Everything you need to know about the menopause
All women will go through the menopause, yet for many, it’s a sensitive and sometimes difficult topic to discuss. We are aiming to demystify the cause and symptoms of the menopause, offering help and advice whether you are experiencing the menopause personally, or if you would like to be better equipped to offer support to a loved one currently managing it.
Why does the menopause occur?
As with puberty, the menopause is a direct result of the change in the balance of the body’s sex hormones. Puberty sees the onset of this stage with the production of oestrogen and progesterone hormones, while menopause marks the end of it. In the natural process of menopause, a woman’s ovaries stop releasing eggs and making these hormones. When this happens, a woman will stop having her period and is no longer fertile.1 This will usually happen between the ages of 45-55. However, around 1 in 100 women experience premature menopause, which is where they enter the menopause before the age of 40.2 Surgical removal of the ovaries, chemotherapy or hormone therapy for the treatment of breast cancer can also cause the menopause.
While the two key markers of the menopause are the stopping of periods and the end of fertility, there are a number of symptoms that occur during the build-up to menopause. Perimenopause is the transition period into menopause, and this is where you are most likely to experience the symptoms that tell you that you are entering this stage. Perimenopause can start 8-20 years before menopause, when a woman is in her 40s or even 30s. Before this time, you are premenopausal, which simply means you have no symptoms of either the perimenopause or menopause.
Men are not exempt from suffering a decline in sex hormones too. While women undergo the menopause, men may undergo what is known as the andropause, which sees symptoms such as loss of libido, suggestive of testosterone deficiency.3 Other symptoms might include:
• Mood swings and irritability
• Loss of muscle mass and a reduced ability to exercise
• Fat redistribution, such as developing a larger belly or holding more fat around the breast tissue
• Tiredness but difficulty sleeping
• Poor concentration or a general lack of energy
Surprising symptoms of the menopause
Some symptoms of the menopause are more common than others. Many symptoms start during the perimenopause, with:
• Irregular periods
• Hot flushes
• Night sweats
• Fatigue but difficulty sleeping
• Anxiety or a low mood
However, there are other surprising symptoms that may affect your physiological health and suggest you may be entering the menopause too:
Water and gas bloating: The hormonal changes brought about by our bodies entering menopause can cause swollen and puffy ankles, hands and feet, as our bodies start storing more water in the extremities. This water bloating is sometimes accompanies by gas bloating.
Vaginal dryness: It’s not always spoken about, but vaginal dryness is in fact one of the more common symptoms of the menopause. This occurs because oestrogen levels are dropping, making the vaginal tissues thinner and more prone to irritation.
Digestive problems: Stomach pain is particularly common during the perimenopause, which adds to stress levels and can impact our digestion. You might have noticed throughout your life that if you become stressed or anxious you can develop stomach pains or cramping – this applies to the menopause too.
Lower libido: It makes sense that as our bodies stop producing the sex hormones oestrogen and progesterone, our sex drives may lower. If this is something that is concerning you, try to enjoy a healthy, nutritious diet and ensure you get at least 30 minutes of exercise each day, to help you feel good about yourself and possibly increase your libido.
Mood swings: Just like premenstrual syndrome, fluctuating hormones around the time of the menopause can leave you irritable, anxious, depressed or tearful. In fact, studies have shown that these symptoms may be even worse during the menopause as the decline is oestrogen changes how our bodies handle serotonin – the happiness hormone.4
Headaches: You might already have experienced the impact of hormones on your head as many women suffer from headaches during their period. Likewise, headaches can be a problem during the menopause.
Weight gain: There are a few reasons why you might find yourself putting on a few extra pounds during the menopause. Again, simply the fluctuation in hormones can be a factor, but there are other menopause-related symptoms such as tiredness that can make us less motivated to exercise, or more likely to reach for high fat, or high sugar snacks rather than taking the time to prepare something more nutritious.
