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Understanding the menopause: why it happens and why it affects people differently

Escrito por: Mr Arvind Vashisht
Publicado: | Actualizado: 02/03/2020
Editado por: Nicholas Howley

Why does the menopause happen, and why does it seem to affect people differently? We spoke to Mr Arvind Vashisht, a leading consultant gynaecologist based in London.

What exactly is the menopause?

People often talk about the menopause as a period in their life or a process that they go through. But in medical terms the menopause itself is actually a particular moment in time. You are said to have “reached” the menopause when it has been exactly one year since your last period.

You can have menopausal symptoms several years before this point. This broader period of time we call the “perimenopause” and many women suffer symptoms without a diagnosis.

Why does the menopause happen?

In the vast majority of women, the menopause is a natural reduction in activity of the ovaries that occurs with age. The average age of the menopause is 50-51 years but it’s quite common for your periods to stop a couple of years earlier or later than this.

With time the ovaries stop producing oestrogen, disrupting your periods. It’s this drop in your oestrogen levels that also causes the classic symptoms of the menopause such as hot flushes and night sweats.

If your periods stop before the age of 40, we call this “early menopause”. Such an early menopause, or premature ovarian insufficiency, is uncommon – it only happens to about 1% of women. For most women with early menopause, it is due to a specific event such as surgery, drugs, or radiotherapy. In this group of women it is particularly important to take treatment for long term disease prevention.

Why do symptoms vary from person to person?

Every woman will experience the menopause differently. The most well-known symptoms are night sweats and hot flushes, but these don’t affect everyone – and some women will go through the whole process without any significant symptoms at all. Less well-known symptoms can include mood changes, joint pains, vaginal dryness, and sexual difficulties.

We know that there are geographical variations in the reports of symptoms such as hot flushes or sweats, but whether that's due to dietary or cultural factors or simply in terms of reporting them, is difficult to know.

We also know that other medical conditions, and lifestyle factors will influence symptoms and conditions associated with the menopause. For example, if you have a very low body mass index (BMI) or if you do not exercise, you’re more susceptible to diseases such as osteoporosis, which can also be exacerbated by a drop in oestrogen.

Still, it’s possible for two people in the same place with the same medical history to have completely different symptoms. We ultimately don’t know why it varies so much from person to person.

Finally, it’s important to recognise that the symptoms may actually be indicative of other problems or a result of medication.

The good news is that there is treatment available to tackle the symptoms of menopause – so if your symptoms are affecting your day-to-day life, it’s worth a visit to a gynaecologist.

Por Mr Arvind Vashisht
Ginecología y Obstetricia

El Sr. Arvind Vashisht es un ginecólogo líder altamente respetado con sede en Londres . Es el líder clínico de ginecología en el University College Hospital y es profesor honorario asociado en el University College de Londres. Es el Presidente de los Centros de Endometriosis de la Sociedad Británica de Endoscopia Ginecológica (BSGE) y miembro del comité de Gobernanza de la Sociedad Británica de Uroginecología (BSUG). Es miembro del consejo de la Royal Society of Medicine, Obstetrics and Gynecology section.

Se especializa en el tratamiento de mujeres con dolor pélvico y endometriosis , problemas posparto, trastornos menstruales y hormonales y problemas del suelo pélvico, como prolapso y síntomas de vejiga.

El Sr. Vashisht tiene un interés particular en la cirugía laparoscópica y vaginal, y dirige talleres de cirugía para consultores y aprendices que demuestran cirugía y técnicas complejas. Es co-director de un programa nacional de capacitación para la enseñanza de cirugía de acceso mínimo avanzado, y ha escrito un plan de estudios actualizado para el programa de capacitación para cirugía laparoscópica avanzada en el Reino Unido. Practica en clínicas en el University College Hospital y el King Edward VII's Hospital. Además de los servicios nacionales especializados de referencia, dirige clínicas de ginecología general.

Se dedica a transmitir su conocimiento experto y ha ocupado diversos puestos educativos. Tiene intereses de investigación activos y supervisa a varios estudiantes que completan estudios superiores en ginecología. Ha publicado en numerosas revistas revisadas por pares.

El Sr. Vashisht da conferencias a nivel nacional e internacional y es un experto invitado para conferencias.

Escribe peritaje médico experto en informes médico-legales en sus áreas de especialización.

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