The menopause occurs when a woman’s ovaries stop making the female hormone oestrogen and is often diagnosed several months after a woman’s last period. The menopause usually occurs naturally between the ages of 45 to 55 years with the average age being 51 years. ‘Premature menopause’ is when periods stop naturally before the age of 40 years and ‘surgical or induced menopause’ is when the ovaries are removed , usually because of disease. Menopause may be a new beginning, rather than an end, of an active life for many women. It is important to realise that many of the symptoms of the menopause can be relieved simply and effectively.
The most common symptoms of the menopause are hot flushes and night sweats. Other common symptoms include:
• Vaginal dryness
• Being unable to sleep
• Passing urine often
• Having frequent urinary infections
You may also suffer from dizziness, depression and poor memory and concentration.
A reduced sex drive may be a result of changing hormone levels and the resulting vaginal dryness causing discomfort during sex. But overall, the menopause has little effect on many women’s relationships with their partners, either sexually or personally.
Rather than seeing the menopause as a negative event, many women are happy to be free from periods and the fear of an unwanted pregnancy. The menopause also often coincides with a time when you have more freedom to pursue new and interesting careers or hobbies. "The change" can be a change for the better.
Women who have close friends and family or are in full-time employment appear to suffer less severe symptoms. This may be related to being more satisfied with life in general or having higher self-esteem.
The need for exercise
Your body shape can change at menopause. Before the menopause, most women have extra body fat on their hips. Thighs and buttocks. This body fat is important for normal periods and fertility.
After the menopause, about 10% of a woman’s body fat is redistributed on the abdomen (a cause of great frustration for many women).
As you age, your metabolic rate tends to slow down. So you need to take regular exercise to prevent putting on weight.
Exercise (such as brisk walking) for 30 minutes three times a week or more is good for controlling weight and increasing or maintaining lean muscle. It also reduces some bone loss after menopause - although oestrogen therapy and calcium in the diet are also important.
Aerobic exercise (which increase the heart rate) will help improve fitness of your heart. It will also give you a feeling of well being and enable you to cope more easily with the unpleasant symptoms such as hot flushes.
The role of diet:
The following foods are important after the menopause
• Low-fat dairy foods
• Fruits and vegetables
• Whole grain cereals for fibre
• Lean meat (for non vegetarians)
• Soya products, lentils, beans and peas
Women need more calcium after the menopause as they lose bone tissue quicker (which may result in osteoporosis - a condition where bones are brittle and break easily).
Hormone Replacement Therapy
Hormone replacement therapy (HRT) replaces oestrogen and progestogens if you have a uterus or oestrogen alone if you have had a hysterectomy.
Oestrogen is very effective in reducing symptoms such as hot flushes and vaginal dryness. Oestrogen is given every day in the form of tablets, patches, gels or implants. If you suffer from vaginal dryness, you can also take oestrogen in the form of vaginal pessaries or creams. Progestogens can be given cyclically (for 12 to 14 days each month) or continuously in the form of tablets or patches.
HRT can occasionally cause side-effects. These include tender breasts, irregular bleeding and, very occasionally, water retention and weight gain. In some women progestogens cause mild depression, irritability and abdominal bloating. Side effects may be related to the type of progestogen as well as the dose, so be sure to talk to your doctor. Altering the dose of either or both hormones will often reduce side-effects.
Other benefits of HRT
Oestrogen is not usually given to women who have recently had breast cancer or who have acute liver disease.
HRT appears to increase the risk of breast cancer but the good news is that the increase is very small and only becomes a factor in women in their 60’s and beyond, if it taken for 10 years or more. Against this very small risk you must weigh the benefits gained from using HRT and the possible reduction in risks, for example, of osteoporosis and heart disease.
It’s important for you to talk with your GP about any problems you have at the time of the menopause. Each woman is different and whether or not you should take hormone therapy depends on your own circumstances.
Many women are asking whether phytoestrogens, which are found in certain plants (e.g. Soya), can help in the menopause. At present, there is little reliable information on these, however they may help some women with menopausal symptoms. It is not known whether they can protect you from osteoporosis.
Remember to examine your breasts once a month (if you’re unsure how to do it properly, ask your doctor or practice nurse) and if you are over 50, have a mammogram every three years. All women over 50 are eligible for free mammograms on the NHS.