World Menopause Day: Dr Bella explains the fundamentals everyone should know

This World Menopause Day, GP and women's health specialist, Dr Bella Smith, blogs about the fundamentals everyone should know about the menopause.

What is the menopause?

The menopause is an inevitable stage in a woman’s life when her periods stop and it marks the end of her fertile years. A natural menopause occurs on average in the UK at the age of 51 but symptoms can start years earlier, often from our mid 40s.

A frequently asked question is ‘What is the difference between the menopause and the perimenopause?’.

The menopause is ‘the end of your periods’, when your periods have stopped for more than a year if you are over 50 and for more than 2 years if you are over 45. The perimenopause is the ‘hormonal rollercoaster stage’ before the menopause most commonly in our mid 40s, when you still have periods – regular or irregular – and develop menopausal symptoms such as hot flushes and night sweats.

Why is the menopause so often overlooked?

  • Stigma

Stigma and embarrassment has historically surrounded the menopause leading to shame and secrecy of symptoms. Women would just ‘put up’ with their symptoms and did not complain to their partners or see their Doctors.

  • Variety of symptoms

The menopause can affect women very differently with a huge variety of symptoms that can make it harder to diagnose. These symptoms may have been tolerated or normalised and the diagnosis may have been overlooked.

  • Life expectancy

The role of women has changed in the past 50 years with women now having successful careers until retirement age, and therefore women are experiencing menopause symptoms at work which is having a bigger impact on their lives. Life expectancy has increased putting more women at risk of the long term post-menopausal complications such as the reduction in bone density.

  • Education

In the past education on the menopause has been lacking in schools, the workplace and the training of health professionals. This has led to a number of women not being able to access the right diagnosis or management of their menopause.  Hopefully this is changing. The menopause is now on the curriculum to be learned in schools and has become an important area of learning in Doctors training.

  • Awareness

Historically the Menopause has been a ‘no-go’ topic in society and in the media but thanks to some brave high profile women coming forward to talk about their own experiences and debilitating symptoms this has raised awareness of the topic so that people are much happier to talk about it.

  • Scientific Evidence

There is increasing research into the menopause and strong scientific evidence that now supports treatments such Hormone Replacement Therapy. There is also NICE guidance available for the diagnosis of the menopause and the management options.

Why is the Menopause important?

The menopause can impact a woman’s physical, mental, emotional and sexual health. Women report symptoms affecting their family life, relationships, friendships and even their ability to work. It is estimated that 20% of women take time off work due to menopausal symptoms and 10% retire early.

How can you tell if it’s the Menopause or Gynaecological Cancer?

There can be an overlap between some of the symptoms we describe for the Eve Appeal as possible gynae cancer symptoms and menopausal symptoms.

A really important symptom is post-menopausal bleeding. If you have been through the menopause and your periods have stopped for more than a year over 50 or more than 2 years over 45, then you should NOT bleed again. And if you do this is classed as a ‘post-menopausal bleed’ and could be a sign of womb cancer. This bleed must be reported to your GP and investigated.

Bleeding after sex is an important symptom to discuss with your GP as it could be a symptom of a gynaecological cancer. It is important to attend for your cervical screening when contacted as this will monitor for any risk of cervical cancer.

The bottom line is that there are hormonal changes in the perimenopause that can change your periods and this can be normal, however if you are concerned then it is important to discuss with your GP.

General changes during menopause

Symptoms of the menopause can include hot flushes, night sweats, joint pain, muscle pain, low mood, anxiety, low sexual desire and vaginal dryness. There are many more symptoms described including sleep disturbance, brain fog, hair loss, breast pain and many more. If you are concerned about the menopause see your own GP or have a look at the British Menopause Society website for a list of all the recognised NHS and private menopause clinics in your area that you can be referred to.  See the Eve Appeal website for information.