Menopause can be a scary word — and it’s rarely spoken about. It’s a totally natural part of ageing though and we’re here to support you to get the information you need.
- What is menopause?
- When does menopause start?
- Why does menopause happen?
- What are the symptoms of menopause?
- Things that can affect menopausal symptoms
- Complications of the menopause
- Ways to manage menopausal symptoms
What is menopause?
Prior to menopause, most women go through perimenopause. This is when your periods become irregular and your flow might become lighter or heavier.
Menopause is when you have stopped having periods for one year — triggered by a drop in the levels of the hormones oestrogen and progesterone. The NHS officially describes it as when a woman stops having periods and is no longer able to get pregnant naturally.
When does menopause start?
Your genetics and ovary health influence when you begin menopause. Typically the menopause occurs between the ages of 45-55. In the UK, the average age is 51. Your periods usually become less frequent or they might stop suddenly.
Some women reach menopause before the age of 45 — roughly 1 in 100. This is called early menopause or premature ovarian insufficiency.
If you’re under 45 and your periods are becoming less frequent or have stopped altogether, it’s important to see your GP or test your hormones to see if they're in the menopausal range. This is because of increased risks that come with early menopause —for example, osteoporosis and heart disease.
Why does menopause happen?
Menopause is a completely natural part of ageing.
Your ovaries ability to produce hormones gradually declines over time — in particular, the hormone oestrogen. The drop in oestrogen triggers the levels of another hormone, follicle-stimulating hormone (FSH), to rise. A menopause test will usually measure these two hormones to see if they're in the menopausal range.
What are the symptoms of menopause?
Symptoms can begin up to five years before your period stops — perimenopause. They can also continue for a long time after that. The most common symptoms of menopause include:
- hot flushes, night sweats, and flushing
- vaginal dryness and discomfort during sex
- difficulty sleeping
- low mood or anxiety
- reduced sex drive (libido)
- problems with memory and concentration
Less common symptoms of the menopause
Some symptoms of menopause are less well known, including:
- changes to vision — including depth perception and spatial awareness
- changes to smell and taste — it’s also common for women to notice a change to their sense of smell
- cold flushes — rather than hot ones!
- skin problems — including acne, eczema and psoriasis
- hair thinning
None of these symptoms are usually anything to worry about, but if you’re concerned you should see your GP.
Things that affect menopausal symptoms
Menopausal symptoms tend to be more severe if you enter menopause suddenly. Lifestyle choices like smoking and drinking a lot of alcohol can also make your symptoms worse.
Interestingly, the most commonly reported symptoms change from one country to the next. In South America, joint pains and discomfort during sex are the most commonly reported symptoms. While in Asia, depressive disorders are more common. Clearly, there’s a cultural element to how these symptoms are experienced and reported by women.
Complications of the menopause
After menopause, dropping hormone levels can put you at an increased risk for a number of conditions, including:
- heart disease — as your oestrogen levels fall, your risk of heart disease increases
- osteoporosis — your bones become weaker so you might be more prone to fractures
- weight gain — your metabolism slows down so it's important to eat well and exercise to avoid gaining weight
- urinary incontinence —your vaginal and urethral tissues lose elasticity so it’s important to strengthen your pelvic floor muscles
Ways to manage menopausal symptoms
The symptoms you experience from hormonal changes can be really tough to manage. What works for each person can be very different, so you’ll need to find what works best for you.
Hormone replacement therapy (HRT)
Synthetic hormone medications can be used to help you transition into menopause and ease symptoms — by artificially boosting your hormone levels. You should always consult your GP to find out if HRT is the right thing for you.
Phytoestrogens are substances found in certain plants that have oestrogen-like effects. These have been shown to reduce hot flushes. Foods high in phytoestrogens include soybeans, tofu, tempeh, and sesame seeds. Some food supplements contain phytoestrogens, like Dong Quai, liquorice, and red clover.
Mild exercise for about 20 minutes, at least three times a week, has been found to reduce hot flashes. It also has a positive impact on mood — reducing anxiety and depression. Taking your exercise outside will also help to boost vitamin D which is really important for your bone health.
A healthy balanced diet, with enough fruit, vegetables, and whole grains is very important as you age. Getting enough calcium, like in dairy or calcium-enriched alternatives, is also really important.
Healthy sleep practices
Aim for 6-8 hours of sleep each night. And try to keep devices like mobile phones and laptops out of your room or at least away from your bed. It's also a good idea to avoid too much caffeine and alcohol as these can cause sleep issues. Meditation or mindfulness exercises can help reduce stress, which also promotes better sleep.
Recommended listening for you
Chen, M. N., Lin, C. C., & Liu, C. F. (2015). Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis and systematic review. Climacteric, 18(2), 260-269.
Makara-Studzińśka, M. T., Kryś-Noszczyk, K. M., & Jakiel, G. (2014). Epidemiology of the symptoms of menopause–an intercontinental review. Przeglad menopauzalny= Menopause review, 13(3), 203.
National Health Services (2017). Conditions: Night sweats. Retrieved 26 November 2018 from https://www.nhs.uk/conditions/night-sweats/.
National Health Services (2018). Treatment: Menopause. Retrieved 26 November 2018 from https://www.nhs.uk/conditions/menopause/.