How do I know if I’m in Menopause? The signs and symptoms to be aware of
The word ‘menopause’ is often misunderstood. While we talk about being menopausal and going through menopause, there are actually various stages that make up the whole process, a series of gradual changes as your body adjusts to your shifting hormones.
Menopause is a biological stage in every woman’s life that happens when you stop menstruating and reach the end of your natural reproductive life. A woman is officially in menopause when she hasn’t had a period for 12 consecutive months. It can also be triggered by a hysterectomy (removal of the ovaries) and certain autoimmune conditions.
The time leading up to the end of your periods is known as perimenopause. This is when you’re still experiencing periods, but they may change in frequency or nature, and you may start to experience menopausal symptoms. Your body is beginning to prepare for menopause, and as a result, changes are beginning to happen.
But, what kinds of changes should you expect, and when? As with any condition, menopause is a unique journey for every woman and symptoms can vary greatly. Here we explore the most common symptoms to look out for, the impact they can have and the steps that we can take to manage them.
When does menopause happen?
The average age for a woman in the UK to reach menopause is 51. For most women, perimenopausal symptoms begin to set in around 45, but rarely, this can start as early as in your 30s. Menopause before the age of 40 is known as premature menopause or Premature Ovarian Insufficiency (POI).
It’s helpful to be aware of all of the possible changes during this time. You’re very unlikely to suffer from all the possible symptoms – at first, you may associate them with your regular PMS or just notice some changes in your monthly cycle.
What symptoms might indicate perimenopause?
The duration and severity of menopausal symptoms can vary significantly between women. While most will experience symptoms for approximately four years, 1 in 10 women will experience symptoms for up to 12 years.
It’s worth knowing what you may be faced with because if you notice a few of these symptoms, you’ll feel a lot more in control of what’s happening within your body.
Changes in cycle length
It’s quite common for periods to become more irregular or lighter as we approach menopause, but you may notice that they become closer together and sometimes heavier for some women.
Sudden worsening of symptoms of PMS
Some women find that symptoms of their usual PMS (premenstrual syndrome) worsen, such as bloating, mood swings, irritability and fatigue. This is usually due to the fluctuating levels of hormones within the body.
Hot flushes are the most common symptom of menopause and affect 3 out of 4 women. They emerge very suddenly and can spread through your body, chest, neck and face. They usually last for several minutes but occasionally for longer. It can help to avoid triggers such as alcohol, caffeine, and spicy food and to carry a cooling spray when managing hot flushes.
Night sweats are also very common and can be very troublesome for those affected. Many women who experience these find that they wake up several times throughout the night drenched in sweat and have to change their bedding and nightwear.
It can be common to forget words, appointments and birthdays. Many women feel that their brain doesn’t feel as engaged as it used to during this time, which can impact their ability to work and function as expected. This is mainly down to the decline in oestrogen – the hormone responsible for keeping us quick-witted and sharp.
Hair and skin changes
When our oestrogen levels take a nosedive, as we approach and go through menopause, women start to notice the onset of rapid ageing in the skin. Oestrogen is an essential component of healthy, youthful skin. It activates oestrogen receptors in crucial skin cells, stimulating collagen, elastin and hyaluronic acid.
As oestrogen levels drop, the skin goes through a significant transformation resulting in acne, dryness, red patches, fines lines and wrinkles and increased fragility. Oestrogen is also very important for your hair growth, so you may begin to notice that your hair starts to shed more and appears less glossy.
Changes in sex drive
If you’ve noticed a sudden drop in your sex drive, this could be why. A nosediving libido is quite common in early menopause due to reductions in hormone levels.
The decline in oestrogen tends to cause the tissues around the vagina to become thinner, drier and inflamed. This can cause sexual intercourse to become painful or uncomfortable. The lack of moisture maintaining the vagina’s natural environment can cause the healthy bacterial balance to be disrupted more easily, too, leaving you prone to thrush and bacterial vaginosis.
Depression, anxiety and irritability
Experiencing menopause can already be a challenging and confusing time. Oestrogen stimulates the feel-good neurotransmitter serotonin in your brain – so, the less you have of the hormone, the lower your mood is likely to be. Many women find that symptoms such as depression, anxiety, panic attacks and irritation worsen so much that they interfere with their quality of life.
Joint and muscle pain
Lower oestrogen levels can sometimes lead to joint and muscle pain, as oestrogen can have an anti-inflammatory effect and keep the bones strong and healthy.
Is there a way to confirm whether I’m going through the menopause?
If you’re 45 or over and have irregular periods with symptoms of menopause, you don’t need to have any tests to diagnose menopause. The diagnosis is confirmed by your symptoms alone. If you’re taking contraception, it may be more challenging to know what your periods are like.
If you’re 45 or under and experiencing symptoms of the menopause, your doctor may recommend a blood test to measure your levels of Follicle Simulating Hormone (FSH), Luteinising Hormone (LH) and oestrogen. If you have low levels of oestrogen and your FSH and LH leves are raised, you’re likely menopausal.
What can you do to manage the menopause?
To alleviate the symptoms of menopause and reduce its long-term impact, the most common treatment is HRT. This therapy replaces your body’s oestrogen levels with a chemically identical alternative. Many women wait until their symptoms are really troublesome before starting HRT. However, taking HRT early will make a big difference to your symptoms and quality of life and reduce the health risks associated with menopause.
Bioidentical hormones are plant-based hormones that were initially derived from the Mexican yam but can also be derived from soya beans or synthesised in a laboratory.
They have an identical chemical and molecular structure to the hormones produced in the body, so they fits its hormone receptor sites, ensuring that messages are correctly translated. The effects are more consistent with the body’s biochemistry.
Bioidentical hormone prescriptions are personalised for each patient’s specific symptoms, hormone levels, and requirements. Before prescribing a course of treatment, a practitioner will assess the patient’s medical history and action a blood test. They can then prescribe a targeted treatment plan and monitor a patient’s progress, along with regular follow-up tests.
Making slight changes to your diet may alleviate symptoms, but they shouldn’t be used as a complete alternative to other treatments. Calcium-rich foods are essential for supporting aching joints and weakened bones. Reducing sugar intake and eating low GI foods can also help with anxiety, poor sleep and irritability. Adding gut-friendly, fermented foods to our diet has been shown to boost our moods. It’s also essential to support your diet with supplementation to ensure you’re getting all the vitamins and minerals you need. Omega 3, Zinc and Vitamin D are essential, but it’s wise to consult with a healthcare professional before deciding what supplements you should take.
Cognitive behavioural therapy (CBT) is a talking therapy that you may be able to access through the NHS. The menopause is a confusing and overwhelming time, and there is evidence that therapies such as this can relieve anxiety and low mood related to menopause.
Enjoyed this? Sign up to our mailing list for weekly tips, tricks and skinspiration from our medical director, Dr Sophie Shotter.
Disclaimer: Please be aware that results and benefits may vary from patient to patient taking into consideration factors such as age, lifestyle and medical history.