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The menopause is sometimes known as the "change of life", and is marked by the ending of menstruation (when a woman's periods stop). In the UK, the average age for a woman to reach the menopause is 52.
A woman is said to have reached the menopause once she has not had a period for one year. After this point, she can be described as post-menopausal. The time leading up to the menopause is known as the peri-menopause.
A woman is said to have reached the menopause once she has not had a period for one year. After this point, she can be described as post-menopausal. The time leading up to the menopause is known as the peri-menopause.
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It is estimated that eight out of ten women in the UK experience symptoms leading up to the menopause, and of these, 45% will find their symptoms difficult to deal with.
In most cases, the first symptom of the peri-menopause is a change in your usual menstrual pattern. You may find that your period starts to appear every two to three weeks, or you may not have one for months at a time. The amount of menstrual blood loss may also change, with most women finding that it increases slightly.
Other common symptoms of the peri-menopause, menopause and post-menopause are detailed below.
Hot flushes and night sweats
A hot flush is a sudden feeling of heat in your upper body, which can start in your face, neck or chest, before spreading upwards and downwards. You may find that the skin on your face, neck and chest becomes red and patchy, and you may start to sweat. You may also experience a change in your heart rate; it may become very rapid (known as tachycardia), or irregular and stronger than usual (known as palpitations).
Hot flushes that occur at night are called night sweats. Most hot flushes only last for a few minutes, and are most common in the first year after your final period.
Sleep disturbance
Many menopausal women have trouble sleeping due to night sweats, but sleep disturbance may also occur as a result of anxiety or insomnia. You may find that a lack of sleep makes you irritable, and that you have problems with your short-term memory and ability to concentrate.
Vaginal symptoms
During the peri-menopause, you may experience vaginal dryness, itching or discomfort. This can cause sex to become difficult or painful, which is known as dyspareunia. These symptoms combined are known as vaginal atrophy.
Approximately 30% of women experience the symptoms of vaginal atrophy during the early post-menopausal period, and up to 47% of women have them during the later post-menopausal period. However, in some cases it is possible to experience vaginal atrophy more than 10 years after your final period.
Urinary symptoms
During the menopause, you may find that you become prone to recurrent lower urinary tract infections, such as cystitis. You may also experience an urgent need to pass urine, and need to pass it more often than normal.
How long do menopausal symptoms last?
Without treatment, most menopausal symptoms are self-limiting, which means they gradually stop happening naturally. This usually happens two to five years after the symptoms start, but some women can experience symptoms for many more years.
If you experience vaginal symptoms, such as dryness, itching and discomfort, it is likely that they will persist or worsen over time unless they are treated.
Protecting your bones from osteoporosis
Loss of bone bulk and osteoporosis are natural features of ageing, but loss of oestrogen accelerates the process in post-menopausal women.
You can reduce your risk of osteoporosis by taking short, frequent sessions of weight-bearing exercise, eating plenty of calcium, giving up smoking and moderating alcohol consumption. If you cannot get enough calcium from your diet, it might be worth trying calcium supplements - but see your doctor before you start taking these.
The menopause involves the end of egg production (ovulation), which occurs as a result of falling levels of the female sex hormone oestrogen, which regulates menstruation.
Causes of premature menopause
In rare cases, a woman may begin to approach menopause before the age of 45 due to her ovaries failing earlier than they are supposed to. This is known as premature ovarian failure. Although it is rare, it is possible for premature ovarian failure to occur at any age, and in many cases no cause will be found.
However, not all women who go through premature ovarian failure find that their periods stop. Approximately 5-15% of these women still have intermittent ovarian function, which means that their ovaries still release eggs once in a while, and they may still be able to conceive.
The possible causes of premature ovarian failure are outlined below:
Medical conditions: enzyme deficiencies, Down's syndrome, Turner's syndrome, Addison's disease and hypothyroidism can all make premature ovarian failure more likely.
