Hello everyone, I thought I discuss this topic because lots of people, both women and men alike will like to understand this significant phase of a woman’s life. This is a very important period in every woman’s life (and indeed in their partner’s and family’s) because it can affect everyday life, relationships, career and overall physical, emotional, psychological and mental health and wellbeing.
Some women who couldn’t make sense of this significant change in their lives and it’s impact on their cognition have made drastic or life-changing decisions affecting their family relationships or careers negatively. I often come across this joke – this menopause problem even starts with men’ i.e MENopause!
Premenopause: There are no noticeable changes in the body but hormonal changes may start to occur.
Perimenopause: or menopause transition, begins several years before menopause. It’s the time when the ovaries gradually begin to release less eggs and make less oestrogen. It usually starts in women’s 40s, but can start earlier. Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs.
Menopause is when a woman stops having periods and is no longer able to get pregnant naturally. Menopause indicates the end of menstrual cycles and is diagnosed after 12 months without a menstrual period for over 50 years and above or 24 months if less than 50.
It is caused by a change in the balance of the body’s sex hormones, which occurs as one gets older. It happens when the ovaries stop producing as much of the hormone oestrogen and no longer release an egg each month. Periods start to become less frequent over a few months or years before they stop altogether. Sometimes they can stop suddenly. Menopause is a natural part of ageing that usually occurs between 45 and 55 years of age, as a woman’s oestrogen levels decline. The average age of a woman to reach menopause according to the Global Library of Women’s Medicine is around 51.
Some women reach menopause before age 40, this is known as premature menopause. Reaching menopause between 40 and 45 is known as early menopause.
Premature or early menopause can occur at any age, and in many cases, there is no clear cause, and it can run in some families. There could be underlying causes such as smoking, surgery to remove the ovaries due to cancer or other diseases, some cancer treatment eg chemotherapy or radiotherapy, due to underlying Genetic condition such as Down Syndrome, Autoimmune conditions such as Addison’s disease (A form of hormonal deficiency ).
Symptoms of Perimenopause: hot flushes · night sweats · vaginal dryness and discomfort during sex · difficulty sleeping. headaches · mood swings. Irritability. Fatigue. low mood or anxiety · reduced sex drive (reduced libido), breast discomfort, hair thinning and hair loss. the appearance of hair in places you rather not. Increased incidence of bladder infections. weight gain. weak bones, problems with memory and concentration amongst others.
Perimenopausal symptoms can begin months or even years before your periods stop and can last 4 years after your last period, although some women experience them for much longer.
Your Doctor can offer many effective treatments to help you during this transitional period. If you have any symptoms that are disrupting your life, schedule an appointment to see your Doctor.
Treatment for Menopausal Symptoms.
Your GP can offer treatments and suggest lifestyle changes if you have severe menopausal symptoms that interfere with your day-to-day life. Many women will need treatment for a few years until most of their menopausal symptoms have passed.
Hormone replacement therapy (HRT) – tablets, skin patches, gels and implants that relieve menopausal symptoms by replacing oestrogen. HRT involves taking oestrogen to replace the decline in your body’s own levels around the time of menopause. This can relieve many of the associated symptoms. HRT is not advisable for some women such as those who have had certain types of breast cancer or are at high risk of getting breast cancer. Your GP can give you information about the risks and benefits of HRT to help you decide whether or not you want to take it.
Vaginal Oestrogen creams, lubricants and moisturisers for vaginal dryness.
Cognitive behavioural Therapy (CBT) –A talking therapy that helps with anxiety and low mood.
Some Antidepressant medications and Clonidine which helps mainly with hot flushes and sweats.
Eating a healthy balanced diet (plus Calcium and vitamin D supplements) and exercising regularly helps with bone health, optimum body metabolism and cognitive function
Reducing alcohol intake and stopping smoking helps to reduce hot flushes and night sweats as well as improve bone health and memory.
Simple home measures to help with hot flushes and night sweats
If you experience hot flushes and night sweats as a result of menopause, simple measures may sometimes help, such as :
Wearing light clothing
Keeping your bedroom cool at night
Taking a cool shower, using a fan or having a cold drink
Trying to reduce your stress levels
Avoiding triggers such as spicy food, caffeine, smoking and alcohol
Taking regular exercise and losing weight if you are overweight.
If you experience vaginal bleeding in your postmenopausal years (after your period has stopped) do not delay to seek care.
Complementary and alternative treatments
Some women consider taking complementary and alternative treatments instead of taking hormone replacement therapy (HRT). There is a massive market for products to help with menopausal symptoms, but many of these are not proven to be safe or do not have good research to support their effectiveness. For example, the following have been marketed for menopausal symptoms: black cohosh, red clover, dong quai, evening primrose oil, ginseng, soy and St John’s wort.
However, just because a product is labelled ‘natural’ does not mean that it is automatically safe and free from potentially damaging chemicals. Herbal remedies are not regulated by a medicine authority in the same way as prescribed medicines are. They should not be considered as a safer alternative to HRT, as there is so much variety in their effectiveness and potency. Many herbal medicines have unpredictable doses and purity. In addition, some products have significant side effects and can interfere with other medicines.
The regulatory bodies have developed a system called Traditional Herbal Registration (THR). Any herbal products that have been approved by this system have a THR logo on their packs. This means that the product has the correct dosage and is of high quality. The pack will also contain product information.
Whilst some women go through these changes without much difficulties and impact on their wellbeing and quality of life a significant number of women struggle around perimenopause and this leaves them overwhelmed. The message here is for all women to know there is help available and safely too to deal with problems that arise at different stages of their reproductive lives. This knowledge will leave so many women feeling empowered to continue to live their lives fully and optimally at all stages.
Not leaving the men out, there is something called Andropause (a collection of symptoms, including fatigue and a decrease in libido, experienced by some middle-aged or older men and attributed to a gradual decline in testosterone levels….a topic for another day.
References: NHS UK, Wakemed, Verywell health,Patient.co.uk, the Global Library of Women’s Medicine, WHO Women’s health, GPnotebook.