Menopause


Specialty of Obstetrics & gynaecology

What is the menopause?

The menopause refers to the process which naturally occurs in women as a result of ageing, meaning they no longer have periods and are unable to conceive. The menopause usually happens between the ages of 45 and 55, with the average age in the UK for women being 51. It is a new stage in a woman’s life and brings a number of both physical and emotional changes.

During the menopause, a woman’s oestrogen levels naturally decrease. This can cause menopausal symptoms, which vary from being mild to severe. Occasionally, women experience early (or premature) menopause, which happens before the age of 40.

What are the symptoms of the menopause?

Symptoms of the menopause can begin months, or years before periods finally cease, and typically go on for around four years after periods have stopped. Common symptoms include:

  • Hot flushes/flashes
  • Vaginal dryness
  • Problems sleeping
  • Feeling low
  • Anxiety
  • A loss of libido
  • Night sweats
  • Difficulty concentrating

What causes the menopause?

As we get older, our sex hormones change, with the ovaries not producing as much oestrogen as they once did. This means that eggs are no longer released from the ovaries. The menopause is a natural part of ageing, but it sometimes occurs earlier than expected, without clear cause.

In some cases, the menopause can be caused by medical treatments, such as treatment for breast cancer (e.g chemotherapy or radiotherapy). Surgery removing the ovaries can also cause menopause to happen, and medical conditions such as Down’s syndrome may be the reason behind early menopause.

How can menopause symptoms be treated?

Hormone replacement therapy (often called HRT) is one of the most effective treatments for menopause symptoms, and it is also able to maintain bone strength, thus helping in the prevention of osteoporosis. Hormone replacement therapy can be applied through hormonal coils, tablets, patches, and pessaries. Gels can also be used, for example in topical application to the vagina, to relieve dryness. However, before using HRT, it is important that the GP or gynaecologist explains the risks and benefits of the therapy, so the patient can make an informed decision.

Symptoms of the menopause can also be managed through lifestyle changes, e.g eating healthily, and exercising regularly. Being at a good level of fitness can help to relieve some of the symptoms of the menopause. Some types of therapy can also help women to deal with low mood, or anxiety.

Should I see a doctor?

If menopause symptoms occur before the age of 45, consult your GP and talk to them about the symptoms you are having. They may order a blood test to see if the symptoms are indeed related to the menopause. Blood tests can also be ordered for those under 40 if the doctor wishes to confirm a suspected early menopause after evaluating symptoms. 

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