Medical treatments and procedures: bilateral oophorectomy surgery (removal of the ovaries), radiotherapy to your pelvic area, chemotherapy and hysterectomy surgery (removal of the womb) can all cause premature ovarian failure, although these cases are rare.
Infections: very rarely, certain infections such as tuberculosis or mumps may bring about premature ovarian failure. However, in the case of mumps, the damage to your ovaries is usually only temporary and normal function tends to return. Malaria, varicella (the infection that causes chickenpox and shingles) and shigella can also cause premature ovarian failure, although this is very rare.
Causes of premature menopause
In rare cases, a woman may begin to approach menopause before the age of 45 due to her ovaries failing earlier than they are supposed to. This is known as premature ovarian failure. Although it is rare, it is possible for premature ovarian failure to occur at any age, and in many cases no cause will be found.
However, not all women who go through premature ovarian failure find that their periods stop. Approximately 5-15% of these women still have intermittent ovarian function, which means that their ovaries still release eggs once in a while, and they may still be able to conceive.
The possible causes of premature ovarian failure are outlined below:
Medical conditions: enzyme deficiencies, Down's syndrome, Turner's syndrome, Addison's disease and hypothyroidism can all make premature ovarian failure more likely.
Medical treatments and procedures: bilateral oophorectomy surgery (removal of the ovaries), radiotherapy to your pelvic area, chemotherapy and hysterectomy surgery (removal of the womb) can all cause premature ovarian failure, although these cases are rare.
Infections: very rarely, certain infections such as tuberculosis or mumps may bring about premature ovarian failure. However, in the case of mumps, the damage to your ovaries is usually only temporary and normal function tends to return. Malaria, varicella (the infection that causes chickenpox and shingles) and shigella can also cause premature ovarian failure, although this is very rare.
If you think you are experiencing menopausal symptoms and you are finding them difficult to deal with, you should see your GP. They should be able to diagnose peri-menopause or menopause by considering your age, whether or not you are still having periods, and asking you about your symptoms.
There is no definitive test to diagnose peri-menopause or menopause, although measuring the level of follicle-stimulating hormone (FSH) in your blood can occasionally help to confirm a diagnosis. This is because FSH rises in women who are menopausal. A product to test your FSH levels is available from Treat Discreet, Suresign Menopause Test.
However, your FSH levels tend to fluctuate widely on an almost daily basis if you are peri-menopausal or menopausal. For this reason, FSH testing is rarely helpful, and a high level of FSH alone is not enough to make a diagnosis.
There is no definitive test to diagnose peri-menopause or menopause, although measuring the level of follicle-stimulating hormone (FSH) in your blood can occasionally help to confirm a diagnosis. This is because FSH rises in women who are menopausal. A product to test your FSH levels is available from Treat Discreet, Suresign Menopause Test.
However, your FSH levels tend to fluctuate widely on an almost daily basis if you are peri-menopausal or menopausal. For this reason, FSH testing is rarely helpful, and a high level of FSH alone is not enough to make a diagnosis.
Only one in 10 women seek medical advice when they go through the menopause, and many do not need any treatment at all. However, if you are having menopausal symptoms and they are severe enough to interfere with your daily life, there are treatments available that can help.
Medical treatment for menopause can be either with or without hormone replacement therapy (HRT). The kind of treatment you can take depends on your symptoms, medical history and your own preferences.
Two of the most common treatments are:
Hormone replacement therapy (HRT)
Hormone replacement therapy (HRT) is effective in treating several of the most common menopausal symptoms, including hot flushes and night sweats, vaginal symptoms such as dryness and itching, and urinary symptoms such as recurrent lower urinary tract infections.
Tibolone
Tibolone is a synthetic steroid that acts in the same way as HRT. It may be used as an alternative to traditional combined HRT for post-menopausal women who want to end their periods. Like HRT, tibolone is effective in treating menopausal symptoms.
