The Menopause

The word menopause literally means "the end of menstruation". It is a natural part of the ageing process and every woman who has periods will go through the menopause at some time in her life, usually between the ages of 42 and 58.

The experience of the menopause can vary greatly from one woman to another. For some, it is completely trouble-free. In others the physical and psychological effects of the menopause may be troublesome and require medical help to overcome them.

The menopause happens when the ovaries stop responding to certain hormones from the brain, and so eggs stop maturing regularly. There is a drop in the levels of oestrogen and progesterone (the two female sex hormones produced by the ovaries). It is this fall in hormone levels that cause symptoms of menopause.

The menopause usually happens gradually. Most women find that their monthly cycle and blood flow become irregular during the few years before their last period. Bleeding may even stop for a few months and then start again. A woman is considered to be through the menopause when a year has passed since her last period.

It's not known why the menopause starts earlier in some women than others, although inherited factors are thought to play a part. Women who smoke go through the menopause an average of two years early. Surgery that removes the ovaries causes an immediate menopause. When the menopause happens before the age of 40 it is considered to be a premature menopause, and usually requires medical treatment.

Symptoms

Although some women have no symptoms of the menopause other than the ending of their periods, most women have some other symptoms. Many of these improve with time:

• Hot flushes and night sweats
• Fatigue
• Emotional changes such as mood swings or a change in sexual interest
• Sleep disturbances (insomnia)
• Drier skin and hair
• Increased growth of facial and body hair
• Aches and pains in the joints
• Headaches
• Palpitations (rapid, irregular heart beats)
• Generalised itching

Other symptoms can be long-term or get worse with time:

• Vaginal changes – dryness, pain during intercourse, increased risk of infections
• Urinary symptoms – inability to control urination (incontinence), increased frequency of urinary infections

Research has shown that women who have close friends and family, or who are in full-time work, appear to have fewer symptoms. In addition, how a woman feels about reaching the menopause can have an impact on her experience. Many women see the menopause as a positive event that frees them from having periods and the risk of unwanted pregnancy.

Health risks and the menopause: The reduced oestrogen levels that happen during the menopause can lead to long-term health effects.

• Loss of bone density: the bones may become brittle and break more easily (a condition called osteoporosis)
• Heart disease, such as atherosclerosis. Fats may be deposited in the blood vessels, which increase the risk of heart attacks and strokes
• Increased blood pressure
• Weight gain, which increases the risk of cardiovascular problems
• Increased cholesterol levels
• Pelvic floor weakness: the pelvic muscles and joints become weaker, which can lead to prolapse of the womb (when the womb drops down into the vagina)

Treatment options: Lifestyle changes and medical treatment can help to reduce the symptoms and health risks of menopause. Treatment will vary from one woman to another, depending on her experience.

Useful Websites

www.womens-health-concern.org

www.menopausematters.co.uk

www.nhs.uk/conditions/menopause

Guidance on menopause and the workplace for managers and staff