Understanding the Menopause

The menopause is part of life, and the way you view it can change your experience from a negative to a more positive one. Yes, it is the natural end of your fertility, it is also the start of a new chapter in your life. It is a time where you can focus on yourself, and what you need from your life. You don’t have to make sweeping changes to your life, but maybe it’s time to pay a little more attention to those opportunities you might otherwise allow to pass by.

The menopause is defined as the end of the menopausal transition period. The menopause is clinically diagnosed in two ways, when you have not had a period for 12 consecutive months or the hormone levels produced by your ovaries have fallen below a set level.

It can happen between the ages of 45 and 55 however some people have been recorded as going through it as early as puberty and as late as their 60s. The best way to tell what age you will go through menopause is to find out when your mother or older sisters’ menopauses happened, genetic similarities lead to families going through menopause at similar times although some variance is natural (you won’t go through the menopause at the exact same age, but it will likely be very similar).


Unusual menopause ages

The menopause can happen earlier than usual. If you go through the menopause before you are 40 it is called Premature Ovarian Failure (POF), it can be a result of autoimmune disorders, thyroid disease, diabetes, chemotherapy, radiotherapy and as a result of hysterectomy (surgical removal of the uterus) however many cases lack a defined cause. Luckily, POF only affects 1-2% of women. If you are experiencing symptoms of the menopause and are under 45, please speak to your doctor.

What happens during menopause?

Your body comes to the end of its fertile period. Your body will stop producing certain hormones (which causes the symptoms of menopause) which will lead to your periods stopping.

How long does Does menopause last?

It depends. The menopause itself can last (see below breakdown for details) up to 10 years and symptoms can last for a staggering 12 years after your last period (the average is 4 years after last period).

What is the menopause?

The menopause is split into four sections: Premenopause, perimenopause, menopause and post menopause.

Premenopause is used to define the years preceding the main menopausal symptoms. It is usually defined as starting a few months before your periods become noticeably irregular.

Perimenopause is the menopausal transition period itself. It is the time where your periods will become irregular and can be accompanied by other symptoms such as hot flashes. This can last from 4 to 10 years after menopausal symptoms start. A lot of changes happen during this time.

Menopause itself is determined retroactively after 12 months have passed since the last menstruation. For some women, they will get to 11 months without a period and then have one and must then start counting all over again.

Post-menopause is the time after the menopause has been determined (12 months after the last period). As hormone levels drop, perimenopausal symptoms such as hot flashes can still continue for a few years. Post-menopausal hormone levels can leave you at risk of diseases like osteoporosis (loss of bone density) and is the primary reason why older people break bones so easily. Any spotting or period-like bleeding in this time (even if it’s only happened once, or there are no other symptoms) is a source of worry so schedule a visit to your GP immediately.

For women who have had their uterus removed, the menopause and post-menopause dates would need to be identified with a blood test to check hormone levels.


Menopause symptoms

Some of the symptoms of menopause are well known (hot flashes) while others are a little more intimate. On average, they last for about 4 years after the last period however some women have them for 12 or even 14 years post menopause. We’ll run you through what you can possibly expect as your body changes, you may get all or none of these:

  • Irregular periods – the cycle can become shorter for a few months then you may miss one

  • Heavier or lighter flow than normal

  • Hot flashes/night sweats

  • Sleep disturbance

  • Vaginal dryness

  • Reduced interest/loss of interest in sex

  • Weight gain – you may need to eat less and exercise more to stay at your current weight

  • Depression/anxiety – can be linked to empty nest syndrome, caring for/death of parents

  • Memory problems/difficulty concentrating – hormone changes affect the brain too!

  • Dry mouth/skin/eyes

  • Sore/tender/less full breasts – as a result of oestrogen level changes

  • Headaches

  • Heart palpitations

  • Reduced muscle mass/painful joints/reduced bone mass – treat with exercise

  • Urinary incontinence – as a result of the loss of elasticity in the groin area

  • Urinary Tract Infections (UTIs)

  • Hair thinning/loss on the head

  • Increase in hair growth on other areas of the body

  • Mood changes


Diseases related to menopause

The massive hormonal changes from the menopause can increase your risk of several illnesses afterward. Common postmenopausal diseases include: osteoporosis – where the bones lose mass more quickly and become brittle and more prone to fractures, stroke and cardiovascular disease (heart disease) which is a leading cause of death in both women and men.

Osteoporosis risk can be reduced by taking calcium and vitamin D supplements and getting weight-bearing exercise.

Heart disease risk can be reduced by maintaining a healthy lifestyle, eating a healthy low cholesterol diet and getting regular exercise (walking, cycling, dancing or swimming are good for heart health).

Stroke risk can be reduced by maintaining a healthy lifestyle, eating a healthy low cholesterol diet, doing plenty of exercises, cut out smoking, and cut back on alcohol.


What can I do to alleviate symptoms/prevent disease?

There are a few treatments that can deal with the signs of menopause, but there is nothing that can actually stop the menopause. It is a natural part of life, not an illness so there is no ‘cure’. If you are finding the symptoms to be particularly unpleasant and are having trouble dealing with day to day life your doctor may advise HRT (Hormone Replacement Therapy), HRT is great at dealing with hot flushes and night sweats but there are some side effects, such as breast tenderness, headaches and vaginal bleeding. The pill form of HRT has also been linked with an increased risk of blood clots, particularly Deep Vein Thrombosis (DVT) and breast cancer (only when used for 10 years or over) in some women, making it a moderately risky menopause treatment. Other symptoms of menopause can be treated with a variety of options, the key is finding what works for you. Complementary and alternative treatments (herbal remedies and bioidentical ‘natural’ hormones) aren’t recommended to treat menopause symptoms because some of them interact negatively with other medications you may be taking. Speak to your GP or pharmacist before self-medicating with vitamin supplements or starting any new complementary or alternative therapies.

The menopause matters, but it isn’t something you need to dread, its not the end of everything, it can be the start of a whole new chapter of your life, a time where you are free to try new things and explore new aspects of yourself. It is a time to finally focus on yourself and your goals, a time of liberation.