What is the menopause?
Menopause is the medical term used for the last
menstrual period a woman will ever have. However, the term is more often used to describe
the years leading up to this time, also called the change of life
or just the change. This period is more accurately known
Menopause is a natural process that every woman
goes through and every womans experience of the menopause is different.
When does the menopause happen?
The menopause usually happens between the ages of
45 and 55, although it can be earlier or later. The average age in Britain
for the menopause to occur is 51 years old. There can sometimes be a
family pattern so it may be worth asking your mother, sister or grandmother
when it happened to them.
No matter what age you are, having a hysterectomy
(in which both ovaries are removed) causes the menopause to happen instantly. If the ovaries
are destroyed by chemotherapy or radiotherapy for cancer
of the cervix, this can also bring on an immediate menopause.
The symptoms of the menopause can be more severe when the menopause
takes place prematurely or abruptly.
Cigarette smokers often reach the menopause earlier
What causes the menopause and why does it happen?
girl is born with all the eggs in her ovaries that she will ever produce
in her lifetime. There is a steady reduction of these eggs over time
as some never mature and others are released each month as your period.
By the time most women have reached their late 40's the supply of eggs
remaining in the ovaries has fallen to low numbers.
gland produces a substance called follicle stimulating hormone (F.S.H.),
which is the main hormone involved in producing mature eggs but the
eggs that now remain are unable to respond as well to F.S.H. as they
did when they were younger. As a result the ovaries will start failing
to release eggs and there will be a greatly reduced production of the
sex hormones. oestrogen and progesterone. However, the hormone F.S.H. which is always present in the body, will
increase dramatically as the pituitary gland makes more F.S.H. in an
attempt to encourage the ovaries to respond and cause the remaining
eggs to mature. At this time your periods will probably become irregular
and unpredictable (until they stop altogether).
The hormones oestrogen and progesterone control
your monthly cycle and prepare your body for pregnancy every month.
When pregnancy does not occur, your body releases an egg and you have
a period. It is the reduced levels of these hormones, which produce
the symptoms of the menopause. The menopause is simply a period of adjustment
to lower hormone levels in your body.
Oestrogen has many functions, it is needed to keep
your body ready for a possible pregnancy and controls sexual development
of female characteristics such as the breasts, genitals and womb development.
When the supply of eggs runs low, oestrogen is no longer required and
so the levels drop causing many effects on the body.
What are the symptoms of the menopause?
Around 80% of women will experience some symptoms
of the menopause with only around 20% of women not having any symptoms
at all, except for the fact that their periods might become irregular.
The symptoms of the menopause result from reduced levels of oestrogen
and some women might have severe problems that affect their lifestyle.
Symptoms of the menopause may include any of the following:
- Periods - most women's periods will become unpredictable
for several months and in some cases for a few years before they actually
stop. The blood flow may also vary from light one month to heavy the
- Hot flushes - the most common symptom of the
menopause. Hot flushes are sudden intense waves of heat, sometimes
accompanied by redness and sweating. They can occur at any time and
some women find that these flushes disrupt their sleep. Hot flushes
can last anything from a few seconds up to several minutes and at
the start of the menopause can occur as frequently as several times
an hour. Hot flushes can be triggered by spicy foods and alcohol.
Hot flushes can be uncomfortable, but they are not harmful.
- Vaginal dryness - your vagina may become dryer and much thinner, making sex painful and uncomfortable.
The thinning of the vagina walls also puts you at an increased risk
of vaginal infections like thrush and cystitis.
Remember, if you do notice any unusual discharge or bleeding from your vagina, a visit to your doctor may be needed.
- Feeling emotional and depressed - the menopause
can make many women experience headaches, forgetfulness and make them
irritable - having unexpected mood swings. Many women go through similar
emotions and even though you may not think so, people will understand
and make allowances.
- Tiredness - this can often be due to difficulties in
It is important to realise that when most women go through
the menopause they could also be trying to cope with problems at home.
