The menopause: All you need to know to make it the best time of your life!

The menopause is a natural phase in a woman’s life. Although it’s often viewed with apprehension, understanding the changes the menopause brings and how to address them can empower you to embrace this transition confidently.

This article explains everything you need to know about the menopause to make it the best time of your life, from hormonal changes to treatment options, and dispelling common myths.

What are the hormonal changes that occur during the menopause?

The menopause begins with the ovaries stop producing eggs, leading to a natural decline in reproductive hormones, primarily oestrogen and progesterone. As these hormone levels fluctuate, this hormonal shift brings several changes to the body:

• Hot flashes and night sweats: A sudden feeling of heat, often accompanied by sweating, caused by changes in the hypothalamus, which regulates body temperature.
• Vaginal dryness: The vaginal lining can become thinner and less lubricated, causing discomfort during intercourse and increasing susceptibility to infections.
• Mood swings: Hormonal fluctuations can affect neurotransmitters like serotonin, contributing to irritability, anxiety, or depression.

Additionally:

• Bone density loss: Oestrogen supports bone health, so its decline increases the risk of osteoporosis and fractures.
• Weight changes: Many women notice a shift in body fat distribution, with an increased tendency for weight gain around the abdomen.
• Sleep disturbances: Lower progesterone levels, which have a calming effect, may contribute to insomnia or disrupted sleep.

When should I see my gynaecologist?

It’s important to consult your gynaecologist both before and during the menopause.

Before the menopause, your gynaecologist can identify early signs of hormonal changes and conduct screenings for conditions like fibroids or endometriosis, which may complicate the menopause.

During the menopause, you should see your gynaecologist if you experience severe or persistent symptoms that disrupt your quality of life, such as extreme hot flashes, vaginal discomfort, or severe mood swings.

Additionally, you should seek medical help if you experience new or unusual symptoms, such as pelvic pain, unexplained weight loss, or heavy/irregular bleeding. Timely medical attention ensures you can access effective treatments tailored to your needs.

What treatment options are available for managing menopausal symptoms?

Hormone replacement therapy (HRT) is one of the most common treatments. It works by supplementing the body with synthetic hormones, primarily oestrogen and sometimes progesterone, to compensate for the reduced production by the ovaries.

HRT can alleviate common menopausal symptoms, such as hot flashes, and is available in various forms. However, it’s important to discuss the risks and benefits with your gynaecologist, as HRT isn’t suitable for everyone.

Besides HRT, there are other treatments available, including:

• Medications: Non-hormonal selective serotonin reuptake inhibitors (SSRIs) can help manage mood swings.
• Vaginal lubricants and moisturisers: These over-the-counter products can relieve vaginal dryness and improve comfort during intercourse.
• Lifestyle modifications: Regular exercise, a balanced diet rich in calcium and vitamin D, and stress management techniques can significantly improve your wellbeing.

Every woman’s experience of the menopause is unique, so treatment will be tailored to your individual needs and preferences.

What are common myths about the menopause I should stop believing?

Misconceptions about the menopause can cause confusion and unnecessary worry. Here are some common myths:

Myth 1: The menopause only happens in your 50s

The menopause typically occurs between ages 45 and 55, but it can happen earlier or later due to genetics, certain medical conditions, or treatments like chemotherapy. Perimenopause symptoms can also begin several years before your periods stop.

Myth 2: All women experience severe symptoms

The menopause affects every woman differently. While some may face intense symptoms, others may experience mild or no symptoms at all - both experiences are normal.

Myth 3: After the menopause, you can stop contraception immediately

While fertility declines significantly during the menopause, pregnancy is still possible until you've had no periods for 12 consecutive months. If you're younger than 50, you should continue using contraception until you've reached that point.

Myth 4: Once the menopause starts, symptoms are permanent

While some menopausal symptoms may last a few years, most women experience symptom relief within 4-5 years after their last period. Some symptoms, such as vaginal dryness, may persist but many women find that with the right treatment, they can continue to lead active, healthy lives after the menopause.