Menopause

Menopause

Menopause is when your periods stop due to lower hormone levels. It usually affects women between the ages of 45 and 55. The average age in the UK is 51. Menopause is defined as 12 months without a period. Menopause is a natural life process which can affect anyone who has a period.

What is Perimenopause?

The period of hormonal change leading up to the menopause when hormone levels start to fluctuate and ultimately decline. The decline in hormones can cause people to experience symptoms (more on these in the next section). Menstrual cycles can also become more erratic. For some people, this period can be relatively quick, with minimal disruption. But for many, its more challenging with both physical and emotional symptoms that can have a big impact on lives for a long period. The perimenopause often lasts 4-5 years but can be much longer, or just a few months. It commonly occurs when people are in their 40’s.

What about post menopause?

The time after menopause has occurred, starting when a woman has not had a period for 12 consecutive months. Once this happens, you are in post menopause for the rest of your life.  If unexplained bleeding recommences, please contact your GP.

After the menopause, the ovaries stop releasing eggs. The body produces less of the hormone’s oestrogen and progesterone. This reduction in hormones can put some people at an increased risk of certain health conditions like osteoporosis and heart disease.

How menopause can affect you

Menopause and perimenopause symptoms can have a big impact on your daily life, including relationships, social life, family life and work. It can feel different for everyone. You may have a number of symptoms or none.

Physical symptoms

• Hot flushes and palpitations
• Night sweats (increased sweating may also be experienced during the day)
• Insomnia and sleep disturbances
• Fatigue
• Headaches
• Muscle and joint stiffness
• Aches and pains
• Skin irritation and dryness
• Dry eyes
• Urinary frequency/ urgency
• Hair loss
• Changes to periods such as irregular, heavy bleeding or painful periods
• Vaginal dryness, itching and discomfort
• Loss of libido
• Weight gain
• Restless legs
• Burning mouth
• New allergies and sensitivities
• Digestive issues

Psychological symptoms

• Anxiety
• Low mood
• Mood swings
• Irritability
• Lack of motivation
• Reduced confidence
• Loss of joy

Cognitive symptoms

• Cognitive symptoms – Brain Fog
• Poor memory or changes to memory
• Poor concentration

How long do symptoms last?

Symptoms can last for months or years, and can change with time. For example, hot flushes and night sweats may improve, and then you may develop low mood and anxiety. Some symptoms, such as joint pain and vaginal dryness, can carry on after your periods stop.

Treatment and self-care

The decision about whether to consider treatment is a personal one and should ideally be based on informed choice. Medical and non-medical treatment and therapy options include:

• Hormone Replacement Therapy (HRT)
• Non hormonal treatment
• Testosterone
• Counselling and Cognitive Behavioural therapy (CBT)
• Exercising regularly
• Eating a healthy diet
• Yoga
• Mindfulness
• Vitamins and supplements
• Natural and alternative remedies.

It’s important that people discuss the various options with their GP for clinical guidance and find out information themselves about the different options, along with any benefits and risks.

Lifestyle tips

Below are some lifestyle tips for self-care during the menopause and beyond, but these are also relevant for any life stage:

• Support a healthy diet: The fall in hormone levels (namely, oestrogen) that accompanies the menopause can increase the risk of heart disease and osteoporosis. A healthy diet is essential at this stage.
• Find your balance: Keep it low in saturated fat and salt to reduce blood pressure and rich in calcium and vitamin D to strengthen bones. This also helps your gut health.
• Try something new: Change up your snacks to healthier alternatives, try nuts or seeds or fresh fruit or vegetables. Trying to paint a rainbow of colourful foods on your plate can be a simple way to get thinking about lots of salads, vegetables, and variety.
• Reduce alcohol Reducing alcohol during menopause transition is a good thing to do. We know it’s good for us not to have excessive alcohol consumption (NHS recommends not to drink more than 14 units of alcohol a week), but alcohol can also exacerbate menopause symptoms.
• Stop smoking: Smoking has been shown to lead to an earlier menopause and trigger hot flushes. If you smoke, you also run a higher risk of developing osteoporosis and coronary heart disease (CHD), which is a common form of death in women.
• Hydrate: Keep well hydrated – water is the best option.
• Keeping active: Some people experience increased stress and anxiety during the menopause. Regular exercise may help to reduce this. Find something you really enjoy you could try cycling, swimming, tennis, running or exercise classes.
• Be outdoors: It’s important for your bone health to get outdoors between April and October. Sunlight on your skin triggers the production of Vitamin D, which helps to keep your bones strong.
• Make exercise part of your routine: If you spend a lot of time in one position during the day, try and make exercise part of your day. You could park the car further away, take the stairs more, or cycle/walk some of your journey to work.
• Get flexi: As much as increasing your heart rate and staying strong are important, don’t forget to stay flexible. Find five minutes each morning and evening to stretch and keep on track.
• Rest and recover: Don’t overdo it. Take time to rest each week and make sure you eat well to support your body.
• Support your mental wellbeing: Hormone fluctuations during the menopause can result in added stress and what some might describe as depression. Relaxation techniques and counselling can be helpful in coping with stress and anxiety.
• Digital detox: We’re constantly connected to our work, friends, and family through our phones, which in some ways can be beneficial as it gives us lots of flexibility, and news at our fingertips. But it can also prevent us from switching off, which can cause heightened stress levels and anxiety. Try having a place to put your phone outside of your bedroom and reading a book and using an alarm clock instead.
• Have a bedtime routine: Often when we are feeling stressed, we lay awake at night worrying. In order to avoid stress-induced insomnia it can help to have a routine to let your mind and body know it’s time for bed. Try having a warm bath or shower and avoid screen use.

Sex and relationships after menopause

During the perimenopause and the menopause you may experience changes in how you feel about sex. There are several possible causes of any changes in your feelings towards sex at this time of life, including:

• Vaginal dryness
• Painful sex
• Reduced sex drive
• Emotional changes

Contraception and menopause

Contraception should be continued until 12 months after the last period. If menopause cannot be confirmed, contraception should be continued until age 55. Please visit our contraception pages for more information

Links

Vaginal dryness (NHS): Includes information about vaginal dryness

Menopause Matters information on what happens leading up to, during and after the menopause, what the consequences can be, what you can do to help and what treatments are available.

Menopause Support home of the national #makemenopausematter campaign. Full of resources including videos, fact sheets, template letters, frequently asked questions, and lots more.

NHS UK information and advice from the National Health Service around managing menopausal symptoms.

Women’s Health Concern providing a confidential, independent service to advise, reassure and educate women of all ages about their sexual health, wellbeing, and lifestyle concerns.

The Menopause Charity working to improve women’s and healthcare professionals’ understanding of the menopause. https://www.themenopausecharity.org

Podcasts and documentaries

The Good, The Bad & The Downright Sweaty available on Apple Podcasts or the Podbean app. Join Diane Danzebrink and Sophie C as they talk frankly and openly about all things Menopause.

The Dr Louise Newson Podcast available on Apple Podcasts. Aims to empower you with the necessary information to make informed decisions regarding any treatment and lifestyle changes, and helps you turn your menopause into a positive experience that does not negatively impact your life.

Davina McCall: Sex, Myths and the Menopause Documentary available online at Channel 4 or on the All 4 app. Davina McCall tells her menopause story, busting midlife taboos from sex to hormone treatment.