point for gynaecology, menopause included. Reached by GP referral, booked in person at Main Reception, Monday to Friday 07:30–12:30, and free or subsidised for residents. It's general gynaecology; there is no dedicated public menopause clinic. See finding a menopause doctor in Malta.

The Women of Malta 7 stages, mapped to STRAW+10

Our seven user-facing stages are STRAW+10 in plain language. Each links to its own page.