In celebration of National Menopause Day, we caught up with Dr Heather Currie MBE from the British Menopause Society (BMS) to answer your questions about the final period.
Dr Heather Currie MBE, Gynaecologist at Dumfries and Galloway Infirmary, Scotland is the author of an award-winning book and managing Director of Menopause Matters Ltd. An independent website that provides up-to-date and accurate guidance around menopause and menopausal symptoms.
1. What is menopause?
The menopause is the final period, we know that we have had our final period after no periods for at least a year. However, the term menopause is used to refer to the changes related to estrogen deficiency – early menopause symptoms and later consequences.
2. Why does menopause happen?
To go through a normal monthly menstrual cycle, as part of the egg development and ovulation (egg release), the ovaries produce estrogen throughout the cycle and progesterone in the second half of the cycle, after ovulation.
Estrogen and progesterone stimulate the womb lining, in preparation to receive a fertilised egg. If no fertilisation takes place, the hormone levels temporarily drop, the womb lining is shed (menstruation or period) and a new cycle starts with further egg development. We have a finite number of eggs and so the egg numbers decrease both in number and quality.
Eventually, no further egg development is possible, estrogen levels remain low, the womb lining is not stimulated and then shed so periods stop. The consequences of menopause are due to the lack of estrogen.
3. At what age does a woman go through menopause?
The average age of the menopause in the UK is 51. Around 1% of women experience menopause before age 40, which is known as premature ovarian insufficiency.
4. When does menopause end/how long does it last?
The menopause is one point in the transition from normal cycles and hormone production to cessation of cycles and hormone production. The stage from ovarian function starting to change, with fluctuating hormone production and irregular cycles, to the final period, can be several years, this stage is known as the peri-menopause. Once the ovarian function has declined and estrogen is low, this stage continues for the rest of life! However, the consequences of low estrogen vary hugely, with the impact varying enormously between individuals.
5. What are the symptoms of menopause?
Estrogen deficiency can cause many symptoms which vary in type, severity, duration and impact. The commonest and most well known include hot flushes and sweats, but low mood, anxiety, difficulty concentrating, brain “fog”, disturbed sleep, joint aches, skin changes, vaginal dryness or discomfort and bladder problems are all common.
6. How can I manage menopause symptoms?
Diet and lifestyle changes such as: maintaining a healthy weight, exercise, cutting down alcohol, reducing caffeine intake and not smoking can all help both symptom control and improve later health. Cognitive behavioural therapy has been shown to help, as well as some alternative therapies such as phytoestrogens and black cohosh. However, the most effective treatment is Hormone Replacement Therapy. For women who are advised not to take HRT, some non-hormonal medications can be prescribed.
7. What should I do if I think I’m going through menopause?
Talk about it to friends, family especially those who have gone through the menopause. Contact your pharmacist or primary care team.
8. Where can I go for more information about menopause?
For help and guidance check out online resources such as Womens Health Concern, Menopause Matters, Manage My Menopause, NHS Inform and the Menopause hub at RCOG.