UNDERSTANDING THE MENOPAUSE

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WHAT
CAUSES THE
MENOPAUSE?		 CHANGES TO
MENSTRUAL CYCLE
OR PERIODS?		 WHAT ARE THE
SYMPTOMS OF
THE MENOPAUSE?		 WHAT TREATMENTS
ARE AVAILABLE
FOR MENOPAUSAL
SYMPTOMS?

UNDERSTANDING THE MENOPAUSE

The menopause is the stopping of the menstrual cycle, or periods, and is a natural part of the ageing process. It marks the end of the fertile years where women are no longer able to get pregnant naturally.

 

Menopause usually happens between 45 to 55 years of age, but can happen earlier. If it happens before this age it is called ‘premature menopause’ and may be as a result of side effects to some medical treatments. Premature menopause affects around 1 in 100 women.¹

If you are under 45 and have noticed your periods becoming infrequent or have stopped altogether, you should speak to your GP.²

WHAT CAUSES THE MENOPAUSE?

The menopause happens when there is a change in the levels of the body's naturally occurring female sex hormones oestrogen and progesterone. This happens naturally, as you get older. Over time, your ovaries produce less of the hormone oestrogen and as a result no longer release an egg each month. This causes changes to your usual menstrual cycle.

In some cases menopause can occur at any age, this is called premature menopause. It is not always clear why this happens, though it can be linked to a family history of early menoapause, treatment such as surgical removal of the ovaries (oophorectomy) or uterus (hysterectomy), or cancer treatments such as chemotherapy or radiotherapy.

 

MENSTRUAL CYCLE CHANGES

Changes to a woman's menstrual cycle (periods) are often the first sign women notice.

 

Periods may become noticeably lighter or heavier as well as becoming irregular, for example, you may have one every 2 to 3 weeks, or you may not have them for a few months at a time. Eventually, your periods will stop.

WHAT ARE THE SYMPTOMS OF THE MENOPAUSE?

Every woman’s experience of the menopause will vary, some will have severe symptoms while others may be able to tolerate them and ‘sail through menopause’ without a problem. However, most women will experience at least some symptoms, and if they are severe they can really impact negatively on daily life and activities.

Common symptoms include³ :

  • Hot flushes
  • Night sweats
  • Insomnia or difficulty sleeping
  • Mood changes or anxiety
  • Reduced sex drive (libido)
  • Vaginal dryness and discomfort during sex
  • Problems with memory and concentration

There is no start time when these symptoms may appear, it may be months, in some cases years, before periods stop and can continue for many years.

There is also an increased risk of post menopausal women developing osteoporosis (weak bones). It is the lower level of oestrogen in the body that causes this.

When should you see a doctor?
You should contact your doctor if you experience symptoms of menopause under the age of 45 or if any of the symptoms are troubling you.

 

Discussing your symptoms with your doctor should enable them to confirm if you are menopausal. In some cases if you are under the age of 45 a blood test to measure your hormone levels can help with diagnosis.

WHAT TREATMENTS ARE AVAILABLE FOR MENOPAUSAL SYMPTOMS?

If your symptoms require treatment, your doctor can offer a variety of options that may range from different types of medication to lifestyle changes or a combination of these.

For example your doctor may discuss the following options:

  • Hormone replacement therapy (HRT) – tablets, gels, skin patches and implants that replace oestrogen to alleviate menopausal symptoms.
  • Vaginal oestrogen products such as creams, moisturisers or lubricants for vaginal dryness.
  • Cognitive behavioural therapy (CBT) – a therapy that examines the things you think and the things you do through talking and can help with feelings such as low mood and anxiety.
  • Healthy diet and exercise – maintaining a healthy weight and staying fit and strong can improve some menopausal symptoms.

You could also think about some practical measures that you could take if you experience hot flushes and night sweats such as:

  • Wearing light clothing.
  • Ensuring your bedroom is cool at night.
  • Taking a cool shower or using a fan.
  • Trying to minimise your stress levels.

Your GP may also refer you to a menopause specialist if your symptoms do not improve after trying treatment or if you're unable to take HRT.

Reference:

  1. Coulam CB et al. Incidence of premature ovarian failure. Obstet Gynecol . 1986 Apr;67(4):604-6.
  2. NHS Early Menopause; https://www.nhs.uk/conditions/early-menopause. Date accessed: 7th June 2023.
  3. Davis SR, et al. Menopause. Nat Rev Dis Primers. 2015 Apr 23;1:15004. doi: 10.1038/nrdp.2015.4. PMID: 27188659.

 

June 2023/HRT-2c(1)