Dr Michelle O'Driscoll: Getting to grips with the menopause (Part 1)

Dr Michelle O'Driscoll is writing a three part series on the menopause. Today in Part 1 she looks at the basics, establishing an understanding of what exactly is happening in our bodies at this time
Dr Michelle O'Driscoll: Getting to grips with the menopause (Part 1)

WELCOME to the WOW! Menopause Mini-Series. Over the next three weeks we will cover all you need to know about menopause (its cause, stages and symptoms) as well as what you can do to deal with it practically, medically and emotionally. Let’s begin with the basics, and establish an understanding of what exactly is happening in our bodies at this time.

What is menopause?

Menopause is a term used to describe the time in a woman’s life when she stops having a period, indicating that her reproductive years have come to an end. It usually occurs during late forties or early fifties, with an average age of 51. Some women go through the menopause earlier than this due to genetics, immune disorders or medical procedures.

When we are born, our ovaries already contain our lifetime supply of eggs. They also release a specific balance of oestrogen and progesterone to control ovulation (egg release) and menstruation (shedding of the lining of the womb). During the menopause, our bodies begin to release less of these hormones, and this affects us in many ways.

Understanding the progression

Menopause is not an event that can be pinned to one particular point in time. It usually occurs progressively over a period of years, and in three stages: perimenopause, menopause and post-menopause.

Peri-menopause is when the ovaries begin to produce less oestrogen, and periods become irregular. Women often progress from missing the occasional period to going months without any. Menopausal symptoms usually begin to emerge towards the end of this stage when oestrogen levels have dipped substantially.

Menopause is officially declared when it has been one year (12 months) since your last period, therefore the process of diagnosing menopause is a retrospective one.

Post-menopause refers to the years after your period stops, when many of the most talked about menopausal symptoms ease, but the health side effects of low oestrogen continue to impact upon women.

Diagnosis of menopause is primarily conducted by taking your age and menstruation frequency into account, but a blood test to measure Follicle Stimulating Hormone (FSH) levels may also be useful to confirm a diagnosis, as FSH rises in menopausal women.

Hot flashes refer to feelings of sudden warmth. Picture: Stock
Hot flashes refer to feelings of sudden warmth. Picture: Stock

Symptoms to recognise

The symptoms of menopause are primarily attributable to low oestrogen. They can vary in intensity from woman to woman, even within families. What your mother experienced during menopause in terms of symptoms does not definitively determine what your experience will be.

Up to 80% of women report experiencing some symptoms, while almost half of women describe their symptoms as ‘difficult to deal with.’

The most common symptoms reported are listed below.

Are you currently going through the menopause and experiencing some of these? If so, you are most certainly not alone!

Hot flashes - this refers to sudden feelings of warmth in the top half of the body, accompanied by blushing and/or sweating. If it occurs at night, they are known as night sweats, and for some women these can be incredibly uncomfortable, with nightwear and bed sheets soaked through.

Mood swings - these can include irritability, anxiety and depression, and for some women they present as the most debilitating symptoms of menopause – think pre-menstrual syndrome (PMS), only multiple times worse!

Vaginal symptoms - the lining of the vagina can become irritated and inflamed during this time, and extremely dry due to a reduction in natural secretions. This can cause day-to-day discomfort, and painful sexual intercourse.

Urinary symptoms - women going through the menopause are more prone to infections of the lower urinary tract, known as cystitis, and can experience problems with increased urinary frequency and bladder control.

Insomnia - this may occur due to the hormonal imbalance itself, the experiencing of hot flashes, a racing mind due to increased anxiety, or a combination of all these things.

Decreased libido - this is a significant symptom for many women, which can really impact them emotionally and take its toll on their relationships. This decrease in the desire to have intercourse can happen independently of any of the vaginal symptoms listed above, although it may also be as a result of them.

Forgetfulness or ‘brain fog’, general aches and pains/headaches and thinning hair/dry skin are other commonly reported menopausal symptoms.

While the symptoms above are most noticeable in stages 1-2 of the menopause, there are also long term effects on health to consider due to long-term hormonal imbalance. These include:

Osteoporosis - a decrease in calcium levels leaves postmenopausal woman more prone to spine, hip and other fractures, particularly in the years just after their last period,

Heart disease - higher levels of LDL (bad cholesterol) increase the risk of heart attack.

Increased risk of Alzheimer’s - linked to the forgetfulness mentioned above

Effects on vision - blurriness, dry eyes, cataracts and glaucoma are reported

Next week: We will provide some general information about the treatment of menopause; practical lifestyle measures to consider implementing yourself, and categories of medications that your doctor may consider prescribing to treat the most debilitating of symptoms.

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