An overview of Menopause

What is menopause?

Menopause occurs when a woman has not had her period for 12 consecutive months and her ovaries lose their reproductive function. Periods usually become less frequent over a few months or years before it stops altogether. Menopause is a normal part of aging, it usually occurs between the ages of 45 and 55, but it can develop before or after this age range. In the UK, the average age is 51.

Why does menopause occur?

In most cases, menopause is caused by a natural aging process, but menopause has other causes. As you reach your late 30s, your ovaries release less oestrogen and progesterone and your chance of getting pregnant decreases because the ovaries produce fewer viable eggs. Your ovaries will eventually stop producing eggs and oestrogen levels will decrease significantly.

Menopause can also occur after surgical removal of a woman’s ovaries or following hormone therapy or chemotherapy for the treatment of breast cancer.

A small number of women (1%) reach menopause before age 40. This is known as premature menopause. This can occur from primary ovarian insufficiency (POI), which occurs when your ovaries are unable to produce sufficient amounts of hormones, or it can occur due to an autoimmune disease, infection or may have a genetic cause. But often, no cause can be found. For these women, hormone therapy is typically recommended at least until the natural age of menopause to protect the brain, heart and bone.

The process of natural menopause

Natural menopause is gradual and has 3 stages:

Perimenopause: this begins years before menopause, when the ovaries gradually makes less oestrogen. During the last 1 to 2 years of perimenopause, the drop-in oestrogen production quickens. Perimenopause lasts until menopause occurs, causing the ovaries to stop releasing eggs.

Menopause: at this stage, the ovaries have stopped releasing eggs and making most of their oestrogen.

Post-menopause: the years after menopause. During this stage, menopausal symptoms ease for most woman, however, health risks due to the loss of oestrogen rises.

Symptoms

Hormonal changes associated with menopause causes different symptoms.

The duration and severity of these symptoms will vary from woman to woman. Most women experience vasomotor symptoms as they go through menopause.

Common vasomotor symptoms include:

• Hot flashes: short and sudden sensation of heat that affects the chest, neck and face
• Night sweats: hot flushes that occur at night

Other menopause symptoms can affect a woman’s quality of life and impact day-to-day activities, such as:

• Mood changes: low mood or anxiety
• Insomnia
• Headaches
• Vaginal dryness and discomfort during sex
• Reduced sex drive (libido)
• Joint and muscles aches and pains
• Problems with memory and concentration

However, not all women experience all of these symptoms.

Symptom treatment

Menopause does not require medical treatment, instead, treatment focuses on relieving symptoms and preventing or managing chronic conditions that may occur with aging.

Hormone replacement therapy (HRT)

Hormone replacement therapy involves taking oestrogen to replenish the decline in your body around the time of menopause. HRT can relieve menopausal symptoms, especially hot flushes and night sweat, but there are many side effects such as, breast tenderness, headaches and an increased risk of blood clots and breast cancer in some women.

Help with low mood

Some women experience low mood, anxiety and mood swings around the time of menopause. Taking regular exercise and doing activities such as yoga and tai chi may be beneficial. Treatments are also available, such as Cognitive behavioural therapy (CBT) – a type of talking therapy that can help improve feelings of anxiety and low mood.

Low-dose antidepressants

A class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) may decrease menopausal hot flashes. A low-dose of antidepressants for the management may be useful for women that cannot take oestrogen for health reasons or for women who need an antidepressant for a mood disorder.

Moisturisers

Your vagina may become dry, painful or itchy as a result of menopause, your GP may prescribe oestrogen treatment that is used directly into your vagina. You can also use vaginal moisturisers or lubricants.

Feminesse Moisturiser is a vaginal moisturiser specifically formulated to soothe the symptoms of vaginal dryness including daily soreness, itchy and during intercourse. It is designed to give continuous relief from the symptoms of vaginal dryness for 3 days at a time. It can be used alongside HRT, radiotherapy and other treatments. You can buy the Feminesse Moisturiser here.

Before deciding on any form of treatment, talk to your doctor about your options and the risks and benefits involved with each.

References: mayo-clinic, women’s-health, health-line and the NHS website.

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