Approximately half of the world is female, meaning that half of the global population is likely to go through menopause at some point and yet it is one of the least spoken about areas of women’s health. At school, we learnt about puberty, sex, how to not to get pregnant but we were not taught about menopause. We might have seen our mothers fanning themselves or opening windows to cool down but talking about menopause? There was silence on the topic. Thankfully things are beginning to change, and menopause has recently been put on the national curriculum in secondary schools but there is still a long way to go!
When does menopause start?
Put simply, menopause means your last period. There is a medical word for your first period as well, menarche, but just as the process of puberty took years and starting your periods was one point in that, so too can the changes and symptoms leading up to menopause. This period of time, leading up to the last period is called perimenopause and you can have symptoms whether your periods are regular or irregular. The average age for menopause in the UK is 51, and women often have symptoms for a few years before the last period, generally in their mid to late 40s, though menopause can happen earlier.
Females are born with all their undeveloped eggs in their ovaries, some are lost before puberty and then each month an egg is used in the menstrual cycle. When these eggs run out, you go through menopause. The ovary is involved in producing the hormones oestrogen and progesterone during the menstrual cycle, once you go through menopause the levels of these hormones fall. It is the loss of these hormones which produces the symptoms of menopause. In fact, menopause can be thought of as a long-term oestrogen deficiency state, as the impact of the loss of oestrogen not only leads to the symptoms in the short term but in the long term increases the risks of conditions such as osteoporosis, where the bones become thin and brittle and more prone to fractures.
What are the symptoms of perimenopause?
Physical symptoms of perimenopause include changes to your periods which may become irregular or even more heavy than previously, hot flushes and night sweats, joint pains, headaches, dry itchy skin, fatigue, insomnia and loss of libido. Psychological symptoms include anxiety and depression, low mood, irritability and mood swings, difficulties with memory and concentration and both insomnia and loss of libido can have a psychological component as well. And there are physical changes to your hair, skin, breasts and more. About 4 out of 5 women will report at least one symptom and for many women the symptoms can be debilitating, affecting their personal, social and work lives.
While the symptom list may sound daunting it is important to know that there are effective treatments for menopause, such as hormone replacement therapy and other non-hormonal treatments as well as lots of lifestyle measures that can help. I am often asked ‘how do I know if my symptoms are bad enough to see the doctor’, the answer is simple – when you are struggling or when your symptoms are affecting or impacting your life in some way. If they are, ask for help.