Menopause

Updated: 03.08.2023
Approved by: General Practitioner, Alice Pan

Menopause is a natural stage in a woman's life when her menstrual periods stop due to declining hormone levels. On average, menopause occurs between the ages of 45 and 55. However, it can happen earlier due to various reasons, such as surgery, cancer treatments, or unknown factors. Perimenopause is the transitional phase before menopause, characterized by symptoms and irregular periods. Menopause and perimenopause can bring about physical and emotional changes, but there are strategies and treatments available to help manage these symptoms.

Symptoms of menopause and perimenopause

Menopause and perimenopause can impact different aspects of daily life, including relationships, social interactions, and work. Symptoms vary among individuals, and some may experience several symptoms while others may have none. The most common symptoms include:

Changes in menstrual patterns, such as irregular periods or their cessation.
Mental health symptoms include mood swings, anxiety, low self-esteem, and difficulties with memory and concentration.
Physical symptoms, such as hot flushes, night sweats, sleep disturbances, palpitations, headaches, muscle aches, joint pains, weight gain, dry and itchy skin, reduced sex drive, vaginal dryness, discomfort during sex, and an increased risk of urinary tract infections (UTIs).

When to seek medical advice

If you suspect you are experiencing perimenopause or menopause symptoms, it is recommended to consult a GP or nurse for guidance. Pharmacists can also provide advice on treatments and self-help strategies. Seeking help early can significantly reduce the impact of perimenopause and menopause on your overall health, relationships, and work.

Lifestyle changes to manage menopause and perimenopause

Making certain lifestyle adjustments can help alleviate symptoms and promote overall well-being during perimenopause and menopause. Consider incorporating the following into your routine:

Get plenty of rest, following regular sleep patterns.
Adopt a healthy, balanced diet.
Consume calcium-rich foods like milk, yoghurt, and kale to maintain bone health.
Engage in regular exercise, including weight-bearing activities like walking, running, or dancing.
Practice relaxation techniques such as yoga, tai chi, or meditation.
Seek support from family, friends, or colleagues who may be experiencing similar challenges.
Consult a doctor before taking herbal supplements or complementary medicines.
Avoid smoking and limit alcohol consumption.

Addressing mood changes

Mood swings, low mood, and anxiety are common during menopause and perimenopause. The following strategies may help ease these symptoms:

Get enough rest.
Engage in regular exercise.
Participate in relaxing activities.
Consider cognitive-behavioural therapy (CBT), a form of talking therapy that can assist with mood regulation, anxiety management, and sleep improvement.

Managing hot flushes and night sweats

To reduce the frequency and intensity of hot flushes and night sweats, try the following:

Wear lightweight clothing.
Maintain a cool sleeping environment.
Take cool showers, use fans, or have cold drinks.
Minimize stress levels.
Avoid triggers like spicy food, caffeine, hot drinks, smoking, and alcohol.
Engage in regular exercise.
Achieve a healthy weight through weight loss if necessary.
CBT techniques can also aid in managing hot flashes.

Addressing vaginal dryness

Over-the-counter vaginal moisturizers or lubricants can help alleviate vaginal dryness. Pharmacists can provide guidance on selecting the right product for your needs. Water-based lubricants are suitable for those using condoms. Additionally, doctors can prescribe hormone replacement therapy (HRT) or hormonal treatments like creams, pessaries, gels, or vaginal rings to address vaginal dryness.

Protecting against weak bones and osteoporosis

To maintain strong bones and reduce the risk of osteoporosis:

Engage in regular exercise, including weight-bearing and resistance exercises.
Consume a healthy diet rich in fruits, vegetables, and calcium sources like milk, yoghurt, and kale.
Get some sunlight to trigger vitamin D production, essential for bone health.
Take vitamin D supplements if necessary.
Quit smoking and moderate alcohol consumption.

Treatment options for menopause and perimenopause

Hormone Replacement Therapy (HRT) is a common treatment for menopause and perimenopause symptoms. It involves replacing the hormones that are at low levels in the body. HRT can effectively relieve symptoms such as hot flushes, brain fog, joint pains, mood swings, and vaginal dryness. Different forms of HRT, including patches, gels, sprays, implants, and tablets, are available. Women with a uterus also need to take progesterone to protect the womb lining. Other treatments, such as testosterone gel for reduced sex drive or estrogen treatments for vaginal dryness, can be considered under the guidance of a specialist.

Benefits and risks of HRT

HRT offers significant benefits, including symptom relief, reduced risks of hormone-related health problems, such as osteoporosis and heart disease, and improved quality of life. While there are small risks associated with HRT, the benefits often outweigh them. Testosterone gel or cream can help restore sex drive, while vaginal estrogen treatments can alleviate dryness and discomfort.