What is Menopause?
Menopause is when your periods stop due to lower hormone levels. It usually affects women between the ages of 45 and 55, but it can happen earlier. It affects anyone who has periods.
Menopause can happen naturally, or for reasons such as surgery to remove the ovaries (oophorectomy) or the uterus (hysterectomy), cancer treatments like chemotherapy, or a genetic reason. Sometimes the reason is unknown.
Perimenopause is when you have symptoms of menopause, but your periods have not stopped. Perimenopause ends and you reach menopause when you have not had a period for 12 months.
Symptoms
It can feel different for everyone. You may have a number of symptoms or none. Symptoms usually start months or years before your periods stop. This is called the perimenopause. Symptoms related to menopause can last for between two and eight years, though the timing and symptoms are highly variable among women.
Changes to your periods
The first sign of the perimenopause is usually, but not always, a change in the normal pattern of your periods, for example, they become irregular. Eventually, you’ll stop having periods altogether.
Mental health symptoms
Common mental health symptoms of menopause and perimenopause include:
- changes to your mood, like low mood, anxiety, mood swings and low self-esteem
- problems with memory or concentration (brain fog)
Physical symptoms
Common physical symptoms of menopause and perimenopause include:
- hot flushes, when you have sudden feelings of hot or cold in your face, neck and chest which can make you dizzy
- difficulty sleeping, which may be a result of night sweats and make you feel tired and irritable during the day
- palpitations, when your heartbeats suddenly become more noticeable
- headaches and migraines that are worse than usual
- muscle aches and joint pains
- changed body shape and weight gain
- skin changes including dry and itchy skin
- reduced sex drive
- vaginal dryness and pain, itching or discomfort during sex
- recurrent urinary tract infections (UTIs)
- sensitive teeth, painful gums or other mouth problems
Age
Women reach menopause at different ages, and the average age of menopause is 52 in the United States. You will only know that you’ve reached menopause when you have not had a period or spotting for a full year.
Managing Menopause Symptoms
Lifestyle Changes to help menopause and perimenopause
Eating well, exercising and looking after your mental wellbeing can help with symptoms during perimenopause and menopause.
It can also help you keep as well as possible in the future.
Do
- get plenty of rest, including keeping to regular sleep routines
- eat a healthy diet
- have calcium-rich food like milk, yoghurt and kale to keep bones healthy
- exercise regularly, try including weight-bearing activities where your feet and legs support your weight like walking, running or dancing
- do relaxing things like yoga, tai chi or meditation
- talk to other people going through the same thing, like family, friends or colleagues
- talk to a doctor before taking herbal supplements or complementary medicines
Don’t
- do not smoke
- do not drink more than the recommended alcohol limit
How to ease mood changes
It’s common to have mood swings, low mood and anxiety around the time of the menopause and perimenopause.
You can try to:
- get plenty of rest
- exercise regularly
- do relaxing activities
Cognitive behavioural therapy (CBT) is a type of talking therapy that can help with a low mood and feelings of anxiety. It can also help with sleep problems.
How to ease hot flushes and night sweats
You can:
- wear light clothing
- keep your bedroom cool at night
- take a cool shower, use a fan or have a cold drink
- try to reduce your stress level
- avoid or reduce potential triggers, such as spicy food, caffeine, hot drinks, smoking and alcohol
- exercise regularly
- lose weight if you’re overweight
CBT can also help manage hot flushes.
How to ease vaginal dryness
There are vaginal moisturizers or lubricants you can get without a prescription at a pharmacy.
If you’re having sex and using condoms, do not use oil-based lubricant as this can damage condoms. You can use a water-based lubricant.
There are other treatments for vaginal dryness that a doctor can prescribe, such as HRT (hormone replacement therapy) or hormonal treatment (creams, pessaries, gel or vaginal rings).
Protecting against weak bones
You can try to:
- exercise regularly, including weight-bearing exercises, where your feet and legs support your weight (like walking, running, or dancing) and resistance exercises (for example, using weights)
- eat a healthy diet that includes plenty of fruit, vegetables, and sources of calcium, such as milk, yoghurt, and kale
- get some sunlight on your skin as this triggers the production of vitamin D, which can help keep your bones healthy
- take vitamin D supplements
- stop smoking and cut down on alcohol
Treatment for menopause and perimenopause
The main medical treatment for menopause and perimenopause symptoms is hormone replacement therapy (HRT), which replaces hormones that are at low levels.
Carry home message
Discuss your symptoms, family and medical history, and preferences with your doctor to determine your best approach. No matter what you decide, see your doctor every year to talk about your treatment plan, bring up any concerns, and discuss any changes you want to make.
