It's called 'the change' for a reason. The menopause is a transition into the next stage of a woman's life and trying to make sense of these changes can take time. Sometimes it feels like we're being completely reintroduced to our own bodies. Recognising the signs of early menopause not only prepares you for what's to come, but also allows you to tackle each symptom head on and from an early stage.
1. ‘Ooh! It’s hot in here!”
Potentially the most widely recognised symptom that women will go through during the menopause is hot flushes, i.e. a sudden and intense feeling of warmth, often accompanied by sweating. Indeed, up to 85% of women will experience hot flushes during this time in their life, and is one of the first symptoms you'll get.
Menopausal hot flushes are most likely caused by the hormone changes in the body and its effect on the hypothalamus. The hypothalamus is a portion of the brain that regulates the body, including temperature, hunger, and hormone levels.
What to do: Professor Studd of The London PMS & Menopause Clinic says: 'Troublesome hot flushes and severe night sweats that can cause chronic insomnia are characteristic symptoms of the menopause. They may last for years and apart from being socially embarrassing they result in tiredness because of lack of sleep as well as depression. These symptoms can be cured with the correct dose of oestrogen. No other treatment is nearly as effective.'
2. “I just need some sleep!”
During the menopause, it can feel as though your hormones are playing havoc with your entire body, making your everyday life more difficult to manage and predict. One review claims that the prevalence of sleep problems go from 12% up to 40% in women aged in their late 40s/early 50s.
Studies have found a significant relationship between the severity of hot flushes in menopausal women and the rate of insomnia. Over 80% of women who get severe hot flushes will also report symptoms of chronic insomnia. However, even in the absence of hot flushes, menopausal women are still more likely to experience sleep disturbances.
What to do: Exercise early in the day and make sure you get out for a walk and see some sunlight. This can help regulate your sleep patterns. Take care about doing exercise in the evening, as if you’re prone to insomnia, this can lead to feeling too wide awake.
3. “Not tonight dear …”
Although age is associated with a decline in sex drive for both men and women, women are up to three times more likely to experience this. While many things can contribute to this lack of sexual desire, the lower levels of oestrogen and psychological stress associated with the menopause are no doubt contributing factors.
In menstruating women, libido tends to peak before and after ovulation (your body's way of increasing your chances of getting pregnant) due to our hormone levels.
What to do: According to Professor Studd, HRT can help here. 'HRT certainly improves libido if oestrogens are used to cure vaginal dryness and painful intercourse,' he explains. 'However, if necessary, the addition of testosterone has an even more dramatic effect upon libido, frequency of intercourse and intensity of orgasm. Women must be aware that testosterone is not a male hormone. It is an essential female hormone that is present, in women, in 10 times the blood levels as is oestrogen. It is an essential hormone, important for energy, mood and sexuality in women and is particularly needed in women who have had a hysterectomy with loss of ovaries and ovarian androgens.,
4. “Ouch!”
Lower levels of oestrogen during the menopause can also reduce the amount of natural lubricant our vagina's produce. This dryness can lead to serious discomfort, particularly during sex. Without proper lubrication, sexual intercourse is more likely to be painful due to friction.
What to do: According to Professor Studd, this also can be successfully treated with oestrogen either by tablets, or through the skin by patches or gels or implants. 'Going through the skin is probably the safest and most effective route' he explains. 'Oestrogens can also be given for this symptom by local vaginal applications of a weak oestrogen that is not absorbed.'
5. “My PMS is getting worse …”
Another common symptom of the menopause is the effect it can have on our emotional wellbeing. Hormonal changes can contribute to erratic feelings (including anger, frustration and depression) but the stress from symptoms can contribute to feelings of anxiety. Other than affecting our ability to become pregnant, the menopause can lead to weight gain, hair loss, a decrease in skin elasticity, and joint stiffness. By no means are all women going to experience these, but even the prospect of such changes can cause a lot of psychological distress.
What to do: Many women say oestrogen therapy stops their depression, their loss of libido and their irritability, they become nicer people for their partners to live with. Professor Studd explains: 'The depression, grumpiness and loss of energy can usually be improved considerably by the appropriate doses of the appropriate hormones. This may be testosterone as well as oestrogen'
6. “Whoops, I forgot!”
The effect that the menopause has on our memory is probably one of the lesser known symptoms that women can experience. Often referred to as 'brain fog', becoming forgetful and lacking in concentration has, in some studies, been reported in 60% of menopausal women. This is thought to be due to the effect oestrogen has on the hippocampus, an area of the brain involved in cognitive function.
What to do: Many women swear by the effects of HRT on 'brain fog' and poor memory. In one study, researchers share that some 60 percent of middle-aged women report difficulty concentrating and other issues with cognition. These issues spike in women going through perimenopause. Talk to your doctor about the possibility of being prescribed HRT.
7. “I'm getting shorter ...”
Getting shorter may be a sign of osteoporosis. The discs between your vertebrae naturally shrink as you get older, making some height loss normal, but if you've lost more than an inch, it may be because the vertebrae are crumbling due to osteoporosis. During the menopausal years, bone thinning can occur. Osteoporosis is commonly associated with age, but women are four times more likely to experience it than men. Oestrogen plays a vital role in the ability to maintain healthy bone density, making women with lower levels of the hormone more likely to experience fractures. The menopause is characterised by a drop in oestrogen levels, and this puts menopausal women at a far greater risk of developing osteoporosis. In fact, up to half of UK women over 50 years old are likely to experience osteoporosis fractures.
What to do: When it comes to bone thinning, prevention is better than a cure. Many women discover they have osteoporosis when they suffer a fracture - but if you know your risk you can take medication and preventative action. You’ll need to have a DEXA scan to discover if your bones have thinned.
8. “Why is my hair falling out?”
Changes in hair can happen during and after the menopause. Experiencing it can have a detrimental effect on confidence and self-esteem. Any time in a woman's life that involves hormonal changes (e.g. puberty, pregnancy, menopause) can affect hair growth and texture. However, genetic predisposition, diet, medical history and stress levels can all contribute to whether you'll experience hair thinning (or loss) during these times in your life.
What to do: Get your bloods done to find out whether there’s an underlying problem such as hypothyroidism or a vitamin deficiency causing your hair loss.
Please see London's leading menopause clinic for further information.
Professor Studd founded the London PMS & Menopause Clinic. Globally recognised as one of the leading experts in the field of HRT, he has handpicked the UK's best gynaecologists to consult at his Wimpole Street clinic.
The team of consultant gynaecologists includes:
The time of a woman’s life when her ovaries stop releasing an egg (ovum) on a monthly cycle, and her periods cease
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