Menopause

Menopause is a natural, inevitable stage in the progression of a woman’s life, and in many cultures women in this life stage are revered for their wisdom.

Menopause is going to arrive for each of us and our experience will be influenced by many things including our age, whether menopause comes about naturally or is induced by surgery, our general health and wellbeing, our ethnicity, environment, and culture. Some women will have few symptoms that are easily managed, whilst others of us may feel a significant impact to our identity, self-esteem, and day to day function. While some cultures will value the older life stages as representing wisdom, other cultures that highly value youth can view this stage more negatively. Let’s claim the wise woman for ourselves whatever our cultural narrative so that we can live full and vibrant lives through this season.

Menopause is defined as the point where we stop releasing eggs from our ovaries and have not had a menstrual period for 12 months. Menopause usually occurs between 45 to 60 years of age, with the average age being 51 years.

Early menopause

Early menopause is when menopause occurs before a woman turns 40. This can be caused by medical intervention such as chemotherapy or radiation treatment, having your ovaries removed or a hysterectomy, or from primary ovary insufficiency which can be genetic, autoimmune, or metabolic. Six out of ten women with early menopause have no known cause.

This experience can be extremely difficult as not only might you be dealing with physical health issues, but then you must deal with the treatment for them and then the consequences of that treatment. How you feel as a woman may be challenged, and you will be facing changes to your fertility and family planning. Self-image, self-confidence, and sexuality can all take a hit during this process. Keep talking to your partner if you have one and use local support groups or a psychologist to help you through. Because of the hormone changes caused by menopause, our longer-term physical health can also be impacted. Discuss with your doctor which checks you should have regularly, for example, for bone density or cardiovascular disease.

Naturally occurring menopause

In the lead up to menopause women, can experience peri menopause where their periods will be more or less frequent, and they may experience a number of unpleasant symptoms. Many of these occur due to a reduction in oestrogen levels in the body. These symptoms typically last 4-6 years but can last for up to 10 years. These symptoms can include (but you wouldn’t expect to be so unlucky asto have them all, or all at once!):

- Hot flushes (chest, neck, and face)/night sweats
- Feeling lightheaded
- Headaches
- Irritability
- Depression
- Feeling unloved
- Anxiety
- Mood changes
- Difficulty concentrating and making decisions
- Sleeplessness
- Unusual tiredness
- Backache
- Joint pain
- Muscle pain
- New facial hair
- Dry skin
- Crawling sensation under the skin
- Lower sex drive/ libido
- Digestive pain
- Dry vagina
- Uncomfortable intercourse
- More frequent urination (and an increased risk of urinary tract infections)

Different cultures can experience different symptoms, with western cultures often experiencing more hot flushes and Asian cultures experiencing more issues with aches, insomnia, and mood disturbance.

Diagnosis

If you are experiencing changes to your periods and any of the above symptoms that are causing concern for you then see your doctor for a consultation. Blood tests are not always reliable in diagnosing menopause so your doctor will take a full history and assess for other causes of the symptoms. If you are of the right age and have noticed changes to your periods then it is likely you are perimenopausal, if your periods have been absent for 12 months then you are likely to be menopausal, hello wise woman.

Managing through menopause:

There are a range of ways you can support your body as you transition through to menopause and beyond with lifestyle changes being the first port of call.

Lifestyle

Lifestyle changes can make a huge positive impact on our wellbeing and how our body feels through the changes of menopause.

Decreasing caffeine, alcohol, and spicy foods may alleviate some hot flushes.
Carry a fan and dress in layers to control temperature if needed.
Exercise to benefit mental health and general physical health.
Maintain a healthy weight, a 10% weight loss can reduce symptoms.
Use lubricants during sex to improve your comfort.
Consider sleeping in your own space so you can adjust the temperature accordingly and not feel like you are disturbing anyone if your sleep is disrupted.
Communicate with your partner about what you are experiencing.
Maintain a good intake of calcium and vitamin D for bone health and vitamin B for tackling tiredness.
Keep checking your breasts regularly and have a mammogram and continue with regular cervical screening.

For some women lifestyle changes will not be enough to manage our symptoms and to function effectively. If you are struggling to deal with the symptoms of menopause, talk to your friends, your partner, your work, your doctor, and support services. They can provide practical and emotional support to you. You deserve to be living to your fullest potential. Practical support might include medications from your doctor.

Menopausal hormone therapy (MHT)

Your doctor may recommend a hormonal treatment depending on your history and symptoms. This could be just oestrogen, progesterone and oestrogen and possibly testosterone. These come in tablet, gel, skin patch, implant, vaginal cream, or pessary formats. The combination and method will depend on your symptoms. These treatments are not possible for all women, depending on our medical histories. Ask your doctor what else you can do if you cannot have hormonal treatment. There is a lot of information available online about MHT, so do some research and find a sympathetic doctor.

Your doctor may recommend other treatments for particular symptoms such as an antidepressant if your mood is affected. If you are finding the symptoms of menopause are affecting your life and functioning, then please request a referral for mental health support or access online or local support groups to help you manage your experience. Useful options may include cognitive behavioural therapy, or mindfulness. A psychologist or counsellor can help with these.

Complementary treatments

There are some supplements that are being researched for use in perimenopause, a naturopath, pharmacist, or Chinese medicine practitioner may be able to assist with these. Always tell your doctor if you are using any of these so they have a full picture of your situation because some medications can interact badly with herbs and natural remedies.

Whenever you experience menopause and whatever your experience of it is, remember this is a right of passage for women, so let’s reframe the process into one of empowerment. Use the support you need to work through this time. You have many years ahead of you being a role model and mentor to younger women and you are strong, capable and amazing.

Resources

Australasian Menopause Society