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The menopause is the time in a women’s reproductive journey when a woman’s menstrual cycle stops, periods become irregular and eventually stop and a natural pregnancy is no longer possible. Menopause happens when the ovaries no longer release an egg each month, hormones produced in the ovaries such as oestrogen, progesterone and testosterone begin to fluctuate and decline.

When is menopause diagnosed?

Menopause is diagnosed after 12 months without a menstrual period, the average age of menopause in the UK is around 52 for women. However, the menopause transition, also known as perimenopause, often begins years before a woman’s last period, it is during this time that hormones begin to fluctuate, and it is these fluctuations that can lead to a variety of different symptoms. During the perimenopause a woman can still continue to have periods, however they may become irregular, research has suggested that the perimenopause can last up to seven years.

Symptoms

Symptoms can be individual and vary for everyone, at present over 36 symptoms have been identified as part of the menopause, this is because we have hormone receptors all over our body which leads to a variety of different symptoms; the most common are hot flushes, night sweats, vaginal dryness, mood changes, anxiety, and brain fog. More unusual symptoms can include electric shocks and a burning sensation of the tongue. It is also important to be aware that symptoms can change and vary on your menopause journey.

Treatment

The good news is there are lots of treatment options available, these range from HRT (Hormone replacement therapy), local oestrogen, supplements, non-hormonal medications, and lifestyle changes. HRT given through the skin as a gel, patch or spray is the safest method combined with a micronized progesterone tablet or coil if you still have a uterus. If you no longer have a uterus, you can just have the oestrogen part of the HRT. Updated guidelines now mean that there is no age limit on stopping or starting HRT. Recent media coverage has led to a fear that HRT may increase the risk of breast cancer, recent studies have confirmed that these risks are low and can be further reduced by using HRT via the skin and the newer micronized progesterone. The research also suggests that for some women there is more of a risk due to lifestyle such as a high BMI, smoking or drinking alcohol.

Non hormonal medication includes medication to treat a specific treatment such as a drug called Clonidine which could be helpful for some women with hot flushes. Some supplements such as Menopace and red clover can be beneficial, however the evidence is limited for these, but for some women they can be enough to help with symptoms. Lifestyle changes are just as important such as stopping smoking, reducing alcohol, a healthy balanced diet and increasing your weekly exercise. Yoga and mindfulness have also been shown to be helpful for some women.

Resources

It is important to be aware that every woman’s menopause journey is different, so treatment options are a personal choice for each individual. Here at Your Fertility Journey, we offer menopause support consultations and information on our website. There is also good support available online such as Menopause Support. NICE guidelines offer more information on best practice and treatment and can be found here. Other resources can also be found at the following:

  • https://www.menopauseandme.co.uk/ – This site is dedicated to supporting women throughout their menopause journey. This site provides tailored information about all stages of the menopause and the tools and support help make informed choices when it comes to managing symptoms
  • https://thebms.org.uk/ – The British Menopause Society (BMS), established in 1989, educates, informs, and guides healthcare professionals in all aspects of post reproductive health.
  • https://yourfertilityjourney.com – Here is a link to finding out more about menopause consultations with YFJ.

Content written by YFJ’s menopause nurse specialist Kate Pleace.