Menopause
Menopause, also known as ‘the change of life’ marks the end of a woman’s reproductive cycle when she is no longer able to fall pregnant naturally. In Latin, the word ‘menopause’ translates to ‘cease month’.
Menopause occurs 12 months after a woman’s last menstrual cycle (or period) and affects most women in their 40s and 50s*.
Common symptoms such as hot flushes and weight gain can be uncomfortable, however menopause is a completely normal stage of womanhood and understanding what to expect during the transition can help greatly in managing symptoms.
When does menopause begin?
During a woman’s life, her peak reproductive years are usually her 20s and early 30s, and egg (or ovulation) quality and quantity will decline with age. Eventually, the body stops producing oestrogen and progesterone, which means ovulation (and your period) stops. Menopause means the end of ovulation, and is measured by the 12 months following the final period^.
As periods can be infrequent and irregular in the leadup to menopause (sometimes months apart), it can be confirmed it was the last menstrual period if there are no further periods in the 12 months following it. Once a woman has had no period for 12 months, she is considered post-menopausal.
Menopause occurs for most women between the ages of 45-50, but some develop it earlier or later. Most women will start experiencing menopause symptoms around 4 years before their period ends, and symptoms may continue for several years after it ends*.
Factors including genetics, ovary health and a history of smoking are thought to play a part in when menopause symptoms begin%. There are several different stages within the menopause journey, and one of these happens well before it; perimenopause.
Perimenopause
The period in the lead up to menopause is called ‘perimenopause’ when your hormones start changing in preparation for menopause, marked by a drop in oestrogen. As women age, less and less estrogen is produced until the point where the ovaries no longer release eggs, and periods stop. Perimenopause usually affects women in their 40s and lasts for 4-6 years>. Often the first sign is changes to your period. Perimenopause can cause symptoms similar to menopause, including%>:
Hot flushes (also known as hot flashes)
Irregular periods - less frequent periods, lighter/heavier or shorter/longer than normal
Tender breasts
Mood swings - feeling teary or irritable
Hair changes
Weight gain
Decreased sex drive
UTIs (urinary tract infections)
Fertility issues
Symptoms of menopause
Just as each of us are different, menopause is a unique experience for each woman. There are many physical and emotional symptoms that are common for most in this life transition, however symptoms vary from person to person, and no two women will experience menopause in the same way. In fact, around 20% of women experience no menopausal symptoms at all. An average of 60% of women experience mild-moderate symptoms, and around 20% experience severe symptoms>. As hormones change approaching menopause, common physical and emotional symptoms include>:
Physical symptoms
Hot flushes
Bloating
Aches and pains
Headaches
Exhaustion
Disturbed sleep, including night sweats and insomnia
Sore breasts
Urinary problems (UTIs, overactive bladder, discomfort)
Vaginal dryness
Weight gain
Emotional symptoms
Difficulty concentrating
Sleep difficulties
Mood swings – anxiety, irritability or lowered mood
Inability to cope as well as previously
Forgetfulness
Increased PMS (premenstrual syndrome)
Decreased sex drive
Decreased collagen and water content
Decreased sebum levels
Menopause can also result from surgery or chemotherapy treatment, and when this occurs it can result in more severe symptoms. It’s important to see your GP if you are concerned about any symptoms or unusual changes you have noticed.
Menopause and weight
Why is menopause linked to gain?
Menopause shouldn't get the blame. Midlife weight gain is mainly caused by aging and lifestyle considerations,3,4such as a sedentary lifestyle coupled with an increased fat to muscle ratio, which slows our metabolism.
What can I do about weight gain?
Because the effects of lifestyle and aging contribute to weight gain during menopause, the healthy lifestyle advice we know and love is more important than ever: eat a varied diet (rich in wholegrains, calcium, proteins and healthy fats) and regularly do cardio and strength training.
Menopause and weight
Why is menopause linked to gain?
Menopause shouldn't get the blame. Midlife weight gain is mainly caused by aging and lifestyle considerations,3,4such as a sedentary lifestyle coupled with an increased fat to muscle ratio, which slows our metabolism.
What can I do about weight gain?
Because the effects of lifestyle and aging contribute to weight gain during menopause, the healthy lifestyle advice we know and love is more important than ever: eat a varied diet (rich in wholegrains, calcium, proteins and healthy fats) and regularly do cardio and strength training.
Menopause and skin
Some of the skin changes seen in women during menopause include natural ageing (due to the passage of time), photoageing (due to repeated exposure to sunlight) and environmental factors such as pollution, all of which are not unique to menopause exclusively.
What does tend to be unique to menopause is skin changes brought about by hormonal deficiency, for example lower levels of estrogen. Hormonal ageing is thought to bring about several structural changes in the skin, such as decreased water and collagen content, loss of elasticity, decreased sebum (oil) production and visible changes such as wrinkling.
What is a hot flush?
One of the best known (but not best loved) symptoms of menopause is a ‘hot flush’ or hot flash - the terms are often used interchangeably. This is a feeling of intense heat and sweating that isn’t caused by an external source, and often appears suddenly. In other words, you may feel hot and sweaty for no reason, and without warning. Duration and frequency of hot flushes vary for each woman. Most hot flushes last around 4 minutes, but some can go longer. And some women will experience a few hot flushes in a week, whereas others experience multiple hot flushes a day.
