The menopause: let’s start talking about it.

We’ve likely all heard of the menopause, a section of almost every woman's life that usually happens much later on in life, yet despite the fact that around half of the world’s population will be affected by the menopause, why is it that there is such scarce awareness about it? In fact, in a UCL-led study conducted in 2023, it was discovered that 49% of the postmenopausal women that they interviewed did not feel informed about the menopause beforehand.

The symptoms of the menopause are a spectrum, and many women experience difficult and at times detrimental symptoms that affect their everyday life, as you will later discover in this article. Thus, the main question that will be discussed is as follows: Should we as a society become more educated on the menopause?

WHAT IS THE MENOPAUSE?

As defined by the NHS, the menopause is when your periods stop due to lower hormone levels. When the menopause begins, both the hormones oestrogen and progesterone decrease dramatically simultaneously, and this drop in oestrogen is the cause of most of the symptoms of the menopause. Oestrogen is a vitally important hormone in the body; not only is it required in the menstrual cycle and pregnancy, but it is also required for good bone strength and many other internal functions. A drop in oestrogen is also a cause of the death of dopamine cells within the brain, which can account for the many mood changes of women who are experiencing the menopause. 

Menopause is caused by both the loss of ovarian follicle function and the decline in oestrogen and the usual age that women experience it is between 45 and 55 years old, though it can occur earlier. It is usually found to occur earlier in women who experienced their first periods at an earlier age, or in those who have never given birth. There are many stages to the menopause: the perimenopause is the beginning stage in which periods can become irregular and symptoms such as hot flushes show, but your period has not yet stopped completely. Then the next stage is the menopause when an individual has not experienced a period for a year, followed by the post-menopause when an individual has again not experienced a period for another consecutive year. 

SYMPTOMS

Menopausal symptoms vary from woman to woman, while also varying in extremity. As well as this, throughout the menopause symptoms can change within the woman herself - they don’t purely differ between women - and some symptoms are more common during certain stages within the menopause. Following on from this, most women will begin to be affected by symptoms during the perimenopausal stage (the time before a woman reaches menopause), which often is a change in the normal patterns of their period. However, while symptoms do differ, there are a group of general symptoms that are most commonly seen in women throughout the entirety of the menopause. These symptoms can be split into two categories: mental health symptoms and physical symptoms.

Some mental health symptoms include…

. Changes in mood, particularly low mood

. Increased anxiety

. Mood swings

. Low self-esteem

. Memory/concentration fog

Some physical symptoms include…

. Hot flushes

. Difficulty sleeping (may be due to night sweats)

. Heart palpitations

. Headaches/migraines

. Muscle aches and joint pain

. Changes in body shape, including weight gain

. Skin changes, such as dry and itchy skin

. Reduced sex drive

. Vaginal dryness, pain, itching or discomfort (particularly during sex)

. Recurrent UTIs

. Sensitive teeth, gums or other mouth problems

Overall, the length of time these symptoms continue depends from woman to woman - this makes it extremely difficult for women to gather specific information about how menopause will affect them. The symptoms can last only a few months but can stretch years, even decades; however the symptoms experienced can and likely will change over this period. Unfortunately, these symptoms aren’t specific to only perimenopause, the symptoms can continue even after a woman’s period stops.

TREATMENTS AND WAYS TO COPE

HRT (hormone replacement therapy) involves using oestrogen to replace the body’s own levels throughout the menopause. This is essential as oestrogen is not purely necessary in a woman’s menstrual cycle but is also needed to maintain strength in bones to prevent osteoporosis (weakening of the bones). HRT treatment only became available for women in 1965 and before then it had only recently been developed. Due to this, there was and still is a lack of research into the beneficial and negative impacts of using this type of treatment, especially following the study completed in 2002 that found ‘a small increased risk of breast cancer, heart disease, stroke and blood clots’. Despite this, HRT treatment is the most commonly utilised treatment of the present day. Although, a complete cure for menopause has not yet been developed and is unlikely to be developed any time soon due to the lack of research being completed. 

The most commonly used HRT treatments are oestrogen-only HRT and oestrogen and progesterone HRT (combined HRT); they both serve different purposes and can be taken in different ways.

Oestrogen only HRT can be taken in the form of…

. Patches

. Gel/spray (applied to skin)

. Implants

. Tablets, which are taken orally

Often oestrogen-only HRT treatments are provided to women who have had a hysterectomy (their womb removed) as without the womb there is no need for progesterone.

However, those who haven’t had a hysterectomy are likely to use combined HRT since they will need to protect their uterine lining from the effects of oestrogen, such as thickening the uterine lining. 

The combined HRT treatment is often taken in the forms of…

. Patches

. IUS (intrauterine system/coil)

. Tablets

Alongside these treatments, some people may be offered doses of testosterone if their sex drive doesn’t improve from HRT treatments. This can occur, since as everything else surrounding menopause, most aspects differ from woman to woman. This also causes the doses within HRT to be different per woman since some need a higher dosage and others need a lower dosage, therefore it is dependent on the individual.

Overall, research suggests so far that while there can be risks to taking HRT treatments, particularly if you have suffered from a serious illness or disease such as cancer, the benefits outweigh the risks. However, for some the risks are still too high. In these cases they may use alternate medicinal methods, although others may use more generalised techniques to aid them and help them cope.

These include…

. Resting well and maintaining a regular sleep routine (can be made difficult, particularly due to night sweats)

. Eating a healthy diet

. Consuming calcium-rich food (prevents bones from becoming too weak due to drop in oestrogen levels)

. Exercising regularly

. Completing relaxing things - this can depend on the person but often individuals partake in yoga, tai chi and meditation

. Talking to others going through the menopause

. Speaking to a doctor (this can be generally but especially before taking herbal supplements)

HOW CAN WE BECOME MORE AWARE?

It’s clear from countless studies that there is not enough awareness about the menopause, despite the fact that women experience it worldwide. With so many women struggling, and most of the time in silence, it is important that we become more open and conscientious towards women who are experiencing it as it can be a very scary time for not just the individual involved, but also for both family and friends. Symptoms can show in varying ways, from small things like having an off day to not being able to have a good night's sleep for months. 

Therefore, what can we do?

Research is the most important thing, as well as finding stories from women who have experienced the menopause to become more educated about the varying ways it can show. Furthermore, be patient with women who are experiencing the menopause and don’t be scared to reach out.

Belly laughs with bio :)

What did the woman call the frozen postman?

The postmenopause

So, question of the day:

Should we as a society become more educated on the menopause?