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Understanding the menopause: its signs, symptoms and stages

Mood swings, hot flushes, irregular periods, sleep problems?

Mood swings, hot flushes, irregular periods, sleep problems? You could be suffering the classic symptoms of the menopause. Luckily, help is available.

No two women’s experience is the same and being aware and able to recognise that your symptoms might be down to fluctuating hormones is the first step to managing them.

For many women, it can be difficult to know if you are going through menopause, especially if you already have irregular periods. The time that leads up to menopause – which can be months or years – is known as perimenopause.

For many women, perimenopause and Menopause can be a life changing and isolating experience. But by raising awareness and education we hope to support women in joining the dots as they understand the connection between menopause symptoms and midlife hormone fluctuations.

I have a question about treatment for menopause symptoms

Mr Ahmed Khalil, Consultant Gynaecologist, discusses the menopause - what the symptoms are and how to access treatment at Benenden Hospital (8 videos).

Why does menopause occur?

Oestrogen is a hormone mainly produced in the ovaries and is responsible for controlling many functions in the body including the production of an egg each month (ovulation). As a woman gets older, their store of eggs in the ovaries naturally declines. Menopause occurs when your ovaries stop producing eggs and your body’s oestrogen levels fall. As a result, there are many changes that can occur to the body including no longer having periods and the symptoms we associate with the menopause.

The symptoms associated with menopause tend to be a result of hormone imbalance and lack of oestrogen.

The menopause explained

The menopause happens when your menstrual period stops permanently, or when you’re no longer able to become pregnant naturally. It’s a fascinating fact that only three species of female live beyond their reproductive potential – humans, killer whales and pilot whales.

What’s the official definition of menopause?

The definition of menopause is when your periods have stopped for more than a year, as it’s possible for them to stop for a while and then start again. Ovarian function declines gradually, so many symptoms start before your periods have completely stopped.

But why do women have problems? Isn’t the menopause just nature taking its course?

As women are living longer, they’re spending more time in the post-reproductive phase. As a result, women are more likely to suffer the consequences of loss of ovarian function including menopausal symptoms such as thinning of the skin and bones.

Can men have symptoms of menopause?

It’s not just women that suffer in their late forties and early fifties – so do men! There’s growing evidence that the andropause, or the manopause, does exist. Around this age men also experience a hormonal shift which can cause physical, emotional and cognitive changes.

When will I go through the stages of menopause?

It’s impossible to say exactly when you’ll go through the stages of menopause. Although the age of girls starting their periods has got steadily younger since the start of the last century, the age of menopause has remained remarkably consistent.

If you started your period at an early age, it’s likely that you have a greater number of egg precursors in the ovaries. As a result, you’ll tend to menstruate for longer and may go through the menopause later than most.

The average age to start is 51, and the stages of menopause can look like this:

  • Perimenopause: Periods become irregular but haven’t stopped. The average age to enter the perimenopause is 47 and, while you may experience symptoms, you can still get pregnant
  • Menopause: Menopause is generally classed as the year after you have your last period. Symptoms such as mood swings and sleep problems are common during this time
  • Postmenopause: If you’ve not had a period for a year, you’re past the menopause. Fortunately, symptoms of the menopause should reduce at this point for most women

Signs and symptoms of menopause

Menopause symptoms typically include hot flushes (which some women describe as “tropical moments”), night sweats, poor sleep, loss of concentration, mental health issues (also described as menopause “mood swings”) and sometimes joint pain. Other signs can include:

  • Vaginal dryness and thinning of the vaginal tissues which can cause burning, vulvar itching and painful intercourse. This is known as vaginal atrophy and is caused by a reduction in the amount of oestrogen produced
  • A loss of skin elasticity, where the skin becomes drier due to a reduction in collagen
  • A need to empty the bladder more frequently or urinary incontinence
  • Long-term thinning of the bones resulting in osteoporosis (brittle bones) and osteopenia (when the bone density is reduced)
  • Weight gain due to a slowed metabolism

The good news is that you don’t need to suffer in silence. There’s plenty of help available.

Treating menopause symptoms with HRT

HRT had a lot of bad press back in 2002, after a major study suggested links with increased risk of breast cancer and stroke. However, updated analysis of the original data, and subsequent studies, have shown that when an appropriate HRT is used the increased risks of serious problems, such as blood clots and breast cancer, are small. The benefits of HRT, often used as a menopause treatment, are generally felt to outweigh the risks.

Private gynaecology treatments and surgery for menopause symptoms

Our female private GPs can discuss all aspects of menstrual health, HRT, osteoporosis and bone health as well as incontinence. Depending on the severity of your symptoms, they may be able to treat you or refer you to one of our Consultant Gynaecologists.

We offer a range of menopause treatments, from the Mirena coil which can help with heavy and irregular bleeding as the menopause approaches to MonaLisa Touch®, a non-surgical laser treatment for the symptoms of vaginal atrophy.

Our specialists are experts in women’s health issues and can help you choose the menopause treatment that’s best for your needs and lifestyle.

‘Natural’ treatments for menopause symptoms

There are also non-pharmacological or natural ways to help tackle menopause symptoms, which some women say work for them. Here are a few popular menopause treatments:

Soya products are rich in isoflavones which are phytoestrogens. Phytoestrogens are plant-based foods that can have an oestrogen-like effect on the body. Aside from soybeans, soy can be found in products such as tofu and soya milk

Red clover and black cohosh, available from health food shops, are also said to help, although to date there is no hard evidence to support this

There’s also bio-identical HRT which is tailored to the individual’s precise needs, but robust scientific evidence is rather limited

Where can I find out more about treatment for the symptoms of menopause?

To find out more about the menopause and the gynaecology treatments we offer at our comfortable and discreet private hospital in the heart in the Wealden countryside, contact our Private Patient Team via Livechat, by completing our online enquiry form or by calling us on 01580 363158.

Published on 20 August 2024