Menopause : The Facts
Something about the word menopause often makes women feel uncomfortable.
It’s as if it represents the end of being female, a marker of getting old.
While technically Menopause is a marker of the end of reproduction, the irony is that it hits many women when they are in their prime.
It is definitely not the end of being a woman.
The symptoms of menopause start well before periods stop.
These symptoms can occur from early 40s and sometimes earlier.*
This is termed The Perimenopause.
I have often had patients have their symptoms dismissed because they are still having periods.
You can actually have many other symptoms before your period finishes.
The good news is there is much that can be done to both manage and treat the symptoms of both Perimenopause and Menopause.
The other good news is that this time in a woman’s life is a great opportunity to reassess lifestyle choices. It is an opportunity to make changes that can improve ones health and wellbeing, and significantly improve the quality of one’s life.
The facts:
Menopause is defined by 12 consecutive months without a period.
It occurs because the ovaries are no longer releasing eggs.
Menopause generally occurs between the ages of 45 to 55,
51 is the average age
12% of women experience menopause before 45
Perimenopause is the fluctuation in hormone levels that occur in the lead up to menopause. It is when a number of symptoms can occur. These include irregular periods, flushes and night sweats and mood changes.It can often occur from early 40s.
Diagnosing menopause
Many women who have started having menopausal/perimenopausal symptoms want to get a test to see whether or not the symptoms are in fact due to menopause.
Unfortunately the hormone that confirms menopause FSH (follicular stimulating hormone) doesn’t usually show menopausal levels until periods have stopped for a year.**
The diagnosis of perimenopause/menopause is based on clinical diagnosis.
It is still important to see a doctor if you are getting persistent or troubling symptoms.
A number of useful tests can be performed to exclude other causes such as iron deficiency or thyroid disease.
The symptoms
Some women will experience minimal symptoms, while others will have debilitating symptoms.
On average symptoms can last 7 years.
20% of women will have no symptoms while 20% have severe symptoms.
The symptoms may fluctuate in when they occur, and how long they occur for.
A woman may have intense symptoms for a few months and then the symptoms may stop and only recur a few months later.
Common symptoms include:
Irregular periods
Cycles tend to vary. Some women have shorter cycles (less time in between periods) and lighter periods, while for other women, periods can become extremely heavy to the point of flooding. For some women cycles get longer.
Hot flushes/night sweats
Around 60-80% of women will experience hot flushes at some point during menopause
They can vary intensity and frequency
Sleep disturbance
Multiple factors can effect the quality and amount of sleep.These include changes in the hormone levels, and sleep disturbance from night sweats. Sleep can also be disturbed from increased anxiety and depression symptoms.
Mood symptoms/Brain fog
It is common to feel irritable, angry, anxious, sad and teary.
It is not unusual to feel these emotions in situations that would not previously have evoked them.
The hormonal changes can also cause an increase in tiredness.
Many women find it hard to concentrate and have memory issues, this is often termed “Brain Fog.”
Vaginal and Urinary issues
50% women experience some genital/urinary issues during menopause
Oestrogen has an important role in the genital and urinary system, ensuring vaginal lubrication and adequate bladder function. Lower levels of oestrogen can cause a number of symptoms.
These may include:
Vaginal dryness which may lead to painful sexual intercourse.This in turn can lead to loss of libido.
Vaginal burning ,itchiness and redness.
Urinary symptoms including frequent urination, painful urination, urinary incontinence and urinary tract infections.
Weight gain/change in weight distribution
Menopause itself does not result in weight gain.That said, as we age our metabolism slows down. From 40 our body tends to try and put on 1/2-1 kg per year.
What does change with menopause is the change in distribution of weight. Unfortunately with decreased levels of oestrogen more weight is distributed around the abdomen.
Other Symptoms
Other common symptoms include muscle aches and pain, joint pains, Itchiness or feelings of crawling under the skin
The following link has a useful symptom checker.
*Premature menopause is defined as menopause before the age of 40
** The exception to testing FSH is if a woman is going through premature menopause or menopause before 45, or if a woman has a contraception such as mirena where they are not getting periods. In these situations it may be worth checking the FSH