Someone experiencing a hot flush often feels:
Skin suddenly feeling warm or unbearably hot
Sweating or perspiration, especially in the upper body (arms, face, neck)
Tingling fingers
Quickened heartbeat
A flushed or red face
It’s not clear what causes hot flushes, however avoiding common triggers may help2:
Alcohol
Caffeine
Spicy food
Heated rooms
Smoking
Bending over
Stress and anxiety
What is a hot flush?
One of the best known (but not best loved) symptoms of menopause is a ‘hot flush’ or hot flash - the terms are often used interchangeably. This is a feeling of intense heat and sweating that isn’t caused by an external source, and often appears suddenly. In other words, you may feel hot and sweaty for no reason, and without warning. Duration and frequency of hot flushes vary for each woman. Most hot flushes last around 4 minutes, but some can go longer. And some women will experience a few hot flushes in a week, whereas others experience multiple hot flushes a day.
Someone experiencing a hot flush often feels:
Skin suddenly feeling warm or unbearably hot
Sweating or perspiration, especially in the upper body (arms, face, neck)
Tingling fingers
Quickened heartbeat
A flushed or red face
It’s not clear what causes hot flushes, however avoiding common triggers may help2:
Alcohol
Caffeine
Spicy food
Heated rooms
Smoking
Bending over
Stress and anxiety
How to treat menopause
Menopause is a natural part of life for women, so there is no ‘cure’ as such, or treatments that can reverse or help prevent it. However, there are a number of options and simple lifestyle changes that may help manage mild symptoms better, and provide some relief:
Healthy lifestyle – find time for exercise and eat healthy, nourishing meals
Try to avoid common triggers that flare up hot flushes
Dress in layers, so you can adjust your clothing to how you’re feeling
Sip a cool drink or ice water at the start of a hot flush
Wear cotton night clothes and use cotton bed linen
Keep a cold pack close by
Keep a small retractable fan in your handbag
Menopausal Hormone Therapy (MHT or HRT)
MHT is the most effective option to control symptoms
It’s delivered via tablet, skin patch, gels or vaginally
MHT is associated with a lowered risk of diabetes, osteoporosis and bowel cancer
While it may slightly increase the risk of other conditions, this is usually far outweighed by the benefits
The recommended type of MHT, as well as your own risk, depends on your age, health and whether you have had a hysterectomy
As there are some slight risks associated with MHT, doctor guidance, coupled with your personal preferences, are essential
Sources:
Non-hormonal therapies
These options are available when MHT is not desired or recommended, or when lifestyle changes are not sufficient to manage symptoms
Some prescription medications traditionally used for other conditions can be used to treat the symptoms of menopause
These include specific low dose antidepressants and some types of epilepsy and high blood pressure medications
Complementary medicines such as black cohosh may help
Speak to your Pharmacist to discuss your options
Source:
Non-medical treatments
Cognitive behavioural therapy (CBT), cooling bracelets and neck pillows can provide relief from symptoms
Yoga, exercising, relaxation, mindfulness and stress reduction can increase wellbeing, resilience and coping strategies
Source:
What else can I do?
Keep moving
This will help build lean muscle and maintain your core and balance
This helps prevent falls, and in turn, lowers the risk of fractures
Exercise naturally lifts our mood (it creates a natural dopamine hit that makes you feel more positive)
Try exercising with friends, such as catching up over a walk or going to a regular class together
Protect your bones
Build strong bones with weight-bearing and resistance-training exercise
Make sure you are eating enough calcium
Calcium is best obtained through your diet, ask your doctor if your diet is not sufficient
Vitamin D is also essential for healthy bones
The best way to get Vitamin D is through careful, incidental sun exposure (such as hanging the washing or walking from the car to the shops)
Consider having a bone density assessment, to prepare to guard against fractures in coming years
Have a big-picture focus
When menopause feels overwhelming, name your emotions, and focus on what needs are not being met (e.g., “I am feeling overwhelmed right now and I need some space to think” not “I am such a mess,”)
Help yourself by understanding that any big change creates some emotional upheaval
Be honest with others about your experience and lean on your circle for support
Remember: this is a phase, it’s natural, and it will pass
What about early menopause?
Chemotherapy, the removal of the ovaries and other reasons can cause early menopause. No longer ovulating can be very difficult, especially for young people and even more so when they have not decided whether they would like to have children. Informed consent is important: Ask your healthcare team about fertility treatments before cancer treatment begins.
If you are experiencing early menopause for any reason, seek support from your healthcare provider for advice on treatments and counseling, as necessary.
Get support
Menopause comes at a time when other life changes are happening; including children leaving home, other health issues, career changes, divorce, ageing parents and financial concerns.
Let's get by together:
Never underestimate the value of friendships
Let family members and your partner know what you are going through and what you need
Increasingly, employers are expected to understand the effects of menopause on their team and react accordingly
If menopause is disrupting your life or you are concerned about your symptoms, it’s important to speak with your GP or pharmacist about what options may suit you specifically, and rule out any other potential underlying health issues.
Each woman’s experience of menopause is completely different, and knowing how to manage this important life change with the right support is important.
At MediADVICE, our expert pharmacists are on hand to support you at all stages of your life and suggest a range of products that may help better manage symptoms - Speak to your local MediADVICE pharmacist today for more information.
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