Menopause

All women will experience the menopause. Nevertheless, the various symptoms that can accompany this natural process can produce anxiety and concern for many women. Menopausal changes can also follow treatments for cancer, such as chemotherapy, oophorectomy, and hormone therapy.

What is the menopause?

The menopause is the stage in a woman’s life when her periods stop and the ovaries lose their reproductive function. Usually, this occurs between the ages of 45 and 55. In the UK the average age is 51. Some women with primary ovarian insufficiency may go through the menopause at a much younger age.

The menopause is influenced by hormones – or rather, by a change in hormone levels. During a woman’s reproductive life, oestrogen is produced by the ovaries, although small amounts are also produced by the adrenal glands. Over time, a woman’s store of eggs in the ovary decreases and oestrogen levels fall. This process can start from the age of 40, and take several years, during which symptoms arise gradually. This gradual change is called the ‘peri-menopause’.

At around the age of 50-55 years, the monthly cycle finally stops – which means periods stop too. This is the menopause.

How will I experience the menopause?

For all women, the menopause is a personal experience.  The reduction of oestrogen can cause symptoms which can be distressing and may require treatment.

Hot flushes are the most common symptom of the menopause, affecting 75% of menopausal women. Other symptoms include night sweats, insomnia, low mood, anxiety, vaginal dryness, reduced libido, frequency and urgency of micturition, thin, dry skin and dry eyes. Symptoms vary hugely in duration, severity and impact.

Decreasing production of oestrogen can also affect other parts of the body, including the brain, causing changes in emotional well-being, and the skin, affecting its elasticity and thickness.

Once the ovaries have stopped producing oestrogen, longer term effects can become apparent. The strength and density of bones can diminish, which increases the risk osteoporosis. Oestrogen keeps the bones strong and prevents the risk of fracture. Unfortunately, there are no obvious symptoms of osteoporosis – the first time you notice is usually when you fracture a bone. So even if the more noticeable symptoms of menopause do not affect you, other changes may be going on which you do not notice.

Some studies also suggest that post-menopausal women are more vulnerable to heart disease and stroke.

How do I know that the menopause has taken place?

It’s not always easy to confirm that you are menopausal. Irregular periods and the occasional hot flush are a sign that changes are happening, but you can’t always tell that you are truly menopausal, especially if you are taking contraceptives or have started Hormone Replacement Therapy (HRT).

Symptoms and pattern of periods can help. Elevated levels of a reproductive hormone known as FSH (follicle-stimulating hormone) may be a sign of the menopause, but the blood test is not always accurate.

Surgical removal of the ovaries will, of course, create an immediate menopause, and the symptoms of the menopause are often much more intense in these circumstances.

What should I do about it?

A healthy lifestyle will help. Treating your body well will help it cope with the changes brought about by the menopause.

Eating: A healthy diet low in saturated fat and salt reduces blood pressure, and a diet rich in calcium and vitamin D strengthens bones.

Exercise: You may feel anxious as the menopause is occurring. Regular exercise reduces stress, gives you energy and guards against heart disease.

Stop smoking – Smoking does lead to an earlier menopause and triggers hot flushes. If you smoke, you also run a higher risk of developing osteoporosis and coronary heart disease (CHD), which is the most common form of death in women

Sensible drinking: Alcohol increases hot flushes. Higher alcohol intake is associated with an increased risk of breast cancer.

Get screened: A late menopause leads to an increased risk of breast cancer. Keep checking for anything abnormal in your breasts, and seek advice if you find anything.

Stay calm, stay positive: When hormone levels fluctuate during the menopause, this can lead to added stress and even depression. Relaxation techniques and mindfulness may help you.

Will complementary & alternative therapies help?

Many women find complimentary therapies such as acupuncture, aromatherapy, herbal treatments, homeopathy, hypnotherapy, yoga and reflexology very helpful in alleviating the symptoms of the menopause.

Conclusions

Menopause is not the same experience for all women. Your body may appear to change a lot, or hardly at all. Most women have to deal with some symptoms, whether mild or severe. The important thing is to stay alert to any changes and to ask for advice if they are causing you trouble. Whatever the symptoms, there are ways of helping.

Above all, stay aware that you are in charge of your body. It deserves looking after.