Menopause 101: Here’s Everything You Need To Know As we mark World Menopause Day, today.
When it comes to menopause, some would say that women have been dealt a bad hand. And while I’m not here to disagree, this isn’t about debating the pros and cons of menopause or making peace with it. This is about grabbing menopause by the horns and owning it.
Remember that you will never be alone during menopause. Approximately 13 million women in the UK alone are either peri- or post-menopausal as of 2021. So, if you’re feeling lost, confused, or just plain fed up, know that you are not alone. It’s time to break the silence around menopause. For too long, women have been suffering quietly as they go through this challenging time in their lives.
Menopause can be a very tough transition, with over 60% of women experiencing symptoms that result in behavior changes. And it’s not just a case of a few hot flashes here and there – one in four women will experience severe debilitating symptoms, almost half of the menopausal women say they feel depressed, and a third suffer from anxiety.
Women commonly complain of feeling as though they are going mad. All of these symptoms can make it difficult for women to function both at home and at work. Unfortunately, there is still a lack of understanding and support for menopausal women, with approximately two-thirds of women saying there is a general lack of support and understanding at home and in the workplace.
A 2019 survey by the Chartered Institute for Personnel and Development (CIPD) found that three in five menopausal women, usually aged between 45 and 55, were negatively affected at work. The survey also revealed that almost 900,000 women in the UK had left their jobs because of menopausal symptoms.
The Basics of Menopause
As we age, our bodies go through a lot of changes. For women, one of the most significant changes is menopause, the natural stage of life when a woman has clocked 12 consecutive months since her last period. You could be 40 or even 60 when you enter menopause, but most women experience it at 51.
Menopause can affect women differently, though some may experience more symptoms than others. Many women dread the onset of menopause, thinking of it as a single, dramatic event. In reality, menopause is a gradual process that can span several years. There are three phases in menopause: perimenopause, menopause, and post-menopause.
Stage #1: Perimenopause
Perimenopause is the first phase of menopause when hormone levels start to fluctuate, and symptoms first appear. It can start up to 10 years before menopause, sometimes striking women in their 30s. During this stage, you’ll experience menopause symptoms and fluctuations in estrogen.
Some women say that this stage is where the symptoms are at their worst. Symptoms of perimenopause include irregular periods, mood swings, hot flashes, difficulty sleeping, issues in the bedroom, vaginal discomfort, and incontinence. If you’re trying for a baby, you don’t need to hit the brakes during perimenopause. Women who are menstruating during this period can still get pregnant.
Stage #2: Menopause
Menopause is a natural stage in which a woman’s ovaries stop producing eggs and estrogen-like they once did. Once you have reached menopause, you will no longer have periods for a full 12 months. After this point, you are considered to be in post-menopause. While the two effects of menopause can be fit into a sentence, the internal process is much more complex.
During menopause, your body enters its third stage of life. Much more is going on, and menopause is not just about our reproductive hormones. For years, our bodies have been governed by our reproductive hormones. But during menopause, these hormones begin to retire, leaving our other hormones to try and pick up the slack. This can lead to several changes in our appetite, mood, sleep patterns, and body temperature.
What Menopause Really Feels Like
Most women experience some changes during menopause, but not all women have the same symptoms or experience them to the same degree. There are over 50 different symptoms that have been associated with menopause.
As women move into their late reproductive years, their menstrual cycles generally become shorter. This means that the intervals between periods grow smaller, and periods themselves may become lighter. During the menopausal transition, cycles may initially become shorter and then grow longer before becoming very irregular and eventually ceasing altogether.
Many women experience vasomotor symptoms, such as hot flashes and night sweats, during menopause. Hot flashes are the most common symptom, experienced by more than 80% of menopausal women. They usually last for one to five minutes but can sometimes last up to 45 minutes. Night sweats can also be disruptive, causing sleep loss and chronic fatigue.
Many women experience emotional symptoms during menopause. One of the most common is mood swings. Many women report feeling more irritable or even angry during menopause; these mood swings can be unpredictable and tough to manage. Other common emotional symptoms include stress and anxiety. The hormonal changes of menopause can lead to feelings of stress and worry, and some women may also experience a loss of confidence.
