If you are troubled by menopausal symptoms, it may help to know that you’re not the only one. While menopause is different for every woman, most women experience at least some symptoms.
Strictly speaking, a woman has reached menopause when one year has passed since her last period. Before menopause, there is a transitional stage, known as the perimenopause, where women have declining fertility and fluctuating hormone levels. Many of the symptoms associated with menopause, such as hot flushes and mood swings, are the result of your body adjusting to fluctuating hormone levels during the perimenopause. Reduced oestrogen levels following menopause can increase your risk of problems such as osteoporosis and heart disease.
Around the time of menopause, you may experience mood swings, nervousness, irritability or fatigue. Some women also have difficulty concentrating, or trouble with their short-term memory. But these symptoms are not always due to hormonal changes — they may also be related to stress and the effects of ageing.
Insomnia is also a problem for some women. Night time hot flushes, often accompanied by night sweats, may disturb your sleep. Alternatively, you may have trouble falling asleep, or achieving a deep, restful sleep. These sleep disturbances can contribute to fatigue and mood disturbances.
2. Hot flushes
Hot flushes are common around the time of menopause. Changing hormone levels cause the blood vessels in your skin to expand rapidly, sending a rush of warm blood to your skin and raising its temperature.
A hot flush is described as a warm or hot feeling that often starts in the chest or shoulders and moves up to the face and neck. They usually last from 30 seconds to about 5 minutes, and may cause your face to become red and flushed. Red blotches may also appear on your neck, chest and arms. Sometimes, there is heavy sweating followed by chills.
To prevent hot flushes, avoid triggers such as alcohol or spicy food. Regular exercise and some herbal remedies may also help. Hormone replacement therapy (HRT) can be used to treat hot flushes in the short term.
Your hair may become drier and thinner after menopause. Also, even though your oestrogen level drops, your body will continue to produce the same small amount of testosterone (male sex hormone) that it always has. As a result of this change in the oestrogen/testosterone balance, some of the hair on your body, e.g. the hair on your chin or upper lip, may become coarser and darker.
Your skin may become drier, less elastic, thinner and more wrinkled following menopause. The layer of fat underneath the skin also thins out, making your skin more vulnerable to injury.
Around the time of menopause, you may experience palpitations — an awareness of your heart beating or pounding in your chest. Many women notice palpitations during, or just before, a hot flush.
Your cholesterol levels may rise after menopause, and your risk of cardiovascular disease increases as your oestrogen level declines. However, by eating a healthy diet, participating in regular exercise, avoiding smoking, and keeping your blood pressure down, you can reduce your risk of heart disease.
Breast tissue needs oestrogen for growth, so after the menopause your breasts may lose some of their fullness. Also, as some of the glandular tissue in your breasts is replaced by fibrous material, your breasts become less firm.
7. Body shape
Your body shape may start to change slightly, with more of your body fat being concentrated around your waist rather than around your hips and thighs. This change in body fat distribution is associated with an increased risk of diabetes and heart disease. So it’s important to maintain a healthy diet and keep active, especially since women often find that they gain weight more easily after menopause.
8. Reproductive system
After menopause, your ovaries and uterus tend to become smaller, and you stop ovulating and having menstrual periods. But most women experience irregular periods or a change in their normal cycle before their periods stop completely. Your periods may also become heavier or lighter than usual before stopping altogether. While pregnancy is still possible until you haven’t had a period for a year, once ovulation begins to fluctuate, it becomes much less likely.
Following menopause, your urethra (the tube that empties the bladder) becomes shorter, and its lining becomes thinner. This can make bladder control more difficult, cause burning and itching when you urinate, and increase your risk of urinary tract infections.
In addition, bladder support is often reduced because of weaker, less elastic pelvic floor muscles. The sphincter muscle that controls the passage of urine through the urethra also loses strength, so it is less able to prevent leakage. These changes are due to general ageing as well as decreased oestrogen levels. Performing pelvic floor muscle exercises may help if you are having trouble with bladder control.
Your vagina may become shorter, narrower and less elastic, and the production of natural lubrication is often reduced. Lack of lubrication can make sex uncomfortable, and increases the risk of developing a vaginal infection. A vaginal lubricant or oestrogen cream can be used to treat vaginal dryness.
Although your libido may decrease, most women who enjoyed an active sex life before menopause continue to enjoy sex afterwards. Maintaining an active sex life can help with vaginal discomfort, because it helps maintain the elasticity of the vaginal walls.
Muscular aches and pains may be associated with menopause, and you may also lose some muscle strength and coordination.
Your bone density also tends to decrease following menopause. As your oestrogen level drops, you start to lose calcium from your bones, increasing your risk of osteoporosis. Osteoporosis causes bones to become weak and prone to fractures. The wrists, spine, and the ends of the thighbones (femurs) at the hips are the most common sites for fractures in women with osteoporosis.
Try to prevent osteoporosis by including plenty of calcium in your diet — 3 to 4 serves of dairy per day is recommended — and participating in weight-bearing exercise. Calcium and vitamin D supplements can also lower the rate of bone loss, and there are medicines available that can be used to prevent and treat osteoporosis.