The Menopause

What Is The Menopause?

The Menopause is an inevitable part of being female. The word menopause simply means your last menstrual period; ‘meno’ referring to your menstrual cycle. Over our lifetime we slowly lose eggs from our ovaries and for most women this loss accelerates around the age of 40 and results in lower oestrogen, progesterone and testosterone levels. Menopause symptoms classically start from the mid-forties but can appear earlier and this ‘period’ up until one year after the last menstrual bleed is known as the PERI-menopause. A lady can say they have gone through the menopause once their periods have ceased for 12 consecutive months or more. Should you have a period 11 months after the last bleed the clock would be reset to zero and you would have to count 12 months again from the last bleed.

A woman’s experience of the menopause is individual to them. Some may find it positive and liberating in terms of no longer having periods or having to worry about contraception where as some may experience debilitating symptoms. For some women these symptoms may be short lived, however for others they can last many months or even years beyond the last period.

Perimenopause

The time from when symptoms of the menopause develop until 12 consecutive months after your last period.

Menopause Symptoms

The better-known symptoms of the perimenopause and menopause are hot flushes and night sweats but in actual fact any symptom emerging around the perimenopause can be down to declining hormone levels. Symptoms are essentially the body withdrawing to these hormones, specifically oestrogen and testosterone.

Every organ in our body is rich in oestrogen receptors, from our eyes to our nails, skin and blood vessels so even dry eyes or hair loss starting in the perimenopause could be due to this. Other symptoms can include insomnia, irritability, low mood, anxiety, problems with memory and concentration, bladder weakness, loss of libido, vaginal dryness and painful intercourse. This is by no means an exhaustive list.

FAQs

What Happens During The Menopause?

Menopause happens when the ovaries no longer release an egg each month, menstruation ceases and you are no longer able to conceive naturally. Menopause is considered a normal part of ageing when it happens after the age of 40.

When Does The Menopause Begin?

The average age of menopause in the UK is 51. The perimenopause commonly starts from the mid forties but there is no age limit for the menopause and sadly a tiny minority can experience a menopause in their 20s or even teens. One per cent of women complete their menopause below age forty and this is known as Premature Ovarian Insufficiency. A menopause between the ages of 40-45 would be considered an early menopause. Menopause can also be induced through hysterectomy, some chemotherapies and pelvic radiotherapy.

The Menopause and Sex

The loss of oestrogen and testosterone at this time can lead to changes in a woman’s body and reduced libido. Vaginal dryness is very common after the menopause and intercourse can become painful. This, coupled with a fall in testosterone, can negatively affect sexual desire. Both of these symptoms can be improved with hormone replacement therapy.

Fertility During The Menopause

Fertility naturally declines with age, especially after the age of 35, however, somewhat paradoxically, it is still possible to conceive up until 12 months after your last menstrual period.

Menopause Diet

Phytoestrogens (plant oestrogens), such as soya and red clover, are substances that occur naturally in plants and have similar chemical structure to our own body’s oestrogen. It remains unclear, however, if consumption of phytoestrogens can minimize some of the symptoms of menopause. Advice is vague but suggests that those women who culturally already follow a diet rich in phytoestrogens should continue with what is considered to be ‘normal levels’ of dietary intake. Extrapolating from this it may be worth women incorporating some into their diet but not to excess. As they are known to have oestrogenic effects on the body, isoflavones including red clover are not recommended for breast cancer survivors.

Herbal Remedies

There is some evidence to support the use of black cohosh in reducing hot flushes though this is less so for breast cancer patients and should be avoided by those taking tamoxifen. It is also associated with significant side effects. Those with a history of breast cancer or at high risk of future development of breast cancer may consider taking St John’s wort for control of sweats and flushes, however there is uncertainty about dosing and again it has the potential for serious interactions with other medications you may be taking. Be mindful to seek a formulation with the Traditional Herbal Remedy (THR) mark, validating strength and quality.