In her new book, Menopause: The Answers, Dr Rosemary Leonard discusses the signs and symptoms of menopause and offers a definitive guide on what to expect, when and why.
So whether you’re wondering when menopause will begin or want to know if hot flushes will ever end, here are answers to some of the most asked questions…
Signs and symptoms of menopause explained
Question: What are the first signs my hormone levels are changing?
Answer: For most women, the first sign is that their periods become erratic – bleeding starts a couple of weeks late, or you miss a period completely and then have a horrendously heavy bleed.
Other signs are worsening premenstrual syndrome, with extreme mood swings and very tender breasts, or hot flushes and sweats.
Question: When will menopause happen?
Answer: The average age of menopause – when a woman’s last period occurs – is 51, but anything five years either side of this is regarded as normal. Perimenopause – when the ovaries are not working as well in the run-up to menopause – can last anywhere from a couple of months to a year.
It is impossible to predict when menopause will occur, though women who smoke have menopause a couple of years earlier than others because smoking narrows the arteries that supply blood to the ovaries.
Genes can influence the timing, too, and if your mother had early – or late – menopause, then you have an above average chance of similar timing, too.
Question: Help, my brain is in a fog! Will I ever feel sharp again?
Answer: Many women feel anxious, irritable, or depressed around the time of the change, or have disrupted sleep and problems concentrating. Talking treatment such as cognitive behavioural therapy can help.
HRT helps smooth out fluctuating hormone levels, but a better option can be antidepressants. These work to reduce anxiety and mood swings, plus their action on the brain’s temperature-regulating centre can help reduce flushes and sweats. They’re non-addictive, and they can make life much more bearable.
Question: What has happened to my waistline?
Answer: Many women notice that in their early 50s their shape changes, with a thickening of their waistline. The culprit is the change in hormone levels. The aim now shouldn’t be to have a classic hourglass figure or even a flat tummy.
Aim for a healthy weight and shape so that your risk of arthritis, heart disease and diabetes is low. It’s very hard to try to maintain the shape you had in your 20s, and it’s not healthy to do so, either.
There’s a biological reason for that ‘middle-aged spread’. After menopause, what little oestrogen your body does have comes from the conversion of androgens, which occurs in fat cells.
The fewer fat cells you have, the lower your oestrogen levels will be. Even having a little oestrogen has health benefits – so you really can be too thin for your own good. And once you are in midlife, you have to take a two-pronged attack to lose weight: exercise and diet.
See here for more tips on how to manage your weight during menopause:
Question: Many women say they lose interest in sex after menopause. Does this happen to everyone and is there anything that can be done?
Answer: Some women find that freedom from worrying about unwanted pregnancy means their sex drive increases. But in others, the lower levels of hormones can lead to a dry vagina and a marked fall in libido.
Topical oestrogen in the form of tiny pessaries twice a week can help, and for most women they are safe to use long-term. Tackling a lack of sex drive is more difficult, and though HRT can help, this isn’t a good option for all women.
Testosterone also plays a role in libido, and though there are no registered products available for women in HRT, some medical experts will prescribe a tiny daily amount of the gel designed for use in men for boosting sex drive in post-menopausal women.
Question: How long will the flushes and sweats carry on for?
Answer: It’s impossible to say. Some women only have them for a couple of months, though six months seems to be about the average. Other, more unlucky, women have them for a couple of years – and occasionally longer.
Indeed, there have been reports of women whose body thermostat stays out of kilter for 10 years or more, but this is very unusual.