What is menopause?

Women past a certain age will experience menopause. Menopause is defined as having no menstrual period for one year. The age you experience it can vary, but it typically occurs in your late 40s or early 50s, but can be earlier or later and your family history may play a part in this.

Menopause can cause many changes in your body. The symptoms are the result of a decreased production of oestrogen and progesterone in your ovaries.

Symptoms may include hot flushes, weight gain, or vaginal dryness which can contribute to vagina dryness. With this, there can be inflammation and thinning of the vaginal tissues which adds to uncomfortable intercourse.

Menopause can also increase your risk for certain conditions like heart disease, strokes, hormonal cancers and osteoporosis.

So what do you really need to know about menopause?

1. What age will I be when I go through menopause?

The average age for onset of menopause is 51, but average doesn’t mean that is when it will happen to you. The majority of women stop having periods somewhere between ages 45 to 55 but the beginning stages of declining ovary function can start years before that in some women. Others will continue to have menstrual periods into their late 50s.

The age of menopause is thought to be genetically determined, for instance when your mother started her menopause, but things such as surgery, chemotherapy or even smoking can accelerate ovary decline, resulting in earlier menopause.

2. What’s the difference between perimenopause and menopause?

Perimenopause refers to the period of time right before menopause begins and your body is beginning the transition into menopause.

That means that hormone production from your ovaries is beginning to decline and you can start to experience some symptoms commonly associated with menopause, like hot flushes.

Your menstrual cycle may become irregular, but it won’t cease during the perimenopause stage, and once you completely stop having a menstrual cycle for 12 consecutive months, you’ve entered menopause.

3. What symptoms are caused by the reduced levels of hormones in my body?

About 75 percent of women experience hot flushes during menopause, making them the most common symptom experienced by menopausal women.

These can occur during the day or at night and some women may also experience muscle and joint pain, known as arthralgia, or mood swings.

It may be difficult to determine whether these symptoms are caused by shifts in your hormones, life circumstances, or the ageing process itself as stress will certainly have an impact on hormones and related symptoms.

4. When do I know that I’m having a hot flush?

First thing you will notice is your body temperature start to rise. Hot flushes generally affect the top half of your body, and your skin may even turn red in colour or become blotchy.

This rush of heat could lead to sweating, heart palpitations, and feelings of dizziness. After the hot flush, you may feel cold and they may come on daily or even multiple times a day. You may experience them over the course of a year or even several years.

Avoiding triggers may reduce the number you experience. These can include:

• consuming alcohol or caffeine
• eating spicy food
• feeling stressed
• being somewhere hot

Being overweight and smoking may also make them worse.

A few techniques may help reduce your symptoms:

• Dress in layers to help with hot flashes, and use a fan at your home or office, or carry a small one in your bag.
• Do breathing exercises during a hot flush to try to calm it.
• Medications such as birth control pills, HRT and antidepressants are often prescribed for these, but you could also consider bioidentical hormones for an effective natural approach.

5. How does menopause affect my bone health?

Osteopenia and osteoporosis definitely increase in risk at menopause due to the significant decline in hormone production.

Many women experience accelerated bone loss the first few years after their last menstrual period as they are not producing as much oestrogen and significantly less progesterone. These two hormones are key to bone loss prevention: oestrogen clears away old bone and progesterone builds new bone so these two need to be in balance.

Osteoporosis can also you more susceptible to hip, spine, and other bone fractures, and calcium supplements are often recommended but they are not enough – you need a specific bone supplement with a combination of vitamin D, essential bone nutrients vitamins C, D and K and minerals Calcium, Magnesium, Boron and Manganese as well as supplementing with bioidentical progesterone.

To keep your bones healthy:

• Eat foods with lots of calcium, such as dairy products or dark leafy greens.
• Take vitamin D supplements.
• Exercise regularly and include weight training in your exercise routine.
• Reduce alcohol consumption.
• Avoid smoking.

 6. Is heart disease linked to menopause?

Conditions related to your heart may arise during menopause, such as dizziness or cardiac palpitations. Decreased oestrogen levels can prevent your body from retaining flexible arteries. This can impact blood flow.

There is also an increased risk of heart disease and strokes if you have excessive oestrogen, oestrogen dominance, so hormone balance is key here.

Watching your weight, eating a healthy and balanced diet, exercising, and not smoking can reduce your chances of developing heart conditions.

7. Will I gain weight when I experience menopause?

Changes in your hormone levels may cause you to gain weight. However, ageing can also contribute to weight gain.

Focus on maintaining a balanced diet, exercising regularly, and practicing other healthy habits to help control your weight. Being overweight can increase your risk for heart disease, diabetes, and other conditions.

Weight management

• Focus on a healthy lifestyle to manage your weight.
• Eat a well-rounded diet that includes increasing calcium-rich foods and reducing sugar intake.
• Engage in regular exercise each week, a mixture of moderate exercise and more intense exercise and include strength exercises in your routine as well.

8. Will I experience the same symptoms as my mother, sister, or friends?

The symptoms of menopause vary from one woman to another, even in the same families. The age and rate of decline of ovary function differ tremendously so you’ll need to manage your menopause individually.

What worked for your mother or best friend may not work for you.

 9. How will I know if I’m going through menopause if I’ve had a hysterectomy?

If your uterus was surgically removed through a hysterectomy, you may not know you’re going through menopause unless you experience hot flushes.

This can also happen if you’ve had an endometrial ablation and your ovaries weren’t removed. Endometrial ablation is the removal of the lining of your uterus as treatment for heavy menstruation.

If you aren’t having any symptoms, a blood test can determine if your ovaries are still functioning. This test can be used to help doctors find out your hormone levels, which may be beneficial if you’re at risk of osteoporosis, so arrange a bone density test

10. Is hormone replacement a safe option for management of menopausal problems?

Some women do well on HRT, but others find the side effects such as weight gain or reaction to the synthetic progestins these contain make it unsuitable.

The benefits and risks vary depending and certainly women with a history or family risk of breast and other hormonal cancers are not advised to use oestrogen alone.

11. Are there other options for the management of menopausal symptoms?

Certainly there are well proven alternative regimes such as bioidentical hormones which have been in use worldwide for many years.

Herbs can also be helpful, but severe symptoms generally need hormones to get back in balance and changes to your lifestyle may help you relieve many of your symptoms.

Lifestyle changes may include:

• weight loss
• exercise
• avoidance of foods that aggravate symptoms
• dressing in light cotton clothing and wearing layers
• therapies such as acupuncture, meditation, homoeopathy, aromatherapy may also help