This article discusses the menopause or change of life and examines what the menopause means to women and their families.
What is the menopause?
The menopause is actually the day after the woman’s last period stops, but as the process is gradual the term often refers to the period of change – also known as the ‘change of life’.
More recently the term perimenopause has been used to describe the period of time around the menopause.
When people discuss the menopause they are usually referring to the natural menopause, where periods stop naturally, most commonly around the age of 50, although anything between the ages of 40-55 is normal. As the egg cells in the ovaries decline in number, hormone levels of the female hormones oestrogen and progesterone decrease. As a result the woman stops releasing eggs each month and menstruation becomes irregular. In some women periods are more frequent, in others they are less frequent; they may get heavier or lighter too. Eventually they will completely stop. Women are no longer fertile after the menopause.
The menopause may be:
- early if it occurs before the age of 45
- or premature if it occurs before the age of 40
- or it may stop artificially, after removal of the ovaries for example.
What are the signs & symptoms that can accompany the menopause?
Hot flushes or flashes and sweats are probably the most commonly associated symptoms that women experience. They can be embarrassing and uncomfortable.
Some women have problems sleeping, which may also be associated with night sweats.
As the hormones decrease, so many women experience vaginal and vulval dryness. This can make sex uncomfortable.
Women also have an increased risk of getting a urinary tract infection or experiencing stress incontinence of urine during the late menopause, as the muscle and tissue in the pelvis becomes less elastic.
Mood changes are common, such as anger, tearfulness, depression and irritability. These will be accentuated if you are not sleeping well.
Bodily changes may occur as time progresses– hair may thin, breasts feel less full, and the bones may get thinner putting women at higher risk of osteoporosis.
Do all women get these signs and symptoms?
While it is common to experience hot flushes and mood swings, for many women the only change they notice is the irregularity and cessation of monthly periods.
Approximately 70% of women experience symptoms of the menopause.
What treatment is available to reduce the symptoms of the menopause?
In the first instance discuss your symptoms to be sure that they are due to the menopause – if in doubt a hormone blood level check can confirm this. For example, irregular bleeding could be due to the menopause, but it could also be due to a disease process such as cervical cancer, so do get this checked out.
Changes to your lifestyle may be recommended. Women that smoke, drink a lot of caffeine, do little exercise or eat an unbalanced diet may suffer the symptoms of mood swings and poor sleeping more than necessary.
Symptoms of the menopause can often be reduced by Hormone Replacement Therapy, which is prescribed by your GP or gynaecologist.
What is HRT?
HRT or Hormone Replacement Therapy is treatment that is available to lessen the symptoms of the perimenopause.
As its name suggests it is drug therapy containing hormones – namely oestrogen and sometimes progesterone. The type of HRT you are prescribed will depend upon why you are taking the HRT and whether you are perimenopausal or post menopausal.
HRT may be:
- oestrogen only
- oestrogen and progesterone combined – continuous combination therapy
- or oestrogen only for part of the month and a combination at other times of the month – sequential HRT.
HRT can also be administered in different forms, depending upon why it is prescribed:
- Tablet form, which is the most common
- Patches or implants, which like tablets will affect the whole body
- Pessaries or cream, for a local effect, such as to relieve vaginal dryness.
The main benefits of HRT are:
- Symptom control the menopausal symptoms that some women suffer from
- Prevention of osteoporosis
The risks of HRT are:
- An increased risk of breast cancer
- An increased risk of disease involving blood clots
Women taking HRT for reduction of menopausal symptoms are often recommended to stop HRT every 2 years for a period of time, to see whether they still need to continue taking the drug.
What can I do?
- To reduce hot flushes avoid caffeine, alcohol and spicy foods to see if that helps.
- Sleep with the window open at night and wear loose cotton clothing to reduce sweating.
- Review your diet – with a dietitian or nutritionist if you are unsure – to help you loose weight if this is an issue for you. Hot flushes and night sweats will be exacerbated if you are overweight.
- Consider whether the benefits of HRT would outweigh the risks. This will depend upon your previous medical history.
- Alternative practitioners offer relief of symptoms related to the menopause and this may be more suitable for you. Herbal supplements or acupuncture are among the many alternative therapies available.
- Review areas of your life that are causing stress and spend some time planning how these factors could be reduced. The psychological symptoms of the menopause can be worsened by concurrent factors in women’s lives – children leaving home, relationship problems, changing roles or problems with teenage children.
Make time for yourself every day! This may be a daily walk with a friend, a trip to the cinema, half and hour with a book, an exercise class or a craft class. Look upon this as therapy and a necessary part of your day to enable you to function and enjoy your roles in life as mother, colleague, friend, partner, daughter or sister.
If your periods become extremely heavy, or you bleed in between periods, have this checked out by your family doctor. This could be a sign of disease, rather than just a sign of the menopause.
To read about the other end of the spectrum, visit our article on Mums, Daughters and Periods, or check out our information fact sheet on Periods.
To understand more about Mammograms, click here
To understand more about the role of Natural Therapists, click here