The menopause
The menopause is the stage in a woman’s life when menstruation stops permanently due to loss of ovarian reproductive function. It is defined as when a woman has had no periods for one year or more. This usually occurs between the ages of 45-55years.
The perimenopause is the period before the menopause when hormonal and clinical features of the approaching menopause start. It is characterised by irregular menstruation and the onset of menopausal symptoms.
Why does menopause occur?
Women have a finite number of eggs at birth: this number declines with each menstrual cycle. The menopause is characterised by the eventual depletion of the egg store.
What do women experience when they go through the menopause?
80-90% of women will experience menopausal symptoms:
The most common symptoms are hot flushes and night sweats (70-80% of women will experience these)
Disturbed sleep and insomnia
Low energy levels
Low mood
Anxiety
Low libido and sex drive
Impaired memory
Joint aches
Headaches
Palpitations
Vaginal dryness
Urinary symptoms
How is the menopause diagnosed?
For women beyond the age of 45years, diagnosis is made by assessing the clinical picture based on menopausal symptoms and a change in menstrual cycle pattern.
Hormonal testing is not always helpful in diagnosing the menopause, as the levels can fluctuate from month to month, and may not give an accurate assessment. However, they may be used in specific cases to aid a diagnosis.
What interventions are available to women going through the menopause?
Hormone replacement therapy (HRT): the main component for symptom control is oestrogen. However, progestogen must also be taken by women who still have a womb (uterus), in order to protect the lining of the womb from the effect of unopposed oestrogen. Testosterone replacement may be effective in low libido and low sex drive.
Oestrogen: can be given in the form of oral tablets, or delivered through the skin in the form of a patch, gel or spray.
Progestogen: can be taken in the form of natural micronized progesterone tablets or in the form of synthetic progestogen which are available as oral tablets, patches or in the form of the Mirena coil.
Testosterone: gel preparations.
For information on the benefits and risk of HRT visit: https://www.womens-health-concern.org/help-and-advice/factsheets/
Healthy Lifestyle changes:
Regular exercise: helps to relieve stress and lower the risk of heart disease.
Diet modifications: low saturated fat and salt to reduce blood pressure, and a diet rich in calcium and vitamin D to strengthen bones.
Stopping smoking: reduces the risk of early menopause.
Drinking in moderation: can reduce hot flushes.
Relaxation techniques: meditation and yoga may help reduce stress and feelings of anxiety.
Complementary and alternative therapies:
Acupuncture
Aromatherapy
Herbal treatments
Homeopathy
Yoga
Reflexology
Cognitive behaviour therapy: can be effective in improving hot flushes, night sweats and other menopausal symptoms.
For more information on all things menopause, you can check out the following websites:
