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April 06, 2018

The M Word

The M Word

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Though it is an inevitable natural process in every woman’s life, the menopause can also be a time of deep anxiety and distress.

According to a recent study carried out by the British Menopause Society (BMS), around three-quarters of women say the menopause caused them to change their life and over half admitted its symptoms had a negative impact on it. The menopause is still very much a taboo subject in the UK, something many don’t feel comfortable talking about. The report, which was published on World Menopause Day 2017 (18 October), highlights the need for greater support for women experiencing this inevitable change in their life.

Brought about by a biological shift, the menopause is when a woman stops having periods and is no longer able to get pregnant naturally. Although it typically occurs between the age of 45 and 55, around one in 100 women experience it before the age of 40—a condition known as premature menopause or premature ovarian insufficiency. 

Possible treatments

Menopause cannot be treated, but its symptoms can be managed. Although not all women will want or need treatment, family doctors are best placed to advise patients on the various management options. The most well-known treatment—possibly because it has been controversially linked to a higher risk of breast cancer in multiple studies—is hormone replacement therapy (HRT). This form of treatment involves taking oestrogen to replace the decline of the hormone in the patient’s body. Available as tablets, skin patches, gel or implants, it is an extremely effective way of relieving symptoms. Some side effects include headaches and breast tenderness—in some women, it is also associated with blood clots and breast cancer. Alternative treatments, such as herbal remedies and natural hormones are generally not recommended by the health service and are considered non-traditional; this is because their safety and effectiveness are still relatively unclear. These therapies include supplements, acupuncture, chiropractic, homeopathy and specialised diets. Botanicals (medicines derived from plants) are also available to relieve uncomfortable symptoms of the menopause—make sure to discuss your wishes and options with your doctor. They will be able to advise you on the best course of action.  

Early menopause

Premature ovarian failure (POF) affects around one in 100 women before the age of 40 and five in 100 before the age of 45. While doctors have different opinions on what the ‘normal’ age for menopause is, most consider it to be ‘early’ if it occurs before a woman turns 45. Some natural causes of POF are chromosomal abnormalities—such as Down’s syndrome—enzyme deficiencies and autoimmune diseases. According to NHS Choices, POF can also be induced through medical treatments damaging egg production (like radiotherapy or chemotherapy), hysterectomies and infections such as tuberculosis, mumps, malaria and chickenpox. Women with premature menopause are also at a higher risk of osteoporosis. In these circumstances, many doctors recommend HRT until a woman reaches the 'normal' age of natural menopause (which is considered to be around 52).

Emotional effects

Going through the menopause is a difficult time for many women. Despite it being a natural phase of every woman’s life, the subject is still surrounded by stigma. Every change that occurs in the body can affect your emotions and mental wellbeing. Many women report mood swings, anxiety and irritability. As hard as it may sound, it is important to think of the positives. Not having a period anymore can be freeing, especially if you’ve been plagued with particularly heavy or painful ones. Visit your doctor if you feel like you are struggling to cope with the menopause—whether that’s due to its symptoms or the anxiety it can cause.

Symptoms 

Although most will experience some symptoms, their duration and severity will vary greatly from woman to woman. They may start months or even years before your periods stop and can last for some time afterwards. Some of the most common symptoms include:

Hot flushes 

Short, sudden feelings of heat—mostly in the face and neck—which can make the skin red, patchy and sweaty. Caused by changes in a woman’s hormone levels, hot flushes can be uncomfortable, embarrassing and disruptive.

Night sweats

These are hot flushes that occur during the night. Night sweats are when the body sweats so profusely that it soaks any night clothes and bedding, even when the sleeping environment is cool.

Difficulty sleeping

Sometimes, due to recurring episodes of night sweats, difficulty sleeping may make sufferers feel tired and irritable during the day.

Vaginal dryness

A decrease in oestrogen during the menopause can cause persisting vaginal dryness. In addition to this common condition, the menopause can also cause pain and itching as well as discomfort during intercourse.

Mood changes

The fluctuation in hormones typical of the menopause may cause mood changes, anxiety and periods of extremely low moods=

Urinary tract infections

UTIs such as cystitis are common infections affecting the bladder, kidneys and the tubes attached to them. They may become more frequent as women approach the menopause.