Let’s talk about Menopause

18th October 2020 - 9:00 AM

What Menopause means
Ovaries produce the eggs for reproduction, but also the hormones oestrogen and progesterone which are needed for the menstrual cycle that facilitates the process. The hormones also have other beneficial effects on women’s bodies that can be lost after the menopause.
Ovaries contain a set number of eggs when we are born and these gradually run out until, by around 50-years-old, there are few left and fertility peters out. As the eggs run out, hormone levels change and fluctuate and periods can become sporadic or more frequent and often heavier. The fall in oestrogen levels, in particular, leads to the usual symptoms of menopause, such as hot flushes, genital and bladder symptoms, low mood and irritability, disturbed sleep, palpitations and later a decline in bone health and increased risk of osteoporosis.

When does menopause happen
Usually at, or around, the age of 50. However, a significant number of women have an early menopause in their 40s or even earlier. It is more important for them to seek advice from health professionals as the risk of osteoporosis in later life is greater.

Management
It may be that no treatment is needed at all. Many women have few or no symptoms or may not wish to take medication. However, for younger women, especially those in their early to mid-forties or younger, the most effective treatment is hormone replacement therapy or HRT.
The main ingredient of HRT is oestrogen but progesterone is also needed to prevent thickening of the lining of the womb which could be dangerous in the long term, unless she has had a hysterectomy or has a progesterone coil in place.
There are some slight risks attached to taking HRT but these can be discussed at a consultation with your GP. We now know the risks are very much lower than they were in the past and many women can benefit from HRT

Lifestyle
Like many conditions, the symptoms of the menopause are helped by a healthy lifestyle, particularly cardiovascular exercise. The exercise needs to be regular, but need not be extremely vigorous. Patients should follow the usual guidance of 150 minutes of exercise per week. Weight loss and maintaining a healthy weight is beneficial. Mindfulness and talking therapies may also help. Stopping smoking is important and can also help symptoms. The fact is that, after the menopause, the risk of cardiovascular disease increases quickly, and so lifestyle and exercise are important anyway to reduce these risks. The risk of osteoporosis (thinning of bones) is reduced by weight-bearing exercise

There are products that can be bought from health food shops intended for the menopause but their safety is uncertain.

So, while the menopause is a natural occurrence, HRT can help with symptoms. These hormonal changes can lead to heart disease as we get older, so all the more reason to exercise, keeps a healthy weight, stop smoking and look after your heart.

Dr Claire Anderton