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Could you be experiencing menopause?

Happy woman standing in field
Learn what happens during the transition to menopause and how you can manage any potential menopausal symptoms in our article.
Menopause is a normal part of the ageing process that marks the end of your menstrual cycle. However, while you’re only said to be ‘in menopause’ when your periods have stopped for 12 months consecutively, the transition towards this can take some time.1-4

Everyone experiences menopause differently, but some of the early signs and symptoms will typically include irregular periods, mood changes, hot flushes, and night sweats.1,2

So if you’re currently experiencing these symptoms, this could be because your body is undergoing the hormonal changes that typically mark the beginning of menopause.1

What is menopause?

Menopause simply means your last menstrual period.1

While the timing and symptoms that you experience will affect everyone differently, anyone who has a period will eventually experience menopause, often between the ages of 45 and 55.1 In the UK, for example, the average age of menopause is 51.1

Menopause might occur after a medical treatment such as an oophorectomy (surgery to remove the ovaries) or hysterectomy (surgery to remove the uterus), or as a result of chemotherapy.3

For most women, however, menopause is an entirely natural transition triggered by hormonal changes.1,3

During menopause, your ovaries stop releasing eggs, and levels of oestrogen and progesterone start to drop. It’s these low levels of oestrogen that could then go on to cause many of the common menopause symptoms.4

What are the symptoms of menopause?

Menopause symptoms can be wide-ranging, affecting you both physically and mentally. However, they affect everyone differently.1,4

Some people find that menopause symptoms can be highly disruptive, for instance, while others may be less affected. You can also experience several symptoms, few or none at all.5

Some of the most common symptoms of menopause include:1,2
  • irregular periods
  • hot flushes
  • night sweats
  • difficulty sleeping
  • low mood problems with memory or concentration (known as brain fog)
  • anxiety
  • vaginal dryness
  • painful sex, often caused by a dry or thinning vagina6
  • changes in libido
  • thinning hair
  • muscle aches and joint pains
  • changes in body shape or weight gain
  • headaches and migraines

What are the stages of menopause?

Although we often use the term ‘menopause’ to refer to the entire journey from start to finish, menopause includes three distinct stages: perimenopause, menopause and postmenopause.1

Let’s take a look at all of these in more detail.

Perimenopause

Otherwise known as the menopause transition, perimenopause covers the start of menopause symptoms and ends after you have your last period.1

There are no set times when it comes to perimenopause. It commonly starts during your mid-to late-forties.1,5 The duration of perimenopause also varies, with most people experiencing it for three to four years.

Often, the first sign of perimenopause is irregular periods caused by declining oestrogen levels. When this happens, you might find that your periods are heavier or lighter than usual, more or less frequent or accompanied by more severe PMS symptoms.1,4,7

As perimenopause progresses, the symptoms are the same as menopause. It’s at this time that you may start noticing symptoms that affect your mental health, including low moodanxiety, and brain fog, as well as vasomotor symptoms like hot flushes and night sweats.8

When you enter the latter stages of perimenopause, you might start to experience symptoms like vaginal dryness or pain when having sex.5

Menopause

As mentioned, menopause specifically refers to your ‘last menstrual period’. Although the term is used more generally, medically, you’ve reached menopause 12 months after your last period.1,3

The average age of menopause varies from person to person. Reaching menopause before the age of 45 is called ‘early menopause’, for example, which affects about one in 20 people. Whereas menopause before the age of 40 is called ‘premature menopause’ or premature ovarian insufficiency (POI) and only affects one in 100 people.9

Many factors affect the age at which you might naturally reach menopause.10

Genetics can appear to play a role. For example, if your mother had an early menopause, you may have a higher chance of experiencing an early menopause too.5,11

However, there are several other influencing factors thought to be at play, including the age you got your first period, whether you smoke, how much you drink, how much you exercise, the number of children you’ve had, and your use of oral contraception.10,12

Postmenopause

Postmenopause describes the time after you have reached menopause (12 months after your last period). You’ll no longer have periods or be able to get pregnant during this phase.1

You may even find that your menopause symptoms diminish or disappear entirely. However, it’s not unusual that you may continue to experience lingering symptoms as a result of low hormone levels.7

Decreased levels of oestrogen during the postmenopause stage are associated with new health challenges, including an increased risk of cardiovascular disease and osteoporosis.4,13 You may also continue to experience symptoms like vaginal dryness and decreased libido, and be at an increased risk of urinary tract infections (UTIs).14,15,16

Help with managing menopause symptoms

Menopause symptoms can be highly disruptive to your life. So if you think you might be entering menopause, consider making some healthy lifestyle changes to help ease the transition.

Here are some of our top tips for managing menopause:
  • focus on your diet: nutrition can impact your hormonal balance, so focus on fruits, vegetables, legumes, and whole grains to support a healthy balance. Avoid processed foods, alcohol, and caffeine, which can exacerbate your symptoms17,18
  • make exercise a part of your daily routine: exercise can reduce your risk of cardiovascular disease, improve your mood and help manage hot flushes18,19,20
  • prioritise a good sleep routine: getting plenty of rest can help boost your moods.18,21, Wear light, breathable clothing at night to minimise night sweats and avoid triggers like hot drinks, smoking, caffeine, alcohol, and spicy foods18,22
  • keep your bones healthy: be sure to incorporate calcium-rich foods in your diet to protect against weak bones18
  • ease vaginal dryness: consider using a lubricant to ease vaginal dryness and prevent discomfort during sexual intercourse23
If sleep disruption and mood changes affect your quality of life and healthy lifestyle changes are not enough, make sure to speak to your GP about any additional treatments or gentle interventions they might recommend.