For example, adolescent teenagers, children that are growing up and
leaving home, elderly relatives, boredom at work or in personal relationships
or they just be finding it difficult coming to terms with their reduced
fertility. The menopause does not cause these problems though it can
make them seem worse, it is important to try and keep a sense of proportion
about what is going on around you. If you are feeling depressed no matter
what the reason you should seek your doctors help.
The menopause does not happen overnight and symptoms
of the menopause can continue for an average of 4 years. However, the
majority of women continue to function well during the menopause. For
some women the menopause brings a sense of freedom since the end of fertility means no more birth control and dealing with periods, which may have
been heavy or painful.
After a woman has had her last menstrual period she can no longer bear children naturally.
Are there any long term effects?
As oestrogen levels fall, a woman's
skin becomes thinner so you may find your skin is more dry and your
hair may also become thinner. As mentioned previously the lining of
the vagina will become thinner and the womb will also become smaller
and the lining thinner. This thinning can also affect the bones and
a condition called osteoporosis can develop, approximately 1 in 4 women are at risk. Osteoporosis tends
to occur after the menopause when the bones have lost much of the calcium
they need to remain strong and firm. For more detailed information on
After the menopause you are also more at risk of heart
disease as oestrogen appears to protect the blood
vessels, as oestrogen levels fall so does this protection.
How is the menopause diagnosed?
Doctors will usually diagnose the menopause from
your symptoms and age alone. Doctors may also check your hormone F.S.H.
If you are experiencing problems or are unsure of
your symptoms you should always discuss these with your GP.
We have a test available on this website which looks for
raised levels of F.S.H. in urine, for more information or to buy click
What treatment is available for the menopause?
Many symptoms of the menopause can
be reduced with certain lifestyle changes such as exercise and diet.
Exercise, such as walking for 20-30 minutes, 3-4 times a week, will
help maintain general fitness, reduce the risk of you developing heart disease and will strengthen the bones.
You should ensue that you eat a well balanced diet containing foods
which provide calcium, such as milk products, cheese, sardines, salmon
and green leafy vegetables. A good intake of calcium will slow down
bone thinning and help to prevent bone fractures. In moderation a small
glass or 2 of red wine can reduce the risk of heart disease and cancer.
If you are suffering from vaginal dryness, try using a
vaginal lubricant like KY jelly™ available
from most pharmacies.
If you are suffering from hot flushes and sweating you
should wear layers of clothes that you can peel off when hot. If you
experience night sweats ensure you bring a glass of water to bed with
you, wear cotton night wear and sleep with the window open.
You should also get out in the sun when you can. Exposure
to the sun stimulates the production of vitamin D in the skin, however,
ensure you don't get burnt! Vitamin D helps the body
absorb calcium from foods and so is essential for healthy bones and
If you smoke you should now stop, smoking can make menopause
symptoms worse and increase the loss of bone density.
The menopause can can be relieved with
treatment. Speak to your pharmacist or doctor about taking supplements,
(e.g. evening primrose oil and vitamin D) as these can help some women
cope with symptoms of the menopause.
Medical treatment which is designed
to make up for the loss of oestrogen is available for women who are
troubled by symptoms of the menopause. This treatment is called Hormone
Replacement Therapy (H.R.T.)
and can help ease or prevent some of the symptoms of the menopause.
For more information on H.R.T. click
Other treatments that are available for the menopause
include, antidepressants, tranquillisers and sleeping pills. If you have any symptoms that are causing you concern
or discomfort then you should seek your doctors advice.
What about contraception?
Plenty of women stop using contraception before their
periods have completely stopped and although fertility decreases with
age, it is important to use adequate contraception until the risk of
pregnancy no longer exists. An unplanned pregnancy at an older age can
be devastating. Generally your periods are considered to be over, one
year after your last period if you are a woman over 50 and two years
if you are under 50 years of age.