A hot mouth: Menopause can reduce your ability to produce saliva, which can result in what is known as ‘burning mouth syndrome’. This affects the roof of your mouth, as well as your lips and cheeks and can also leave a metallic taste in your mouth.
Hair thinning: As with the other symptoms of menopause, thinning hair is a result of hormonal changes. Oestrogen and progesterone both help our hair to grow, and falling levels can increase the growth of androgen, which shrinks the hair follicles, making your hair appear thinner. Poor diet and stress can also cause hair loss.
Pins and needles: One of the stranger symptoms of the menopause is that fluctuating oestrogen levels have an impact on our central nervous system, meaning our nerves can sometimes misfire and cause numbness or tingling in our hands and feet.
Itchy skin: Declining oestrogen levels have a knock-on effect on our skin’s producing of natural oils and collagen. As these start to decrease, you can find your skin feeling less hydrated and itchier.
Heart palpitations: Any change in your regular heartbeat pattern can be scary, but although it’s always worth checking with a medical professional, heart palpitations can be a symptom of the menopause. They are usually nothing to worry about and are simply a result of lower oestrogen levels causing an overstimulation of your central nervous system.
Osteoporosis: Bone density is another thing that is affected by hormonal changes and osteoporosis is very closely related to oestrogen deficiency. Speak to a medical professional if you are worried, but it’s always a good idea to make sure you have enough calcium in your diet too, as calcium has been shown to be essential for healthy bones.5
How can I help myself when going through the menopause?
The most important thing to remember when going through the menopause is that you are not alone, and there is help out there. Whether you speak to a medical professional, family member, friend or even a stranger at a local or online support group, it’s important to let people know if you are struggling. The symptoms you may experience can often be managed, but are beyond your control. I If you are suffering from negative thoughts or any other mental or physical symptom, remind yourself that it is not your fault.
Maintaining a healthy diet is one of the best things you can do to manage many of your symptoms. Cutting back on salt and fizzy drinks, chewing food more thoroughly, eating smaller meals, and eating them more slowly are all great tips to reduce water and gas bloating. Hot flushes can be managed by sipping a cool drink, as well as cutting back on caffeine and alcohol. Thinner hair may be more manageable if you ensure you get enough whole grains, fruits and vegetables.
Suffering from mood swings? If you find yourself struggling with negative emotions, there are ways that you can boost your body’s serotonin levels naturally. Vitamin D and the omega-3 fatty acids have been shown to control serotonin synthesis6. Short bursts of sun exposure will help your body produce Vitamin D, and you can consume it by eating a healthy diet containing oily fish like mackerel and salmon, cheese and egg yolks, as well as foods fortified with Vitamin D, like orange juice and cereals.
How do you live with someone going through the menopause?
The menopause can be a difficult time, not only for the person going through it, but for those that live with them. From being at the receiving end of a mood swing or having to watch someone you love struggling with a number of physical or emotional symptoms, it can undoubtedly be a challenge. This can be made even more difficult if others within your household are going through hormone-related changes or difficulties with their own physiological health. In a household with parents and teenagers, it’s entirely possible that they could all be experiencing either the menopause, andropause, puberty or the onset of periods at the same time.
Remember to be kind to yourself, but also to each other. As much as it’s beyond your control to experience menopause, it’s equally beyond the control of your partner or children to be suffering at the hand of hormones too. Always remember that support is available, and never to block your family members out.
- https://www.nichd.nih.gov/health/topics/menopause/conditioninfo/causes [↩]
- https://www.nhs.uk/conditions/menopause/ [↩]
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4046605/ [↩]
- https://journals.sagepub.com/doi/abs/10.1177/1534582305277152 [↩]
- https://www.health.harvard.edu/blog/how-well-does-calcium-intake-really-protect-your-bones-201509308384 [↩]
- https://faseb.onlinelibrary.wiley.com/doi/full/10.1096/fj.14-268342 [↩]