Menopause
Discover more about the menopause, why it occurs, its symptoms, and health consequences
Menopause?
The Menopause occurs because the ovaries of a woman are no longer able to produce hormones, oestrogen being the most important. As a result, periods stop and the loss of oestrogen leads to a variety of symptoms, and can have long-term health consequences, with an increased risk of heart disease, osteoporosis, and dementia.
The average age of the menopause is 51. However, the ovaries may produce reduced quantities of oestrogen in the years leading up to the menopause when the woman may still be experiencing regular periods, though very often the periods can become irregular at this time. This is sometimes referred to as the peri-menopause or menopause transition.
Sometimes the symptoms are most troublesome in the peri-menopause but may not be recognised as being due to oestrogen deficiency because the woman feels she is too young or because she is still having periods.
What are the symptoms?
The symptoms experienced vary from woman to woman; the main symptoms are listed below:
- Hot flushes and nights are the most common symptoms of the menopause. 80% of women will experience hot flushes and on average last for about 5 years but in some women can last for much longer. They may be relatively minor or very severe and can disturb sleep when they occur at night.
- Sleep disturbance may be associated with hot flushes and night sweats but quality of sleep can be disturbed even without these associated symptoms.
- Tiredness is common symptom of the menopause and may be exacerbated by poor sleep.
- Headaches tend to become more frequent around the time of the menopause.
- Vaginal dryness can occur due to thinning of (atrophy) of the vaginal tissue.
- Frequency of micturition which is caused by Atrophy of the urinary tract.
- Skin can become thinner, dryer and loose some of its elasticity as a result of the menopause.
- Forgetfulness – many women experience forgetfulness and are less able to concentrate, which can impact their personal and professional life.
- Depression and mood changes can be the most difficult symptoms of the menopause and often not recognised as being menopausal. Patients may therefore not be offered HRT but prescribed antidepressants instead, which do not always help and can exacerbate symptoms such as tiredness.
Long term effects of the menopause
Osteoporosis
The bone density declines in both men and women but in women there is a marked increase in the rate of loss of bone density following the menopause leading to osteoporosis or brittle bones. This can result in fractures particularly of the hip bone and vertebrae (spine) which can lead to curvature of the spine, sometimes referred to as dowagers hump, loss of height and back pain.
Heart disease
The risk of heart disease increases in women after the menopause because oestrogen is thought to have a protective effect and women who have a premature menopause are particularly at risk of heart disease.
How can it be treated?
Benefits of HRT
Oestrogen replacement can help alleviate the symptoms of the menopause improve quality of life, and reduce the risk of developing, osteoporosis, heart disease and possibly dementia.
Book your appointment
Book your appointment with our specialist team
Dr Neale Watson
Consultant Gynaecologist
Dr Mike Savvas
Consultant Gynaecologist
Dr Marilena Nicou
GP Menopause specialist
Frequently Asked Questions
When can I expect to to experience the menopause?
The average age of the menopause is around 50 but in 5% of women it occurs before the age of 45 and this is termed an early menopause. In one percent of cases, menopause occurs before the age of 40 and that is termed premature menopause or premature ovarian insufficiency.
What is meant by a surgical menopause or medically induced menopause?
A surgical menopause occurs when the ovaries are surgically removed perhaps because of cancer or other conditions. Medical treatment with chemotherapy or radiotherapy can also lead to menopause. This is sometimes called a medically induced or iatrogenic menopause. The loss of oestrogen production following medically induced or surgical menopause is more abrupt and the symptoms tend to be more severe. Women who have a medically induced menopause should be offered HRT to help with the symptoms and prevent the long-term problems such as osteoporosis.
My memory is not as good as it used to be. I am increasingly forgetful and find it difficult to concentrate on things as well as I used to. Could this be early onset dementia?
These are common symptoms experienced by women around the time of the menopause and are very unlikely to be due to dementia. Such symptoms may be due to tiredness, poor sleep perhaps because of hot flushes, or depression. However, these symptoms may also be due to the menopause and can be helped by hormone replacement therapy.
Do I need a blood test to diagnose menopause?
Blood tests are not usually necessary to diagnose the menopause but may be useful if in very young women (before the age of 40). Blood tests can also help to exclude other conditions such as anaemia or underactive thyroid which can mimic some of the symptoms of the menopause.
Apart from HRT, is there anything else that I can do to maintain my health as I get older?
It is especially important to maintain a healthy lifestyle as you get older. This includes quitting smoking, maintaining a healthy weight, taking regular exercise and eating healthily. You should avoid excessive alcohol; less than 14 units of alcohol per week. Taking vitamin D supplements is recommended during the winter months between October and May.
Is thinning of the skin a consequence of the menopause or aging and can HRT help?
As women get older the skin becomes thinner less elastic due to loss of collagen. This is due to aging but there is an acceleration in these changes with the menopause which to some extent can be prevented and improved by hormone replacement therapy (HRT).
What else can I do to help with mood swings during the menopause?
HRT can often help with depression, but persistent symptoms often require joint management from a HRT specialist as well as a psychiatrist.
What to Expect From Your Visit
The first visit will entail a comprehensive consultation, examination and hormone profile testing if required. Our highly qualified menopause specialists will guide you through the process of choosing the safest and most effective treatment to manage your symptoms.
A prescription will usually be issued, at the first visit if appropriate and a follow-up is arranged after 2-3 months to assess the effectiveness of the treatment and make changes as required. Our clinic allows for remote consultation for those who cannot make an in-person follow-up. This may be via a video or telephone call.
Additional services such as pelvic ultrasound scan, coil fittings, smear tests and bone density scan (DEXA) may also be performed as appropriate. We can also arrange for you to have a mammogram if you need one.