Natural menopause happens gradually, the ovaries slow down and so unlike a surgical menopause from a hysterectomy, the body has time to adjust.
This gradual transition to menopause is the perimenopause state, but menopause proper is not reckoned until at least continuous twelve months since any period and you are no longer able to get pregnant naturally.
In the UK that is usually between 45 and 55 years of age, and the average is 51. During perimenopause, it’s still possible to get pregnant as although periods may become more unpredictable, your ovaries are still working and you still may ovulate, though not always monthly.
What causes menopause?
Age is the leading cause of menopause, but certain surgeries and medical treatment can induce it. Those include hysterectomy, surgical removal of the ovaries (bilateral oophorectomy), chemotherapy, and pelvic radiation therapy.
Although 51 may be the average, it can start earlier or later. A few women start menopause as young as 40, and a very small percentage as late as 60.
Women who smoke tend to go through menopause a few years earlier than nonsmokers, but there is no proven way to predict menopausal age.
What to expect
Every woman is different so some women reach menopause with little to no trouble but others have severe symptoms. Just because your mother had a hard time, or your sister found it easy, it can’t be predicted how your own menopause will be.
When menopause starts suddenly as a result of surgery, chemotherapy, or radiation, the adjustment can be particularly difficult.
Menopause common symptoms
Although you may be dreading physical discomfort from hot flushes, night sweats, and other symptoms, it can also be the opportunity to guard against major health risks like heart disease, cancer and osteoporosis.
As menopause approaches, the menstrual cycle will likely change, but again it can vary from woman to woman.
Periods may get shorter or longer, heavier or lighter, with more or less time between periods.
Such changes are normal, but certain signs such as if your periods come very close together, if you have heavy bleeding or spotting, or if your periods last more than a week, should always be reported to your doctor to be checked.
This is the main symptom experienced by the majority of women and again can vary in intensity.
It may be a brief feeling of heat that may make the face and neck flushed and cause temporary red blotches to appear on the chest, back, and arms. Sweating and chills may follow, particularly at night.
They vary in intensity and typically last between 30 seconds and 10 minutes, though frankly for some women it can be much longer.
You will find your own ways of dealing with them, but dressing in light layers, using a fan, getting regular exercise, avoiding spicy foods and heat, and managing stress may help you deal with them more effectively.
As oestrogen levels decline, it can lead to vaginal dryness, which may make intercourse uncomfortable or painful. Try using a water-soluble lubricant or a hormone cream with oestrogen applied vaginally.
Libido is subject to many factors including stress, medications, depression, poor sleep, and relationship problems. These all affect your sex drive, and it is progesterone that is responsible for this in women.
Although oestrogen levels decline at menopause,progeserone levels decline further and faster so ensuring good levels can certainly help your sex drive.
Sexually transmitted diseases (STDs) don’t end with menopause, so ’safer sex’ still counts so discuss with your doctor, or a clinic, if you have any of these:
- discharge (thick or thin, milky white, yellow, or green leakage from the vagina)
- vaginal itching, rash or blisters in the genital area
- burning on urination
Managing your symptoms
If menopause symptoms are a problem your doctor is most likely to prescribe HRT or antidepressants, or the Pill/miniPill or a coil. For vaginal atrophy or dryness an oestrogen cream given short term can be helpful.
HRT is always best taken short term as studies have linked its long-term use to a greater risk of heart attacks, strokes, blood clots, and breast cancer.
All of these medical options do have side effects and it can also take a while to settle on a form of HRT that works for you. Many women find the weight gain and other issues make it an undesirable option.
Bioidentical hormones are a more natural option, with either progesterone or progesterone and oestrogen creams replacing the synthetic options.
Herbs have been used for many years to help treat symptoms of menopause with black cohosh, dong quai, red clover and soy being the most common.
Menopause health risks
With menopause comes an increased risk for heart disease which is a bigger death threat to women than cancer, though breast cancer risk still continues at this time.
The second risk is osteoporosis or thinning bones but all risks can be reduced with changes in lifestyle and hormone supplementation.
Living a healthy lifestyle is important throughout a woman’s life and menopause is also a great time to really address your diet, physical activity, and stress management.
It is never too late to change and even if you have not been very active previously if you start sensible, regular exercise now you will really reap the benefits.