The menopause occurs when a woman stops having periods; a diagnosis of which can confidently be made when there has been no period for more than 12 months. In the time leading up to full menopause, a woman’s periods will typically start to become less frequent, before stopping altogether. This can happen suddenly or over some years.
The menopause is caused by changes in the balance of sex hormones in the body, which occurs as a woman ages. As women get older, their ovaries will produce less oestrogen and no longer release an egg each month. Menopause will usually occur between the ages of 45-55, with the UK average being 51, though around 1 in 100 women will experience premature menopause, thus facing symptoms before they reach the age of 40.
Early menopause can occur for several reasons, including surgery to remove ovaries, certain breast cancer treatments, chemotherapy, radiotherapy, or by an underlying medical condition, such as Addison’s disease or Down’s Syndrome.
Where menopausal symptoms are particularly bothersome and are affecting your daily life, it is a good idea to seek medical advice to discuss the types of treatment options available.
During the menopause, a woman’s hormone levels drop significantly, often causing several uncomfortable symptoms, the severity of which will vary from woman to woman. Menopausal symptoms usually first occur during the perimenopause stage – the months or years leading up to the end of the periods. The first sign of menopause is a noticeable change to the normal pattern of your periods, such as becoming unusually light or heavy, or different in frequency. Eventually, they will stop completely.
Common symptoms include:
- Hot flushes
- Night sweats
- Vaginal dryness (also known as vaginal atrophy)
- Reduced libido
- Sleep disturbance
- Mood swings, anxiety and in some cases, depression
- Difficulty remembering things
- Difficulty concentrating
- Frequent urinary tract infections (UTIs)
- Bladder incontinence
- Aching limbs or stiffness
- Dry skin
Over time, menopause can also cause other health problems, such as osteoporosis, which is the weakening of the bones.
Many women are able to manage their symptoms themselves, while others will find them exceptionally troublesome. Luckily, there are several different treatment options available to help you manage menopause symptoms and live a happy life during these years. A detailed assessment of the symptoms and the woman’s medical history will lead to the appropriate individualised treatment.
Hormone Replacement Therapy (HRT)
HRT is a highly effective treatment option, which involves replacing the oestrogen and progesterone hormones, which are significantly reduced during the menopause. HRT is particularly useful in alleviating several symptoms of menopause, including hot flashes, vaginal dryness, UTIs and incontinence. It can also help in preventing osteoporosis since oestrogen plays an important role in promoting healthy bone growth.
Though HRT has received some bad press over the years due to misinformation and conflicting advice, the majority of women who undergo HRT will find that it dramatically helps alleviate their menopause symptoms. At The London Women’s Centre, we provide evidence-based advice regarding the risks and benefits of different types of HRT preparations (tablets, skin patches, gels, implants).
There are two main types of HRT available:
- Combined HRT (Oestrogen and progesterone) – for those who still have a womb
- Oestrogen-only HRT – for those who have had the womb removed through hysterectomy
When deciding whether HRT is the right treatment option for you, your GP will assess the severity of your symptoms, your age, lifestyle and personal and family medical history.
There are a number of lifestyle changes you can make to help lessen your symptoms. Ensuring you exercise regularly, eat a well-balanced diet and get enough sleep is highly recommended and often helps improve symptoms. Furthermore, practising relaxation methods such as breathing techniques, yoga or tai chi can help relieve menopausal symptoms related to moods, anxiety and stress. If you smoke or drink excessively, it is a good idea to stop, as this can increase the risk of heart disease, stroke, osteoporosis and cancer, whilst also increasing hot flashes.
Cognitive Behavioural Therapy (CBT)
CBT is a type of ‘talking therapy’ which helps alter the way people think, by attempting to change behaviours and recognise distorted ways of thinking. CBT is particularly useful as a treatment option for women who are experiencing mood swings, anxiety or depression as a result of the menopause.
Some women prefer to seek relief through alternative methods such as acupuncture, rather than undergo HRT. Sceptics have argued that this only causes a placebo effect, but many doctors have confirmed that acupuncture can be a reasonable alternative where menopause symptoms are less severe and do not require medicinal treatment. Additionally, hypnotherapy as a treatment option has increased in popularity over the past few years.