The menopause, sometimes referred to as ‘the change’, is something that every woman goes through. It is a completely natural process associated with ageing, and marks the point in a woman’s life at which she stops menstruating, thereafter becoming infertile. The menopause is caused by falling levels of oestrogen and progesterone in the body. It causes symptoms which, depending on their severity, can be very uncomfortable and not easily managed. Hormone Replacement Therapy is a popular choice for women who want to bring their symptoms under control during and after the menopause.
Most women begin the menopause in their early fifties (currently, the average age in the UK is 51). However, some women start to experience it in their 30s - this is known as premature ovarian failure.
Am I going through the menopause?
If you are over the age of 50 and experiencing any of the following symptoms, then it is likely that you are in the beginning stages of the menopause (known as perimenopause):
- a change in the pattern of your periods - have they become lighter or heavier, or are they coming at irregular times?
- hot flushes night sweats
- vaginal dryness - you might notice some pain or discomfort during sex
- heart palpitations
- mood swings
If you are under the age of 50 and only experiencing a few of these symptoms, there is a chance you are not going through the menopause, but may be suffering from another medical condition. A change in your period pattern, for instance, could indicate pregnancy or be a result of weight gain or weight loss. Mood swings, headaches and insomnia, meanwhile, can all be linked to psychological stress or anxiety.
Typically, menopause will be diagnosed in women over 50 after 12 months without a period, and women under 50 after 24 months without a period.
What causes menopause symptoms?
As you move into menopause, your body produces less oestrogen. It is thought that the falling levels of oestrogen affect your body’s ability to regulate temperature, leading to hot flushes (episodes lasting between 30 seconds and five minutes, characterised by heat spreading to your face, chest and sometimes entire body). This in turn can cause night sweats and heart palpitations.
A drop in oestrogen also causes the linings of the vagina and the urethra to thin, which leads to vaginal dryness and discomfort, alongside making urinary tract infections more likely.
Some of these symptoms, however, may simply be triggered by the stress and anxiety you feel about going through the menopause, and will not necessarily be physiological factors of the change.
Osteoporosis and heart disease
For many women, the menopause also comes with health risks such as osteoporosis and heart disease.
It is thought that oestrogen plays a significant role in the slowing down of bone reabsorption (loss of bone density), which means that when your oestrogen levels drop, your bones can become weaker or more brittle. This increases the risk of sudden and unexpected fractures.
Oestrogen is also associated with increasing blood flow through the body and protecting blood vessels from becoming diseased. This means that when some women go through menopause they become more vulnerable to heart disease. You are more likely to be at risk of heart disease if you have an unhealthy lifestyle or a family history of the condition. As a result, it is worth considering how you could adapt your lifestyle to become more healthy when you become menopausal. The evidence for the effect of HRT on heart disease is mixed. In general, if you take HRT under the age of 60 it can help protect against heart disease, but if taken over the age of 60 it can be harmful.
If you are concerned that you might be going through the menopause, or would like to start Hormone Replacement Therapy, you should talk to your GP.