“Am I experiencing menopause or perimenopause?”
At the heart of my work is the whole life course to women’s reproductive health. Perimenopause and menopause are a significant part this journey. In the work on reproductive health we emphasise the importance of a positive approach where the opportunity for reproductive health and access to reproductive healthcare, to be free from stigma and embarrassmentI.
Ensuring that young people understand the reproductive life cycle including the onset and cessation of periods is key.
Menstruation and of significance here menopause will be part of the new statutory Relationships Sex and Health Education from September 2020. This is an important step towards creating a positive approach towards women’s reproductive health.
The definition of the menopause is when a woman has gone 12 months without a period.
That stated, changes to periods and onset of symptoms can happen over months or even years and this time is referred to as the perimenopause. Periods may become lighter or heavier, less frequent or more frequent or just stop abruptly. The menopause is a natural part of ageing that usually occurs between 45 and 55 years of age, as a woman's ovaries stop releasing eggs and oestrogen levels decline. In the UK, the average age for a woman to reach the menopause is around 51. But around 1 in 100 women experience the menopause before 40 years of age, known as premature menopause or premature ovarian insufficiencyii.
The symptoms of menopause occur as a result of the changes in hormone levels.
Fluctuating hormone levels commonly cause symptoms such as hot flushes, night sweats, sleeplessness, irritated skin, low mood, anxiety and reduced interest in sex Hot flushes are the most common symptom, occurring in three in every four menopausal women. Symptoms vary hugely in duration, severity and the impact they have on womeniii. Over a period of time the hormone levels stop fluctuating and many symptoms settle. In the postmenopausal period, symptoms related to low oestrogen levels are more common such as vaginal dryness and urinary frequency.
Hormone replacement therapy (HRT)
HRT is a medical treatment for menopausal symptoms and contains the hormones oestrogen and progestogen. It can effectively control symptoms when they are having a significant impact such as hot flushes and vaginal dryness. HRT can be taken orally as a tablet or a transdermal patch or gel. Oestrogen can also be used in the form of a cream or vaginal tablet to relieve symptoms such as vaginal dryness and irritation
There have been concerns over the safety of HRT. In particular whether it may increase the risk of breast cancer and reviewing a woman’s individual risk is an important part of assessing their suitability for treatment. While, HRT is not 100% risk free, it does remain one of the most effective treatments for relieving menopausal symptoms which is also effective in preventing osteoporosisiv.
Alternative therapies to help the menopause
Some women who do not choose or who are unable to take HRT have found alternative therapies, which can come in the form of acupuncture, aromatherapy, herbal treatments, homeopathy, hypnotherapy, yoga and reflexology. These have all been reported as being helpful in the menopause.
Other lifestyle factors are important at this stage of life for general well-being. It is often a time when there is a complex array of other issues for an individual which may include children leaving home, elderly parents to care for, or new onset of an illness. Taking regular exercise and moderating alcohol intake can help counteract negative effects of menopause. Diet is also extremely important and can be an effective way to help with symptoms. One which is low in saturated fat and salt is beneficial and there are many guides that can help to maintain a healthy diet around this period of a woman’s life.
And finally, it's good to just talk about it
In talking about the menopause, the perimenopause is extremely important, as hormonal changes do not happen overnight and the way they affect a woman are very individual. I look forward to progressing the agenda further, where women’s reproductive health is more prominent and we are now able to talk about the perimenopause and menopause more freely, knowing support is available.