Menopause

older woman riding bicycle

The menopause is when a woman stops having her period and her ovaries lose their reproductive function.

Call it what you will - ‘the change', ’that time in her life' - it is something that all women go through. Menopause usually occurs between the ages of 45-55, in the UK the average age is 51. In a small number of cases, some women become menopausal in their early 40s or even younger.

See early-menopause.

You may wish to print this fact sheet to help with your discussion with your healthcare professional.

What causes the menopause?

The menopause is influenced by a change in hormone levels. When a woman is fertile, her ovaries produce hormones called oestrogen and progesterone in response to other hormones (follicle stimulating hormone (FSH), and luteinising hormone (LH)).

All these hormones interact as part of the monthly menstrual cycle, which results in the development of an egg in one of the ovaries. In premature menopause, the ovaries stop producing normal levels of oestrogen and eggs may not develop.

As a woman gets older, her store of eggs in her ovaries decreases, as does her ability to conceive. Less and less oestrogen is produced, causing the body to behave differently. The body does not stop producing oestrogen overnight, and the process can take several years. This change is called the peri-menopause.

What are the signs and symptoms of the menopause?

For all women the menopause is an individual experience. For some women, the loss of reproductive ability may be deeply upsetting.

The decrease of oestrogen is often the cause of a variety of symptoms, which may be distressing and may require medical attention. Oestrogen deficiency can affect many parts of the body (causing physical changes) and the brain (causing changes in emotional well-being), and the skin (causing changes in its elasticity and thickness).

8 out of 10 women experience some menopausal symptoms. For about half of women, menopause symptoms will typically last for about seven years after their last period.

For 10% of women, symptoms can continue for up to 12 years.

Symptoms may include:
  •    Hot flushes (also known as hot flashes) and night sweats are the most common symptoms of the menopause 
  • Sleeplessness or insomnia
  • Vaginal dryness
  • Irritated skin
  • More frequent urinary incontinence
  • Urinary tract infections
  • Low mood
  • Reduced interest in sex
  • Problems with memory and concentration
  • Mood changes
  • Palpitations
  • Joint stiffness, aches and pains
  • Reduced muscle mass
  • Low energy levels

Every woman is an individual and symptoms can vary hugely in duration and severity.

Once the ovaries have ceased their production of oestrogen, other changes may take place, which can have an effect on long-term health. This includes changes that affect the strength and density of bones increasing the risk of osteoporosis (bone-thinning disease).

Have I definitely gone through the menopause?

Most healthcare professionals will evaluate a woman's menopausal status according to her symptoms, pattern of periods and medical records.

Some women may have had a hysterectomy, and at the same time surgical removal of the ovaries for various medical reasons. Removal of the ovaries (oophorectomy) creates an immediate menopause. A woman who has either has a hysterectomy or both ovaries removed often faces more intense menopausal symptoms than a woman who reaches the menopause naturally, as this abruptly cuts off hormone production. Discuss how to manage your symptoms with your healthcare professional before your operation.

What treatments are recommended?

Hormone replacement therapy (HRT) is the most effective and widely used treatment for menopausal symptoms. As the name suggests, it's simply a way of replacing the hormone oestrogen that is lost during the menopause.

HRT aims to relieve the symptoms caused by oestrogen deficiency. Ask your healthcare professional about the benefits and risks of HRT.

CBT (cognitive behavioral therapy) may also be considered to alleviate low mood or anxiety that arise as a result of the menopause.

For those wishing to try complementary therapies, the quality, purity and constituents of these products is still unknown and should be discussed with a health care professional.

You should also establish a healthy lifestyle, which includes activities such as regular weight-bearing exercise, a healthy diet, and stopping smoking.

Attend your regular mammography and blood tests, which will screen for diabetes and high cholesterol. You may also want to consider a bone density test, which is recommended for women under 65 who have one or more risk factors for osteoporosis. Risk factors include a close relative with osteoporosis, smoking and a slender build.

Your health is your responsibility and you are in charge of your own well-being!

If you feel you are struggling with any aspect of your menopause journey, ask your GP for advice and help. You are not alone. Whatever the symptoms, help is available for you.

If you are concerned, try talking to your partner or family and friends about what you are going through and explain that this is a natural transition for every woman.