Menopause, and its transition, is the biggest hormonal upheaval since puberty and is often a traumatic part of a woman's life. Internationally renowned hormone expert Dr Erika Schwartz describes it as
“The menopause experience changes one’s sense of self. Lots of little things go wrong and then suddenly, one day, you find you are not the same person anymore”.
What is the menopause?
The menopause is when you stop having periods and are no longer able to get pregnant naturally. Typically your periods will become less frequent over a few months or years before they stop altogether, but sometimes they can stop suddenly. It is caused by a change in the balance of your body's sex hormones, which occurs as you get older.
The menopause is a normal part of ageing, but perimenopause symptoms can start as early as 35. Most women will experience changes from their early 40s with the average transition taking 7 years, but it is not uncommon for the change to last 15 years. In the UK the average age for a woman to reach menopause is 51.
The 15 most common symptoms of perimenopause & menopause
During perimenopause and menopause it can be surprisingly difficult to see that all the symptoms you’re experiencing are related. Especially when they arise separately over months or even years. The average woman has eight different symptoms, but often never connects the dots to realize that the underlying cause behind all of these confusing symptoms is hormonal imbalance.
- Irregular periods: The most important question to answer about your period is - is it irregular for you? In terms of the length of your cycle or heaviness of your period. Changes in your period are can be the first signal that your sex hormones are beginning to shift in peri-menopause.
- Hot flushes and night sweats: Hot flushes can strike once a day, or up to 20 times or more, causing intense flush of heat along with increased heart rate, dizziness, headache and even claustrophobia or the feeling of being trapped. They can be debilitating, especially when they occur at night and cause sleeplessness.
- Sleep difficulties: You may toss and turn restlessly as you try to sleep, or wake up regularly in the middle of the night. This insomnia is can be caused by a progesterone deficiency in peri-menopause or menopause.
- Weight gain: Changes to your weight or body shape are another noticeable symptom. Shifting hormones tell your body to store fat in the abdominal area, even if you’ve never had a weight problem before. This menopause and peri-menopause weight gain can be difficult to lose even with diet and exercise.
- Fatigue/loss of energy: Not getting enough sleep may make you feel tired, but exhaustion or crashing fatigue can occur even when you get a lot of rest, leaving you feeling physically and emotionally drained.
- Forgetfulness or fuzzy thinking: One of the most alarming symptoms for many women is memory changes or fuzzy thinking and it’s extremely common.
- Thinning hair or hair loss: Imbalances between estrogen and testosterone can cause thinning hair. Many women start to notice clumps of hair in their shower drains during menopause or perimenopause.
- Vaginal dryness: It can be a difficult symptom to discuss, but 50% of women in perimenopause and menopause experience vaginal dryness, itching and pain that affects their sex lives and relationships.
- Low libido: While vaginal dryness can contribute to low libido, a drop in progesterone or a testosterone deficiency by itself can also leave you without a sex drive.
- Joint discomfort /stiffness: Joint pain or stiffness in the back, knees or hips is an unexpected symptom that may be caused by fluctuating estrogen levels. Hard to believe, but true!
- Food cravings: If you had cravings with PMS, you may notice they are getting worse. This can be due to your body’s increased needs for valuable micronutrients, or to the rollercoaster pattern of fatigue / carbohydrates / fatigue with hormonal imbalance affect on insulin.
- Anxiety and/or sadness: Perimenopause can raise your stress level, and can create hormonal imbalances that affect mood and emotional health. Stress hormones directly affect the production and balance of other hormones.
- Irritability and/or moodiness: Feeling angry all the time and snapping at your friends and family doesn’t feel good for you or them. Outbursts and mood swings are some of the first signs many women notice in peri-menopause.
- PMS-like symptoms: You may think stronger cramps, bloating, breast tenderness, headaches or mood swings are due to worsening PMS, but as symptoms get more frequent or severe, it’s often a sign of peri-menopause.
- Feeling overwhelmed: Perimenopause and menopause can compound existing stress levels causing your body to be overcome with too many demands. Under these conditions it’s likely you’ll feel overwhelmed mentally and find it difficult to deal effectively with anything.
