The symptoms of menopause can be frustrating and confusing. While you probably learned about the hormonal changes you could expect during puberty, either from your mum, from classmates or ‘sex education’ classes, or even by reading Judy Blume novels, nobody really tells you about menopause. And there doesn’t seem to be much to look forward to. Puberty was the start of an exciting emotional ride; crushes, first kisses, falling in love… What does menopause mean? Is that it now?
Menopause is a slow process. The initial perimenopause stage can last more than five years. For most women, symptoms begin in their late 40s, though they can start much earlier, with full menopause happening at an average age of 51.
Once a woman has had 12 months without a period, she is classified as being in menopause, and for the rest of her life is described as post-menopausal.
Many women feel unprepared for the changes of menopause, for what the hormonal changes mean. It’s really common to feel a sense almost akin to bereavement.
“Menopause? But I’m still young, right?”
HuffPost blogger Tracy Morrison describes her horrified reaction to diagnosis:
“I drove home that day confused. There was no menopause party. There’s no drink at Starbucks that seems appropriate for the occasion. Buying a new handbag didn’t seem logical, and there was no one I could call. I couldn’t call my husband and shock him with the fact that he’s now married to an old woman. I didn’t want to call my mother and join ‘her club’ or hear her words of encouragement as she would tell me that ‘the change’ is not so bad. Because I don’t want to bond over anything to do with my body with a 66 year old… And then I wondered if menopause was just something you were suppose to go through alone without fanfare or attention… Something you mourn when you walked past the feminine hygiene aisle at Target when just months ago you were complaining about how much you spent each month on tampons…”
Actress Angelina Jolie had a different response. Jolie’s menopause was brought on by a decision to have her ovaries and fallopian tubes removed, and a subsequent operation to remove both breasts after the death of her mother to breast cancer.
In an interview in the Daily Telegraph, the actress says, “I actually love being in menopause.”
“I haven’t had a terrible reaction to it, so I’m very fortunate. I feel older, and I feel settled being older.”
The symptoms can be hard to deal with: Hot flushes don’t sound so bad on paper, but they some women find them unbearable.
Washington Post journalist, Janice Lynch Schuster shares her experience:
“At first, I would feel heat rising through my face and head, then spreading to my entire body. I would be suffused by it and would fan my face or look around to see if others had noticed the local climate change.
Within a few months, the hot flashes were occurring several times a day, and I would sweat in unlikely places: my knees and shins, my elbows. At night, my fitful sleep would end when a drenching sweat would wake me, leaving me soaked and shivering.
The last straw came during a meeting for work. In the midst of a conversation with senior leaders, a hot flash erupted, and sweat streamed from my brow…”
Often, preoccupied with family life, or with menstrual cycles disrupted by contraceptives, women don’t really pay much attention when their periods change or stop.
How do I know if I’m in menopause?
Your GP can take a blood test that measures the level of follicle-stimulating hormone (FSH). The results of this test can indicate whether you are in menopause.
There is, however, no single moment that confirms you are entering menopause. It’s a gradual transition. Because of the way hormones fluctuate, by the time you are officially in menopause, you may have been experiencing symptoms for a long time, anything from several months to more than 10 years.
As well as the hot flushes, night sweats, vaginal dryness, even painful sex, many other symptoms can arise because of the hormonal changes. Some of these can be debilitating and frightening:
- Irregular periods
- Hot flushes, often with night sweats
- PMS-like symptoms
- Difficulty sleeping
- Emotional symptoms such as feeling sad, overwhelmed, moody, feelings of anxiety or panic attacks, even sometimes with heart palpitations
- Feeling irritable, just not feeling like yourself
- Feeling tired
- Feeling forgetful, or like you have ‘brain fog’
- Joint pains and stiffness
- Weight gain, especially around the abdomen
- Loss or increases of libido or a change in sexual desire
- Thinning hair or hair loss
- Vaginal dryness
- Bloating, gas, diarrhoea, constipation or nausea
- Cravings for certain foods
However, despite the fact this change happens to every single woman, your GP may not actually know a lot about menopause. Because GPs are general practitioners, and because their workloads can be stressful with limited time for each person, they may not be able to offer the reassurance you need. In fact, GPs are not trained to deal with the menopause. The British Menopause Society offers training courses for GPs, but doctors are under no obligation to attend, meaning that only those who do so are up to date. This means that many GPs are not able to educate their menopausal patients.
That makes it really important to educate yourself, to take your needs to your GP and to learn about natural ways to ease your symptoms.
HRT – Hormone Replacement Therapy
For most women, knowledge of Hormone Therapy is limited to a nagging belief that it is dangerous or even deadly. Results from the National Institutes of Health’s Women’s Health Initiative in 2002 led to an 80% drop in HRT prescriptions worldwide.
But these findings have since been revised, and HRT currently has a positive reputation as the best form of relief, over exercise and herbal therapies.
The more recent analyses of the Women’s Health Initiative data, along with other new studies, show that for women in their 50s, just beginning menopause, HRT is quite safe. It can be used for up to five years without any risk of heart disease, although it is still important to have regular screening for high blood pressure and breast cancer.
Experts widely agree that the benefits outweigh the risks. The low doses of oestrogen and, for women with a uterus, progesterone, can help relieve symptoms and increase quality of life. There are several treatment options: You can take oestrogen as a pill or a patch. The patch prevents the hormone being metabolised through the liver, decreasing the risk of blood clots in the legs. It is generally considered a safer option for women who suffer from high blood pressure.
It’s also possible to relieve symptoms by noticing and adjusting everyday triggers. Caffeine, alcohol, stress and lack of exercise can all add to hot flushes. Recent studies have even found that in some cases, some antidepressants and the anti-seizure drug gabapentin can help. Other symptoms such as vaginal dryness can be eased with prescription creams or vaginal pessaries.
Whatever you are going through, it’s important to find a doctor who will really listen to your concerns. Your doctor should understand your risk factors as well as the symptoms you are facing. Build a good relationship with your doctor, and surround yourself with people who can support you.
And it’s not all as bleak as it may feel. There is life after the menopause. In fact, there are things to love about your menopause too.
Love your menopause
As they enter menopause, many women feel stronger, happier, healthier, and more empowered than they ever have. It’s a time to explore the things you love in life, without worrying what anyone else thinks. After all, your hormones don’t define who you are. It’s time to be brave and try new things, get some ticks on your bucket list, and spend time being the woman you want to be.
Women’s health and wellness advocate and menopause awareness expert, Ellen Dolgen says menopause made her closer to her husband:
“My husband walked alongside me during my menopause journey and, because of it, we have grown to understand each other more completely. The result: We are more in love than ever! We have been married for 37 years and still date each other! Learn how to talk to your partner about perimenopause and menopause.”
And it made her appreciate her mother too:
“Of course I’ve always loved my mom. But it was through menopause that I gained the wisdom and experience to reflect back on my childhood and my mother’s role within it. Only then did I learn to appreciate her for the incredible woman she is.”
Your menopause symptoms are messages from your body, communicating that your hormones are out of balance. Remember, there’s a lot you can do to support your system and gain equilibrium, easing you through menopause and on to the rest of your life, fulfilled, confident and happy.