The final say

Reaching menopause is an entirely normal part of the ageing process and officially happens 12 months after your last period.1

However, the phase leading up to this – known as perimenopause – can be a particularly turbulent time, characterised by a wide range of physical and emotional symptoms.1,4

While it’s not possible to predict the onset or duration of menopause, adopting a healthy lifestyle throughout this transitional period can enhance your resilience to any symptoms and optimise your overall health as you enter into menopause, and beyond.18

However, if you notice that any of your symptoms are causing you particular pain, or impacting your ability to perform daily activities, make sure to consult your GP.

Sources

  1. NHS Inform. Menopause [Internet]. [cited 2024 Feb 23]. Available from: https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/menopause/.
  2. NHS. Symptoms - Menopause [Internet]. [2024 Feb 23]. Available from: https://www.nhs.uk/conditions/menopause/symptoms/.
  3. NHS. Overview - Menopause [Internet]. [2024 Feb 23]. Available from: https://www.nhs.uk/conditions/menopause/ 
  4. National Institute on Aging. What is menopause? [Internet]. [cited 2024 Feb 23]. Available from: https://www.nia.nih.gov/health/menopause/what-menopause.
  5. World Health Organization. Menopause [Internet]. [cited 2024 Feb 23]. Available from: https://www.who.int/news-room/fact-sheets/detail/menopause.
  6. NHS Inform. Sexual wellbeing, intimacy and menopause [Internet]. [cited 2024 Feb 23]. Available from: https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/sexual-wellbeing-intimacy-and-menopause/.‌ 
  7. Peacock K, Ketvertis KM. Menopause [Internet]. NIH. StatPearls Publishing [cited 2024 Feb 23]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507826/.‌
  8. Santoro, N. Perimenopause: From Research to Practice. Journal of Women’s Health. 2016;25(4):332–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834516/.
  9. NHS Inform. Early and premature menopause [Internet]. 2023 [cited 2024 Feb 23]. Available from: https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/early-and-premature-menopause/
  10. NHS. Early menopause [Internet]. [cited 2024 Feb 23]. Available from: https://www.nhs.uk/conditions/early-menopause/. ‌
  11. Özdemir O, Çöl M. The age at menopause and associated factors at the health center area in Ankara, Turkey. Maturitas. 2004 Nov;49(3):211–9.‌ Available from: https://pubmed.ncbi.nlm.nih.gov/15488349/.
  12. Ceylan, B., et al. Factors affecting age of onset of menopause and determination of quality of life in menopause. Journal of Turkish Society of Obstetric and Gynecology. 2015;12(1):43–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5558404/‌
  13. Nash, Z., et al. Bone and heart health in menopause. Best Practice & Research Clinical Obstetrics & Gynaecology. 2022;81:61–68. Available from: https://www.sciencedirect.com/science/article/pii/S1521693422000414?via%3Dihub.
  14. El Khoudary S.R., et al. The menopause transition and womenʼs health at midlife. Menopause. 2019 Oct;26(10):1213–27. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6784846/.‌
  15. Jung C., Brubaker L. The etiology and management of recurrent urinary tract infections in postmenopausal women. Climacteric. 2019 Jan 9;22(3):242–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6629580/. 
  16. Caretto M., et al. Preventing urinary tract infections after menopause without antibiotics. Maturitas. 2017 May;99:43–6.‌ Available from: https://doi.org/10.1016/j.maturitas.2017.02.004.
  17. BDA. Menopause and diet [Internet]. [cited 2024 Feb 28]. Available from: https://www.bda.uk.com/resource/menopause-diet.html.
  18. NHS. Menopause - Things you can do [Internet]. [cited 2024 Feb 23]. Available from: https://www.nhs.uk/conditions/menopause/things-you-can-do/‌.
  19. British Heart Foundation. Menopause and your heart [Internet]. [cited 2024 Feb 28]. Available from: https://www.bhf.org.uk/informationsupport/support/women-with-a-heart-condition/menopause-and-heart-disease.
  20. Mishra N, Devanshi, Mishra V. Exercise beyond menopause: Dos and don′ts. Journal of Mid-life Health. 2011;2(2):51. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3296386/. ‌
  21. Triantafillou S., et al. Relationship Between Sleep Quality and Mood: Ecological Momentary Assessment Study. JMIR Mental Health. 2019 Mar 27;6(3):e12613. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6456824/.
  22. National Institute on Aging. Sleep Problems and Menopause: What Can I Do? [Internet]. [cited 2024 Feb 28]. Available from: https://www.nia.nih.gov/health/menopause/sleep-problems-and-menopause-what-can-i-do/. ‌
  23. NHS. Vaginal dryness [Internet]. [cited 2024 Feb 28]. Available from: https://www.nhs.uk/conditions/vaginal-dryness/.
 
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