Menopause. You know the word. You know it can cause some nasty symptoms. But WTF actually is menopause?? This is my menopause 101 guide to give you an overview of what to expect and how to navigate it.
The National Institute for Health and Care Excellence (NICE) define menopause as:
“Menopause is when you stop having periods, which usually happens between the ages of 45 and 55. For a small number of women menopause occurs earlier. If it happens before you are 40 it’s called premature menopause (or premature ovarian insufficiency).”
The reason this happens is because, as you get older, your ovaries stop producing the hormone oestrogen which stops the release of eggs every month. Now this doesn’t happen overnight. For most women, it can take a number of years for things to slow down before your periods eventually stop. This period of time is called perimenopause.
What about the stages?
You may hear different terms used but essentially, as soon as you start having symptoms, you are perimenopausal. For technicality’s sake, menopause only occurs once the periods have completely stopped. It’s generally assumed that if you haven’t had a period for 12 months, you’ve reached menopause. Based on this logic, you are literally in menopause for 1 day. The day after, you become post-menopausal!
Anyway, tomayto, tomato, it’s all menopause for the most part so don’t get too hung up on terminology.
Do I need a diagnosis from my GP?
NICE guidelines recommend making a diagnosis based on symptoms alone in women over 45 years of age. This is because the main hormone they would measure is called follicle-stimulating hormone (FSH). FSH is a really important hormone as it helps control your menstrual cycle and stimulates the growth of eggs in the ovaries. FSH levels change through your cycle, with the highest levels happening just before an egg is released by the ovary (ovulation). So this can be an unreliable measure of where you are at with menopause given that the levels can literally change from one day to the next. It is essentially a snapshot of your FSH level and does not give any meaningful information regarding perimenopause.
If you intend to speak to your GP for support, it would be much more helpful to keep a symptom diary for at least 1 – 3 months. This will given them much better information to work with when considering treatment. You can grab a copy of my free symptom tracker booklet here 👇
What will peri/menopause be like?
You will hear wildly different accounts of women’s experiences of menopause too. For some, they seem to sail through it with no issues but for others it can seem like an absolute shit show.
Symptoms can hugely vary and there are literally dozens. Some women may have a few random ones which they don’t even necessarily attribute to menopause and they may just pass quickly. At the other end of the spectrum you have women who have multiple daily symptoms that can really impact their ability to undertake a lot of their usual day to day activities such as work, socialising, exercising etc.
Forget the horror stories you hear because that may not be the experience you have. I mean, the women not having symptoms aren’t broadcasting all over their social media that they’re sailing through menopause are they?? Obvs you’re mainly going to hear about the crap side.
How come there are so many symptoms?
Your ovaries actually start decreasing in oestrogen and progesterone hormones towards the end of your 30’s. By the time you get into your 40’s, the levels fluctuate even more which leads to changes in your menstrual cycle. It can also affect other things such as your mood which can lead to loads of symptoms such as depression, anxiety, low concentration and focus, feeling tearful, not sleeping, mood swings, irritability and low motivation. The tissues in your vagina also lose elasticity during menopause. This can lead to incontinence. The tissues can also become dry which can cause pain and bleeding during sex. Decreased sensation in there can also reduce your libido (I hate that word 🤢). You might also experience a dry mouth, eyes, skin or hair.
Essentially, the symptoms you will experience is your body adapting to the fluctuating and decreasing levels of hormones. You can find out more about the more common symptoms in this post. (There are 30+!)
What about work?
This can be a really difficult aspect of life to manage for many women. The connotations alone regarding menopause are often negative or it’s not taken seriously or seen as a health condition. My experience as an occupational health nurse has shown me that menopausal women often have much bigger difficulties and challenges at work than many women with chronic illnesses or disabilities. Yet those women get taken much more seriously and supported without question. I truly believe that this is just down to lack of education and awareness though and the only way to change this is to talk about it more and bring it to the awareness of employers.
It can be difficult to decide whether or not to tell your employer. For a lot of women, this is because they don’t regard menopause as an illness or disability. I would urge you to challenge your perception and to consider disclosing it to your employer if you are having difficulty undertaking any of your tasks, duties or responsibilities at work because of menopause symptoms. I have some posts about menopause and work that you may find useful. One of them is about whether you should tell your employer and can be found here.
There is often a lot of simple support your employer can put in place for you regardless of your job or work environment but they can’t be expected to do this if they don’t know! You can find out more about simple workplace adjustments in this post. If you’re not confident that your manager would know what to do, there’s nothing wrong with doing your own research and making suggestions.
Do I just have to put up with menopause?
Fuck no! There is loads you can do to help with symptoms. Some stuff you can do yourself by making lifestyle changes, other support can come in the form of medication.
Now for the boring part…..you’ve had it rammed down your neck for years that not drinking, not smoking, eating a healthy diet and exercising will keep you healthy. And sadly, that applies in menopause too. Making some changes can have a huge impact on your symptoms so it’s definitely worth considering. It’s not about starving yourself and going to the gym everyday but starting with small changes like reducing triggers such as caffeine or spicy foods, reducing your alcohol consumption, not eating too close to bedtime or going for a walk every day can be a good start. Small changes lead to bigger ones and they all add up.
Some of these lifestyle changes will almost certainly help with your sleeping pattern, help stop weight gain and reduce joint and muscle pain amongst other things.
A good example of lifestyle changes might be with regard to hot flushes. You can often improve these by reducing your alcohol and caffeine intake, wearing light loose layers, sipping cool drinks regularly and making ice packs your best friend. There is also really good evidence that cognitive behavioural therapy (CBT) can help with hot flushes. This post goes into more detail and provides tips on how to manage them.
Medications can also be helpful. GP’s can prescribe a number of things to relieve symptoms although it won’t make menopause go away!
An example of simple medications or preparations is for symptoms of a dry vagina. There are lots of lubricants and moisturisers that can improve your general comfort as well as your sex life. This post goes into more detail and gives advice on treatment options as well as self-help support.
There are also a number of antidepressant and anxiety drugs which can help with your symptoms of low mood or anxiety. Many also act as a mild sedative which can help with your sleep. Some are even helpful in treating hot flushes.
Eye drops can be used for dry eyes and painkillers such as ibuprofen and paracetamol can help with joint and muscle pain as well as topical anti-inflammatories.
Many women use different supplements such as magnesium, black cohosh, evening primrose oil and vitamins amongst others. There isn’t much scientific evidence to support their effectiveness but, anecdotally, so many women benefit from them so I’m a big advocate for trying things to see what works for you.
Another option is HRT. This can be a godsend for many women and it’s worth exploring if it’s right for you. It’s had a lot of controversy and is seen as a complex issue but in reality it’s not! You can speak to your GP and I’ve also written a full guide to HRT which you can read here. GP knowledge and confidence around HRT does vary wildly so you may come up against obstacles. If this is the case for you, please get in touch for advice.
As you can see, menopause is vastly different for every women in terms of how it might affect you. If you’re struggling or need some guidance, please feel free to contact me through the contact page and I’m happy to chat through what support I can offer and see if it would be helpful for you.
I also advise you browse my blog to read other posts and educate yourself as much as possible on what is happening to body. This is the best way for you to know what is best for you and to help you to advocate for treatment on your own behalf if needed.
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