Menopause

Menopause is a stage of life when menstrual cycles stop. At this point in life, women stop having periods and their hormones change. This can affect your life and the way you feel.

There are three stages of menopause:

• Perimenopause is the period before menopause when you start having symptoms. Your periods often become irregular.
• Menopause starts when you haven’t had your period for a year.
• Postmenopause is when you haven’t had a period for at least a year.¹

Menopause is a natural process, but it can cause a variety of symptoms. If you’re struggling with them, there are treatments and lifestyle changes that can help you.

Why does menopause happen?

Menopause is a natural life stage, caused by changing hormone levels. First your level of oestrogen drops. The lack of oestrogen makes follicle stimulating hormone (FSH) and the luteinizing hormone (LH) increase.²

When these hormone changes start, you enter perimenopause. Your periods become irregular before they stop altogether. You may also experience other symptoms due to hormone changes, both physical and emotional.

Menopause can cause changes to the way you feel. Some women who go through menopause find that they experience low mood, mood swings or anxiety.³

It can also affect your concentration and memory. Some women experience disturbances in their sleep patterns. If you struggle to get enough sleep, it can worsen any other symptoms you have.³

If you’re struggling with changes to your mood, concentration or thinking, talk to your GP. Talking therapy or medication such as anti-depressants may help.

Does menopause cause complications?

Menopause doesn’t affect everyone in the same way. Some people will have mild symptoms that ease quickly. Others will have more severe symptoms that last for months or even years.³

Because oestrogen helps keep your bones strong, menopause can put you at a higher risk of developing osteoporosis.⁴ This is a condition where your bones become weaker and more prone to breaking.

A lack of oestrogen can also cause vaginal atrophy, which is when the tissues in your vagina become thinner and more prone to damage. This can cause problems like frequent urinary tract infections (UTIs), and painful sex.⁵

Most women experience menopause between the ages of 45 and 55, with the average age of menopause in the UK being 51.¹

Menopause symptoms can vary in how long they last. Some people only experience symptoms for months, while for others they can persist for up to 15 years.⁵

Some women experience symptoms before the age of 45. This is known as early menopause. Early menopause symptoms can be treated with the combined pill or hormone replacement treatment (HRT).⁷

Going through menopause early will affect your fertility, but you have options if you want to be a parent. You may want to consider IVF using donated eggs, surrogacy or adoption.⁷

Do men experience menopause?

While men also experience hormonal changes over the course of their lives, these hormone changes are not the same as menopause. These changes can cause issues for some men such as a lower sex drive, mood problems, lower muscle mass and erectile dysfunction.⁸

Testosterone production drops when men reach their 30s or 40s, but it does so at a steady rate of around 1% a year, rather than suddenly as for women. So any symptoms develop gradually.⁸

If you are worried about your hormone levels or another aspect of your health, you should speak to your doctor.

Menopause cannot be reversed. Your hormone levels will never naturally return to the same levels as before menopause. But many of the symptoms caused by menopause can be managed.

Symptoms of menopause are usually treated with HRT. There are different types of HRT. If you have a uterus, you’ll need to take a type of HRT with progesterone as well as oestrogen in it. There are also lots of options for how you can use HRT, like patches, pills, sprays, gels and implants.⁹

There are other options for specific symptoms of menopause. Testosterone gel or cream can be used to help raise your sex drive and improve your mood and concentration. Topical oestrogen comes as a cream, gel or tablet you put into your vagina. This can help prevent vaginal atrophy and UTIs.⁹

If you want to manage symptoms like hot flushes, there is medication like clonidine and gabapentin that can help. For mood problems caused by menopause, you can talk to your GP about anti-depressants.⁹

Can menopause symptoms be managed without medication?

If you’re struggling with low mood because of menopause, you may want to talk to a counsellor. These are professionals who are trained to listen. You may also want to reach out to friends or relatives who have experienced the same thing.

Eating well and exercising can help ease your symptoms and protect you against complications of menopause like osteoporosis. Wearing loose-fitting clothing and taking cool showers can help manage hot flushes.¹⁰

Vaginal moisturisers and lubricants are available at pharmacies. They can help you with the discomfort that can come with vaginal dryness and make it easier to have sex.¹⁰