What is the menopause?

The menopause is when your periods stop.

The medical definition is one year after the last period.

Your periods stop because your ovaries no longer produce eggs and as a result the levels of the hormones oestrogen, progesterone and testosterone produced by the ovaries fall.

The symptoms of the menopause are caused by the fluctuating and falling levels of these hormones, mainly the oestrogen.

Oestrogen affects the brain, bones, skin, heart, urinary system and genital area.

When does it happen?

The perimenopause is the time before the last period when you are still having periods but you get symptoms of the changing hormone levels.

Women’s periods vary greatly at this time, some finding they get closer together and heavier and others finding that they get further apart and lighter or are completely irregular.

Symptoms of the perimenopause can start months or years before the last period.

The average age for the menopause is 51 in the UK so the last period will be around 50.

The symptoms of oestrogen deficiency can start at about 45 years.

This describes a natural menopause. For some women surgery, radiotherapy, chemotherapy or certain genetic and autoimmune conditions cause an early menopause.

Symptoms

Oestrogen deficiency may lead to symptoms in some women that are hugely troublesome in their personal and working lives and may even lead to unemployment.
In addition long term health problems like heart disease, osteoporosis and dementia.
It can be helpful to track your symptoms using the Menopause Symptom Questionnaire or the Balance App

Diagnosis

For most women the alteration in the menstrual cycle and symptoms of the perimenopause will be all that is needed to make the diagnosis.

For women under 45 (early menopause) or indeed under 40 (premature menopause) further investigations may be needed.

Treatments

Replacing the hormones is the most effective way to treat the symptoms and to gain other health benefits, protecting against osteoporosis, heart disease, dementia, type 2 diabetes and bowel cancer.

For most women the benefits out way the risks but it is important to get individualised advice to assess your own risks.

It is also important to minimise your perimenopausal symptoms and maximize your health generally by making lifestyle changes including stopping smoking, reducing alcohol, eating a healthy diet and exercising regularly.