The menopause is a biological stage that occurs in every woman’s life, irrespective of whether you have had children or not. It is a natural part of the aging process and occurs due to an imbalance in the body's sex hormones (oestrogen, progesterone and testosterone), caused by a gradual decline in the levels of oestrogen. It is split into three stages:
Perimenopause: The period before the menopause when you start to experience menopausal symptoms but are still having periods. During this time, oestrogen and progesterone, which help to regulate your menstrual cycle, start to fluctuate resulting in the many symptoms of menopause. The average age to start the perimenopause is 45 years of age. Some women experience perimenopausal symptoms for a few months before their periods stop, for others the symptoms can occur for months to years and can be quite debilitating. The most common symptoms are changes in menstrual cycle.
Menopause: This occurs, and is diagnosed when, you have not had a period for one year. The average age for most women to reach the menopause is 51 years, although this can vary between different ethnic groups.
Post menopause: The time period after a woman has not had a menstrual period for 12 consecutive months.
Emotional and psychological challenges
Women in the perimenopause or menopause are often ‘sandwiched’ between caring for aging parents and losing touch with teenagers or adult children leaving home. This can be an emotionally difficult time leaving women struggling with burden or feeling lost without a sense of purpose.
Coupled with this are external changes to a woman’s appearance – skin loses it elasticity and vitality, weight starts to creep up around the tummy and hair starts to thin out or change in texture. Women begin to feel the loss of youth and for some, an increasing sense of feeling invisible. This can really shake a woman’s sense of confidence, self-esteem and may be a trigger for low mood.
The menopause can be a troublesome time. Only 20% of women are fortunate to experience the menopause with little or no symptoms, although they may experience urinary and vaginal symptoms as they age.
The rest can experience any of 34 symptoms, including hot flushes, night sweats, palpitations, mood changes, brain fog, headaches, sleep disturbances, joint pain, urinary symptoms, vaginal dryness, and reduced libido.
The extent and duration of symptoms is very much an individual experience but on average can last around four years after the last period. For some women, these symptoms can have a significant impact on their overall wellbeing in their personal and professional life.
For most women aged over 45 years, a diagnosis of the perimenopause or menopause is based on an account of the symptoms you are experiencing, so blood tests are not normally required.
This is usually the most effective treatment for the symptoms of the menopause and replaces the oestrogen your body no longer produces. If you have a womb, you also need a progestogen to protect its lining. HRT can also reduce your risk of osteoporosis, heart disease, type 2 diabetes, bowel cancer and dementia and for most women the benefits outweigh the risks.HRT is available in a wide range of formulations: tablets, skin patches, a gel to rub into the skin or implants.
Healthy changes to your lifestyle can help offset the negative impact of menopausal symptoms. These include all the elements of the six pillars of health:
A healthy well-balanced diet: Promotes good gut health, reduces risk of osteoporosis, cardiovascular disease, stroke and type 2 diabetes.
Regular exercise and movement: Helps keep your heart and bones healthy, can prevent weight gain and helps reduce your risk of cancer, heart disease, high blood pressure, and type 2 diabetes. It can also boost mood, self-confidence and self-esteem and may prevent cognitive decline and risk of depression.
Restorative sleep: Good sleep hygiene can help with women who have difficulty falling asleep and staying asleep and help alleviate other menopausal symptoms.
Stress management: Relaxation strategies reduce stress and anxiety and boost your mood and self-confidence.
Avoidance or reduction of smoking and alcohol: Can help reduce or alleviate symptoms such as night sweats, palpitations and hot flushes.
Positive social connections: Turn to friends, family and menopause support networks to help you transition through this uncertain time in your life.
These include bio-identical hormones, acupuncture, herbal preparations, vitamin and mineral supplements, isoflavones and phytoestrogens.