Menopause is the time in a woman’s life when her periods stop. It is inevitable and natural. The ovaries no longer produce eggs, as a result decreasing hormone levels occur. The hormones oestrogen, progesterone and testosterone are the hormones that influence how we feel and contribute to the symptoms that we experience in menopause as they decrease gradually over several years.
The menopause usually occurs between 45 and 55 years of age. The average age in the UK is 51 years. The definition of menopause is when a woman has not experienced a period for 12 months.
Perimenopause
Leading up to menopause is the perimenopause when we may see start to see changes in the menstrual cycle. Bleeding patterns change and periods start to become irregular or less frequent.
The hormones oestrogen and progesterone work together to regulate your menstrual cycle and the production of eggs. During the perimenopause the levels of these hormones fluctuate greatly, and it is often the imbalance of these hormones which leads to symptoms of the menopause occurring.
The average age for onset of perimenopause is 47 although symptoms may begin well before this age. Menopause before the age of 45 is called early menopause and may run in the family. All women will experience menopause, up to 80—90 % will experience symptoms, the symptoms can vary in severity, at times being completely debilitating. Menopause symptoms may last for many years. Our life expectancy has now increased and working age is extended, this can have a significant impact on the quality of life in our later years.
Menopausal Symptoms
30 years is a long time to be suffering from symptoms that may be eased by hormone supplementation and other therapies.
The symptoms of menopause are most notably: - hot flushes and night sweats which we refer to as vasomotor symptoms. Other symptoms can include insomnia, headaches, brain fog, sleep disturbance, fatigue, low mood and low energy, lack of motivation, lack of concentration, low libido, urinary symptoms, vaginal dryness, joint pain, muscle aches, hair loss and thinning, skin changes, weight change or change in fat distribution. There may be other causes of these symptoms, but most menopausal women can relate to many of the symptoms listed here.
Most of these symptoms are also due to decreasing amounts of oestrogen. Less obvious but more concerning are changes that we don’t see such as osteoporosis (loss of bone density) which long term can lead to fractures. Cardiovascular health may suffer as oestrogen levels diminish
Surgical Menopause
If you have had your womb removed by an operation called a hysterectomy before your menopause would have happened you could experience an early menopause even if your ovaries are not removed. The ovaries will still make some oestrogen after the hysterectomy, but it is common that the levels of oestrogen will fall at an earlier age than average. Women do not have periods after a hysterectomy,
How Do You Diagnose the Menopause?
The diagnosis of the menopause is a clinical diagnosis based on a combination of menopausal symptoms and change in menstrual cycle and pattern in women of 45 and over. Hormonal testing is not necessary for a diagnosis in women over 45. In perimenopausal women aged 40 to 45, hormone testing may be helpful in some cases as a tool to aid diagnosis but again not always necessary.
Perimenopausal women can take HRT and current evidence is supportive in beginning HRT during the perimenopause to minimise symptoms such as hot flushes. There are women younger than 40 who can experience early menopause due to premature ovarian insufficiency (POI).
A thorough medical history is needed to determine the best treatment plan tailored to suit the individual. An adaptive approach as the menopause progresses is a good idea so reviews of treatment are important
Blood Tests
The most common test is a blood test measuring a level of a hormone called follicle stimulating hormone (FSH). If this is raised, then it is very likely that you are menopausal. This blood test is often repeated 4 to 6 weeks later as it does fluctuate depending on your cycle. If you are under 40 then you may be advised to have further investigations to rule out other conditions that can stop periods or affect your hormones.
Arrange Your Menopause Consultation
If you are seeking advice or help on anything to do with the menopause, its stages, diagnosis and treatments, please do get in touch. I provide face-to-face consultations for women living in the Wirral, Liverpool and Chester areas, and can provide telephone or video-call consultations to those further afield.
Please email me amanda@amandaprince.com to arrange your menopause consultation.
I look forward to hearing from you.
Amanda