Symptoms Related to Sexual Function
As women enter menopause, they may experience changes in their sexual function. One of the most common problems is the genitourinary syndrome of menopause (GSM), which is caused by decreased estrogen production. This can lead to vulvovaginal atrophy or the thinning and inflammation of the vaginal walls. Other symptoms include vaginal dryness, itching, and dyspareunia or pain during intercourse.
Why Do We Have So Many Symptoms?
It all comes down to hormones. Women have estrogen receptors all over their bodies and, when levels of this hormone start to decline during menopause, we can experience a whole host of physical and mental symptoms. Other hormones like testosterone, progesterone, and cortisol can also become out of balance during menopause, further exacerbating symptoms.
One of the best places to start is tracking your symptoms. When we do this, we can identify the category they fall into psychological, physical, or vasomotor. From there, you can then look at the different solutions and options you have to help abate the symptoms.
Stage #3: Postmenopause
As women, our hormones constantly change, impacting our bodies in various ways. For example, during our 40s and 50s, our hormone levels start to decline, leading to changes in our cardiovascular system, bones, and metabolism. This can make us more susceptible to osteoporosis, insulin resistance, and cardiovascular disease.
Additionally, these changes can also cause psychological effects that have an impact on how we feel and take care of ourselves. Some symptoms can result from long-term estrogen deficiency and unhealthy lifestyle choices. One example is bone loss, which is a common symptom of menopause. Estrogen helps keep our bones strong, so we risk developing osteoporosis and fragility fractures when levels start to decline.
Cardiovascular disease is another potential complication of menopause. Lipid profiles worsen, and weight increases, as does the risk for myocardial infarction and thromboembolic events. Hair, muscle, and skin issues are also common during menopause. The hair thins and the skin becomes drier and rougher. We also lose lean mass and muscle tone, increasing fat mass. At the same time, the genitourinary syndrome of menopause can also cause dryness, dyspareunia, pelvic organ prolapses, incontinence issues, and UTIs.
Top Tips on Owning Your Menopause
Now that you understand what menopause is, here are a few tips to start owning your menopause. One word of wisdom from someone who is going through it and specialises in menopause wellness: don’t fall into the trap of thinking that this is not for you, or that you are too young to think about it. The earlier you can get yourself into healthy lifestyle habits, the easier it is to change as you enter perimenopause. I have taken small snippets of each category, just to give you an insight into the small changes you can start making today.
Food is the key to everything. Certain things may not agree with you anymore, may make you feel bloated, or cause digestive issues and energy levels to drop. There may be unexplained weight gain, too. So, to keep your body from throwing tantrums, try the elimination process. Swap acidic foods for alkaline foods – this helps with inflammation.
Trying to limit dairy and spicy foods is a good start. In my experience working with clients, there is no quick fix for this, and it is a very individual process, so give yourself time to explore new habits and monitor symptoms. Protein is essential, although eating it at the right time is equally important. Save protein for breakfast and lunch instead of dinner. Protein creates heat inside your body to be digested, so having it at dinner will create internal digestive heat, leading to hot flashes at bedtime. Not fun for anyone.
Exercising is fantastic, although it’s essential to be mindful of how and when you exercise during menopause. Hitting the gym at night can cause a bad night’s sleep. Focus on strength training and aerobic exercise to boost your heart, lungs, and physical stability. Heart palpitations are also a symptom of menopause, which you can manage with supplements and lifestyle changes.
The inner hurricane of hormones may leave you feeling anxious, agitated, irritated, depressed, or a ghoulish cocktail of all these emotions. You can combat this by identifying the triggers and learning what solutions are out there to help you put a new menopause action plan together. For example, did you know that serotonin, called ‘the happy hormone’, can be stocked up on by exposing yourself to morning sunlight? This can help you with your sleep and improve your mood.
Menopause can cause cracks in social and workplace relationships. It’s essential to allow yourself to feel what you’re feeling. You may consider having an intimate conversation with your loved ones about how they can be present for you and support you. Consider requesting special arrangements to be made at the office, should you need them.
Education and Talking Is Key
If you’re experiencing symptoms that are making your life unbearable, and you’ve tried changing your lifestyle habits without any relief, it might be time to look into hormone replacement therapy. This is a topic that warrants its own discussion, but I want to briefly touch on it here. We’ve come a long way since the Women’s Health Initiative published its