Menopausal symptoms: When to consult your gynaecologist

The menopause is a natural stage in a woman’s life that signifies the end of her menstrual cycles. In some cases, however, this process can lead to significant changes and a range of symptoms affecting physical and emotional wellbeing that require medical attention.

This article addresses common menopausal symptoms, treatment options, and important screenings during and after the menopause.

What are common symptoms of the menopause?

The symptoms of the menopause can vary widely in type and intensity. However, the most common include:

• Hot flashes and night sweats: Sudden feelings of heat in the upper body, often accompanied by sweating and flushing of the skin, that can occur during the day or at night.
• Mood changes: These may include irritability, anxiety, sadness, or even depression.
• Vaginal dryness: The thinning and drying of the vaginal walls during the menopause can cause discomfort during intercourse and sometimes leading to urinary issues.
• Decreased libido: Reduced desire for sex.
• Brain fog: Difficulty with concentration, forgetfulness, and a sense of mental fog.

While these are the most common symptoms, some women may experience others, such as joint pain, headaches, and weight gain particularly around the abdominal area.

When should I consult my gynaecologist about my menopausal symptoms?

It’s advisable to consult your gynaecologist:

• If your menopausal symptoms cause significant discomfort.
• If your menopausal symptoms interfere with your quality of life.
• If you experience any heavy or prolonged bleeding, or bleeding after the menopause.
• If you are unsure whether your symptoms are related to the menopause itself.

A consultation with your gynaecologist can help clarify the situation and guide you towards appropriate treatment.

How are menopausal symptoms managed? What options are available?

There is no one-size-fits-all approach to managing menopausal symptoms; treatment is tailored to an individual’s specific needs and health profile.

Hormone replacement therapy (HRT) is one of the most effective treatments for severe menopausal symptoms like hot flashes, night sweats, and vaginal dryness. It involves taking oestrogen or a combination of oestrogen and progesterone to replenish the hormones that decline during the menopause. However, HRT isn’t suitable for everyone - your gynaecologist will assess whether HRT is appropriate for you.

For women who can’t take or prefer not to take HRT, antidepressants can help with mood swings and hot flashes, while medications like gabapentin or clonidine have been shown to also alleviate hot flashes and night sweats.

For vaginal dryness and discomfort during sex, non-hormonal vaginal moisturisers and lubricants can provide relief. Meanwhile, cognitive behavioural therapy (CBT) can help manage anxiety, depression, and other emotional symptoms associated with the menopause.

Lastly, maintaining a healthy diet, regular physical activity, and stress management techniques can all improve overall wellbeing, as well as managing hot flashes, mood swings, and weight changes.

In addition to menopausal symptoms, are there specific screenings I need to be aware of during and after the menopause?

Certain health screenings become even more important during and after the menopause. These include:

• Bone density testing: As oestrogen levels decrease during the menopause, the risk of osteoporosis increases. A bone density scan, often referred to as a DEXA scan, is a test that can detect early bone loss.
• Breast cancer screening: Women over 50 should regularly attend mammograms for breast cancer screening. Between scheduled screenings, it’s important to remain vigilant about breast health and report any changes.
• Cervical smear test: Until the age of 65, women should attend regular cervical screenings every three years to detect any abnormal cell changes that may lead to cervical cancer.
• Heart health check: As oestrogen levels decrease during the menopause, the risk of cardiovascular disease also increases. Regular check-ups, including blood pressure monitoring and a lipid profile for cholesterol levels, are recommended.

The symptoms of the menopause can be challenging, but understanding them and knowing when to seek appropriate care can greatly improve overall quality of life, helping you navigate the menopause with confidence and comfort.