By Dr Liza Thomas-Emrus – award-winning GP and Medichecks’ Mind-Body Medicine Specialist.
The menopause can carry a heavy emotional, mental and physical burden for many women.
The term itself means ‘last menstrual period’ and is caused by the ovaries no longer producing oestrogen and progesterone. Ordinarily, a woman will reach menopause around the age of 51, with the vast majority of natural menopause occurring between the ages of 45 and 55.
It is important to be aware of the various stages of the menopause. Some women, around one in 20, will be affected by early (aged 40-45) or premature (under 40) menopause, and we are seeing more cases of this. This might be for a range of reasons, from more people in their 30s having hysterectomies, to advances in chemotherapy impacting early menopause.
Experience of menopause
Symptoms vary enormously and there’s no way of predicting what an individual’s experience of menopause will be. Among the most common symptoms are mood swings and anxiety to fatigue, weight gain, hot flushes and night sweats, typically lasting around four years from your last period. However, one in 10 could experience symptoms for up to 12 years.
A study by Medichecks into the differing experiences of menopause found a myriad of symptoms that were affecting quality of life.
- Brain fog and disturbed sleep are battled by more than 70%
- A loss of sex drive is an issue for more than two thirds (67%)
- Weight gain was reported by 65%
- Anxiety for more than half (62%) of those polled
- More than 1 in 4 (29%) experienced formication – the feeling of insects crawling on the skin
- 82% said they felt overwhelmed
Overall, 70% of women cited menopause as negatively affecting their self-worth, and almost half (46%) believed menopause was damaging to their career.
The findings uncover the suffering caused by menopause for many women, with 82% confessing they felt overwhelmed by the change, and the same number believing there is still too much stigma around the issue.
Worryingly, 49% of the respondents who had some understanding of menopause said that it was much worse than they were expecting.
No matter which stage you may find yourself, I believe that proactivity is key to dealing with this life-changing experience. Spotting and addressing possible symptoms early will help women come to terms with the situation they are facing, and this includes identifying perimenopausal symptoms.
Perimenopause refers to the time during which your body makes the natural transition to menopause. Some tell-tale signs include changing bleeding patterns, skin and hair alterations, growing anxiety and anger, memory issues, insomnia and joint pain.
How to better manage menopause
Many women in and around their 40s are in the prime of their careers with busy lives that may also involve looking after children and older relatives. Our natural inclination is to ‘get on with it’. In fact, some women value themselves based on the amount of stress they can cope with, but it is important to realise that it is OK to seek help.
One of the things I focus on with my patients is lifestyle, because this can have a huge impact on the experience of menopause. Plan A for all women should be to live a healthier lifestyle for longer, which can help delay the onset of menopause symptoms.
An observational study around diet and the menopause found that eating lots of refined carbohydrates such as rice and pasta was associated with reaching menopause around 18 months earlier. It found that in some cases, dietary changes to staples such as fresh oily fish and legumes could delay menopause by several years. Making your plate look colourful, with plenty of fresh fruit and vegetables is a good rule of thumb.
In terms of reducing the severity of symptoms, exercising and cutting down on alcohol and caffeine can help with hot flushes.
Because of the complexities of menopause, a first port of call should be to speak with a GP – they have expertise in listening to all symptoms described and advising on the likely cause and best management options. In women over 45, usually blood tests aren’t needed as the symptoms and signs can be used to conclude a diagnosis of perimenopause or menopause. Blood testing has a role to play in ruling out other health issues that could be at play, such as thyroid conditions.
Medichecks offers a Menopause Blood Test that measures levels of five key hormones, including FSH, LH and oestradiol. Levels of FSH rise in women as egg production declines, for example, so this can be identified and doctors can provide actionable advice.
A positive life change?
Worryingly, the study found that just 1% felt prepared for menopause, and 93% called for more resources to support women going through the transition.
Too often menopause is framed entirely negatively, and that isn’t always the case. In fact, when we asked what advice women would give to others facing menopause, the responses were all about empowerment.
“It’s time to slow down, listen deeply to your intuition, take time for yourself, and follow what you enjoy.”
“Self care is so important when experiencing menopause, it is a good stage in life to rejuvenate yourself.”
“Menopause will happen. Educate yourself, demand healthcare support, ensure you get blood tests and health checks, and talk to people about it!”
It’s true – opening up and finding support early can really help women to embrace the positivity that this new chapter of life can bring.
Many women tend to describe menopause as a rollercoaster, over which they have a lack of control. The women I find cope the best with menopause are those who are accepting of what’s happening and show themselves compassion.
My plea is to address it sooner rather than later, don’t suffer in silence for years and hit rock bottom, because there are things that can be done to help. Most women try to battle through, probably longer than necessary.
Not experiencing periods in and of themselves can be life-changing, especially for women whose experiences were particularly uncomfortable. Hormones start to settle, and for many this can deliver a newfound sense of freedom, where different questions relating to what you want to achieve in life can be asked.
For others, menopause will create problems relating to their libido, but this should not be a cause for negativity. Menopause and sex is not talked about enough, and the more women talk about it, the easier it will be to build up intimacy again through other means. This is the overarching message we want women to take away.
It is OK to open up and seek support, and there are a range of services, treatments and forums through which women can be helped. Stress management, meditation, mindfulness, better sleep hygiene, improved nutrition – these are all good tools to use, in addition to the management options that Western medicine can give us.
HRT is an effective management option for the majority of women. It shouldn’t be feared and worth having an informed discussion about the risks and benefits of HRT as they can be life changing. Lifestyle optimisation will always help reduce risks and improve response to HRT too.
Be proactive, talk about the menopause before it gets you down, and try to embrace the positives.
About the expert
Dr Liza Thomas-Emrus is Medichecks’ Mind-Body Medicine Specialist and an award winning GP, providing lifestyle medicine for a holistic approach to health, focused on compassion and connection. She is passionate about the transformation of everyone’s health and wellbeing through empowerment, co-creation and reducing inequalities.
Dr Liza Thomas-Emrus has a free 5 minute meditation on her YouTube channel Revive Prescribed, called Pause for Menopause.