Anxiety, sleeplessness, memory fog, lack of motivation and emotional upheaval… they are all linked to the menopause
We women all go through it at some point, but there is still a reluctance to talk about it. However, seeking advice early can really help when it comes to dealing with the symptoms of the menopause. So here is our guide to everything you wanted to know about it… but were too afraid to ask.
What is the menopause?
The menopause occurs after your periods stop. When your ovaries stop producing eggs, your oestrogen levels fall. However, the symptoms can be there up to five years beforehand, as the oestrogen gradually declines. This is known as perimenopause.
Among its many functions, oestrogen aids cognition and memory. It also improves collagen in the skin, maintains bone density and keeps blood vessels clear of the sticky deposits that can lead to cardiovascular disease.
It maintains the pH balance in the vagina, reducing the likelihood of infections, prevents the vaginal wall from thinning and keeps the area moist. Therefore, a decline in oestrogen can wreak mental and physical havoc, with symptoms often worsening over time.
GP and menopause specialist Dr Louise Newson says: ‘The most common psychological symptoms are a loss of self-esteem and confidence, anxiety and panic attacks. Lots of people have depressive symptoms but they’re not actually depressed. They’re short-tempered and irrational. The psychological symptoms are the ones that floor people — and they don’t realise they’re related to the menopause.’
The most common physical symptoms are hot flushes and night sweats. Some women have them occasionally, while others have them every few minutes.
Other women get dizzy episodes or palpitations. Then there are the dry eyes, dry skin, lank hair and brittle nails. Even people who don’t have night sweats can have patchy sleep. And some suffer from fatigue, even if they’re sleeping well.
Other physical effects include not being able to hold on to urine, and vaginal dryness.
HRT — what it does
Hormone replacement therapy (HRT) replaces oestrogen and progesterone. It does not postpone the menopause — it simply replaces the depleted hormones. Progesterone is taken for two of every four weeks, or daily if you no longer have periods. Oestrogen is taken daily.
‘The earlier you take HRT, the better,’ says Dr Newson. ‘Take it when you’re perimenopausal, rather than waiting till you’re postmenopausal. Even if it’s just one symptom — say, hot flushes, — interfering with your quality of life, it might benefit you.’
Alternatives to HRT
There is a range of alternative options available, including red clover and St John’s wort. However, in many cases there is limited evidence to support their effectiveness, and some are associated with health risks, especially if you have a history of breast cancer or are taking other prescribed medications.
Diet and exercise
There is evidence that lifestyle changes such as quitting smoking, losing weight and exercising regularly can improve some symptoms of the menopause.Cutting down on caffeine, alcohol and sugary and processed foods can also help, as does eating lots of fruit and vegetables.
Edited by Zoe Pinks
For more information, see Dr Louise Newson’s website menopausedoctor.co.uk
The benefits of HRT
Oestrogen, especially if taken before 60, reduces your risk of osteoporosis. The hormone is essential for bone health — you have a massive bone density loss when you go through the change.
Dr Newson, who began taking HRT aged 46, says: ‘When I think back to shouting at my husband for no reason, and feeling tired the whole time, the change is amazing.
‘I have more energy, my mood is better, I can concentrate. My sleep is great. I used to toss and turn, in a terrible sweat most of the night. I no longer have that worn-down feeling.’
The risks of HRT
According to statistics, 90 per cent of women avoid HRT — some for medical reasons, others because they believe it’s not safe. Evidence suggests that HRT does not cause cancer, although in rare cases some types may accelerate the growth of breast cancer cells already present.