Most women will experience the menopause at some point. But despite the fact it affects around half of the global population, menopause is still a subject that doesn’t always get a huge amount of attention, both in terms of how we talk about it and in how it’s dealt with and treated.
This article aims to help women better understand the menopause, provide support on how to handle it and enable women to understand and seek out the appropriate treatment where necessary.
Menopause is when you stop having periods, which usually happens between the ages of 45 and 55. For a small number of women, menopause occurs earlier. If it happens before you are 40 it’s called premature menopause (or premature ovarian insufficiency). If you are between the ages of 40-45 it is called early menopause.
Menopause happens when your ovaries stop producing a hormone called oestrogen and no longer release eggs. The medical definition of being menopausal is when you have not had a period for 12 months. The average age for this is 51 in the UK, but it varies a lot. For some time before this – it could be for a few months or for several years – your periods may become less regular as your oestrogen levels fall. This is called perimenopause – which means “around” menopause and is when you experience menopausal symptoms but are still having periods.
During perimenopause (before your periods stop), you might have a variety of symptoms which can also continue once your periods finish. These can include:
The feelings you have during the menopause are similar to emotional problems such as depression or anxiety and some other physical problems. So, keep an open mind about whether these symptoms are caused by the menopause or caused by other issues. If in doubt, please talk to your GP.
Irregular bleeding which is common in menopause can be a sign of other problems, so it’s best to contact your GP about those. Bleeding after sex and vaginal discharge also require advice. It is most important to contact your GP if you bleed a year after your periods have stopped.
Menopause affects every woman differently. You may have no symptoms at all, or they might be brief and short‑lived. For some women they are severe and distressing.
Symptoms associated with the perimenopause, the transition into menopause, can start a few months or years before your periods stop. According to the NHS, <https://www.nhs.uk/conditions/menopause/symptoms/> on average, most symptoms last around 4 years from your last period. However, around 1 in every 10 women experience them for up to 12 years.
You can still get menopause symptoms if you have had a hysterectomy (an operation to remove your womb). In fact, sometimes, a hysterectomy can start your menopause.
Other natural changes as you age can be intensified by menopause. For example, you may lose some muscle strength and have a higher risk of conditions such as osteoporosis and heart disease.
The menopause is often talked about with dread, but it’s worth thinking about some of the positives it brings! You won’t have to have a period every month. For some women that might mean less disruption, pain, or premenstrual syndrome. You can also have sex without worrying about pregnancy.
Many women (as many as 70-80%) suffer from uterine fibroids at some point. These are small benign growths that can develop in the wall of your womb and cause some women to have heavy periods or experience pain. The hormone changes in menopause stop these tumours growing <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6994343/> and of course the heavy bleeding linked with fibroids also stops.
It’s easy to get bogged down in the physical symptoms, bad and good of the menopause. But it’s important to step back and look at the overall impact of this time in life. Depression and anxiety are common around the time of the menopause, particularly in women who previously suffered from post-natal depression or premenstrual syndrome.
Whether the menopause arrives suddenly, prematurely or over a period of months or years, it is not surprising that alongside the hormonal and consequent physical changes, there will be conflicted feelings, confusion, anxiety and (unnecessary) shame. There are physical and psychological losses to be faced and perhaps an acceptance that some hopes and aspirations will not be fulfilled.
But, for some, the menopause also creates opportunities for change. Space to make lifestyle changes, deepen relationships and develop a new understanding of a new developing identity.
Everyone will have a different and very personal experience of menopause, so it’s important women are supported to understand and makes choices that work for them.
There are many things you can do yourself to control symptoms or protect against the effects of reducing oestrogen. And there are medications such as HRT that your GP can prescribe.
However you experience the menopause, your GP should support you during this time. Our other articles linked below are all intended to give you evidence-based information for you to choose the approach you want to take. Don’t be afraid to ask for help and make your own choices.
Menopause: Treatment and Support <https://www.evergreen-life.co.uk/health-and-wellbeing/menopause-treatment-and-support>
Life after Menopause <https://www.evergreen-life.co.uk/health-and-wellbeing/life-after-menopause>