Many women who speak to me, begin by saying, “I know I’m not in menopause because I don’t have hot flushes or night sweats.” But when I ask for specifics about their symptoms, e.g. “Are you fatigued and irritable? Is your thinking fuzzy?”, it can be a clarifying moment. Often I hear back, “Well, yes, I am tired and snappy. Yes, my thinking is muddled.” and one that’s so common, “Yes, I’ve definitely gained weight."
Ignoring the menopause can impact your health
Whilst a few lucky women may find yoga, supplements, avocado or chia seeds help - for the majority these approaches on their own will not significantly improve their symptoms or quality of life. Many women feel very isolated in their suffering. Some feel their relationship is falling apart or they simply don’t recognize, or even like, themselves. It’s a huge relief to speak to a peri-menopausal woman, such as myself, who understands and can help.
The full effect of hormonal change is often not understood by many GPs because traditional guidance is based on oestrogen. Progesterone is not acknowledged to have any other function, but to protect the wall of your womb. So the term Progesterone is used inter-changeably with the synthetic Progesterin and Progesteron. This is not the limit of understanding in France, Canada and America were 77% of women choose to take bio-identical hormones.
For years we have laughed about hot flushes, been embarrassed when we forgot things, had our wombs and ovaries removed and talked in hushed tones about “breakdowns". Now we are being told its OK to wet yourself as you dance through the street in carnival leotard and Tena pants, use a non-hormonal cream for vaginal dryness and continue to get urinary tract infections and painful sex, and take antidepressants when you have no history of depression.
The common message is grin and be stoic, or write it down in a diary as it will make you feel better, since in seven years you’ll be through the menopause. I believe this is not good enough! It is not good advice and its detrimental to your health, happiness and relationships. Typical risks associated with ignoring menopause symptoms include:
- Increased risk of heart attack and strokes.
- Increased risk of cancer rates for breast, colon.
- Increased risk of bone fractures from osteoporosis.
- Bladder weakness.
- Impact on relationships due to painful sex or reduced sexual sensitivity / loss of desire.
- Loss of interest in work, relationships and life in general - caused by a loss of mental sharpness, foggy brain, tiredness and a feeling of can't be bothered.
- Full blown depression.
Your genetics and lifestyle will determine what symptoms you will suffer as you pass through the menopause and age. Take a moment to reflect on your close family and what their experienced in their later years.
What lifestyle changes can you do to reduce perimenopause symptoms?
Exercising regularly and eating a healthy diet is a starting point, but overwhelming evidence shows that keeping your hormones in balance is the best way to keeping you strong, mentally agile and sexually active.
Clinical evidence shows that starting Bio-identical Hormone Replacement Therapy (BHRT) early significantly reduces symptoms and improves your long term health. BHRT use hormones from nature which have the same chemical structure as your hormones, derived from specially prepared soya and yam, and do not have any known side-effects or risks.
BHRT can help:
- Women with hormonal imbalance at any age, but mainly between the age of 35-65.
- You must start within 10 years of your last period or 62.
- Older women suffering urinary incontinence.
- Women with PMT.
- Women with adult acne.
- Women suffering hair thinning and loss.
Bio-identical hormone prescriptions seek to match your own natural hormones, so they improve your symptoms with very few minor side effects. You take them, once or twice a day as recommended, using a lozenge or skin cream.
Your personal prescription is prepared using micronized wild yam and soya, by a special compounding pharmacy who are regulated by the General Pharmaceutical Council. It is not mashed together on a kitchen table - I know because I have had a tour of their their state-of-the-art facilities.
Taking back control?
I am an advocate for taking back control of your health. I will help you to have the best health through the hormonal transition and into old age. I want your 80 year old self to tell you now, that the post menopause years are healthier, happier and more independent, because you made the informed choice to take hormone replacement. To learn more visit our Menopause & BHRT service page or call 0131 226 9610 to arrange a consultation with myself.
Dr Victoria
