Navigating the menopause: From symptoms to management strategies

The menopause is a significant phase in a woman's life, signifying the end of her reproductive years. This natural biological process can bring about various changes and symptoms, and understanding these aspects can help in managing them effectively.

Ms Evangelia Bakali, renowned consultant gynaecologist, offers a comprehensive overview of the menopause, explaining its stages, symptoms, and management strategies available.

What are the different stages of the menopause?

The menopause is divided into three distinct stages: the perimenopause, the menopause, and the postmenopause.

The perimenopause

The perimenopause is the transitional period that precedes the menopause. It typically begins in a woman’s 40s but can start earlier or later. During this period, hormone levels begin to fluctuate, causing changes in menstrual cycles. The perimenopause can last for several years, and women may experience various symptoms, such as irregular periods, hot flashes, and mood swings.

The menopause

The menopause is officially diagnosed when a woman hasn’t had a menstrual period for 12 consecutive months. The average age for the menopause is around 51, but it can occur anytime between the ages of 45 and 55. The menopause marks the end of a woman's reproductive years, where the ovaries stop releasing eggs, leading to a decline in oestrogen and progesterone levels.

The postmenopause

The postmenopause refers to the years that come after the menopause. During this phase, menopause symptoms may continue for some time but generally diminish. The postmenopause is a time when the risk of certain health conditions increases due to decreased oestrogen levels.

What menopause symptoms should I be aware of?

The menopause can present a variety of symptoms, which can vary in intensity and duration. Common symptoms include:

• Hot flashes: Unexpected feelings of warmth, often accompanied by sweating and flushing.
• Night sweats: Hot flashes that happen during sleep, resulting in excessive sweating and disturbed rest.
• Irregular periods: Changes in the menstrual cycle, including heavier or lighter bleeding, or skipped periods.
• Vaginal dryness: Reduced moisture in the vaginal area, which can lead to discomfort during intercourse (dyspareunia).

Additionally, other common symptoms include:

• Mood swings: Emotional changes, such as irritability, anxiety, or depression.
• Sleeping problems: Trouble falling or staying asleep, often caused by night sweats or hormonal changes.
• Reduced libido: Decreased interest in sexual activity.
• Memory issues: Difficulty concentrating or experiencing memory lapses.

These symptoms result from the hormonal changes that occur and can impact daily life as well as wellbeing.

How can I manage menopause symptoms?

Managing menopause symptoms involves a combination of lifestyle changes and medical treatments.

Your gynaecologist may recommend the following lifestyle modifications:

• Diet: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help manage symptoms. Foods rich in calcium and vitamin D are especially important for maintaining bone health.
• Exercise: Regular physical activity can help with weight management. It can also reduce hot flashes, improve mood, and enhance overall wellbeing.
• Stress management: Techniques such as mindfulness, meditation, and relaxation exercises can help alleviate stress and mood swings.

When should I consider hormone replacement therapy (HRT)?

HRT involves the administration of hormones to replace the natural hormones that the body no longer produces. Treatment can be tailored to individual needs and may involve a combination of hormones.

HRT can offer significant relief from menopause symptoms but it also comes with potential risks and side effects, so it’s important to discuss these with your gynaecologist to determine the most appropriate treatment plan for your particular situation.

Consider discussing the use of HRT with your gynaecologist if:

• You are experiencing severe symptoms that don’t improve with lifestyle changes or non-hormonal treatments.
• Your symptoms have a considerable effect on your quality of life.
• You have no contraindications to HRT, such as a history of certain cancers, blood clots, or liver disease.

Your gynaecologist will assess your health history and menopause symptoms to determine if HRT is a suitable option and to help you understand the associated risks and benefits.

How often should I have check-ups with my gynaecologist during the menopause?

Regular check-ups during the menopause are essential for tracking overall health. One key aspect is scheduling annual appointments with your gynaecologist to track your symptoms, adjust treatments as needed, and screen for any potential health issues associated with the menopause.

Additionally, bone density tests are important for women who are at an increased risk of osteoporosis. These tests help assess bone health and determine if any preventive measures or treatments are necessary. Your gynaecologist will recommend how frequently these tests should be conducted based on your individual risk factors.

The menopause also raises the risk of cardiovascular disease, making it essential to monitor cardiovascular health closely. Regular check-ups also include assessments of blood pressure, cholesterol levels, and other key cardiovascular risk factors to help prevent heart-related complications.

Finally, mental health can be significantly affected during the menopause. If you experience notable mood changes or other mental health concerns, it’s important to bring these up during your check-ups. Addressing mental health issues with your gynaecologist will ensure that you receive the appropriate support and interventions.

If you would like to schedule an appointment with Ms Evangelia Bakali, head on over to her Top Doctors profile today.