What is the menopause?
Advice from Dr Niamh Scanlon of Mary Street Medical Centre
Did you know that World Menopause Day was recently celebrated on the 18th October 2022? The menopause is an important time in every woman’s life and something that all women will experience. But often it is not something that is spoken about openly or well understood. Thankfully this has started to change with more coverage in the media and organisations promoting information on menopause. The Irish government has recently launched a campaign about breaking the silence around menopause. And many GPs, like myself, have developed a special interest in women’s health to help patients during this life transition.
What is the menopause?
Menopause is the time in a woman’s life when her periods stop. This usually occurs between 45 to 55 years of age. The average age of menopause in Ireland is 51 years old. However, it’s a gradual process that usually lasts a number of years and in some cases it can be over 10 years.
Women initially experience a change in menstrual cycle pattern when periods become infrequent and the cycles become longer. Due to fluctuations in the female hormones oestrogen and progesterone, women may experience menopausal symptoms. There are over 41 recognised symptoms of menopause. Two thirds of women will experience at least 1 menopausal symptom. The most common symptoms are hot flushes and night sweats (vasomotor symptoms), experienced by 70-80% of women. Other symptoms include disturbed sleep and insomnia, low energy levels, low mood, anxiety, irritability, low sexual drive, impaired memory and concentration, a sensation of ‘brain fog’, joint aches, headaches, palpitations, vaginal dryness and irritation, painful sex, and urinary symptoms such as needing to go to the toilet more frequently or urgently.
How is menopause diagnosed ?
The menopause can be diagnosed by a visit to your GP. Your GP will discuss the symptoms you are having and your menstrual history. They will ask you about your past medical history and conditions that run in your family such as heart disease, blood clots, stroke and cancer. They will ask if you smoke and what your alcohol intake is. For most women, after going through these questions menopause can be diagnosed. For a small number of individuals, a hormonal blood test may be required. Other investigations may be done to assess your bone and heart health. This is because the change in hormones at menopause can affect the strength and density of bones, increasing the risk of the bone-thinning disease osteoporosis. It can also have an impact on your heart health. Your GP can advise on what tests are required and if a bone scan is needed.
Another important consideration is that depending on your age, there can still be a risk of pregnancy (don’t fall off your chair!). Contraception may still be required up to the age of 55 years. Your GP can also discuss this with you.
What can I do to help my menopausal symptoms?
The good news is that there are many treatment options available to you, both hormonal and non- hormonal. Hormone Replacement Therapy (HRT) is the most commonly used treatment for managing menopausal symptoms and it is very effective. Your GP can explain the risks and benefits of HRT, and if it is a suitable option for you. Benefits include symptom relief, improvement in quality of life and protection against osteoporosis. HRT started in women under the age of 60 or within 10 years of their last period has also been shown to significantly reduce the risk of heart disease and cardiovascular death. HRT comes in different forms such as gels, sprays, patches and oral or vaginal capsules. Your GP can help decide which is the best type for you.
Non hormonal lifestyle changes have been shown to help the symptoms of menopause whilst also having a positive impact on your overall health. It is recommended to have a healthy diet that is low in saturated fat and salt to reduce blood pressure, and a diet that is rich in calcium and vitamin D that will strengthen bones. Regular exercise can relieve stress, reduce severity of hot flushes, strengthen bones and lower the risk of heart disease. Smoking has been shown to increase the risk of an earlier menopause and trigger hot flushes, so another good reason to quit! Alcohol increases hot flushes so women should try not to drink more than 2 to 3 units of alcohol per day, and keep at least one day a week alcohol-free. Relaxation techniques such as meditation and yoga can reduce stress levels and help cope with anxiety. Cognitive Behavioural Therapy (CBT) has also been proven to help alleviate the symptoms of menopause.
Women experience the menopause in different ways. Some women experience minimal or no symptoms while others can experience symptoms that significantly impact their quality of life. The most important thing is that you don’t suffer in silence. Speak to your GP about an individual plan to improve your health and alleviate your symptoms. And remember this is a natural stage of life. In eastern cultures, such as Japan, it is viewed as a re-energising time heralding your “ second spring”, so take the time to prioritise your health and wellbeing entering this new season in your life.