Menopause is a natural stage of life marking the end of a woman’s reproductive years. It is officially defined as occurring 12 months after a woman’s final menstrual period. Menopause often brings about physical and emotional changes due to hormonal fluctuations. This page explores the causes, diagnostic process, and treatment options for menopause.

Causes of Menopause

Menopause occurs as a result of natural changes in hormone levels, though it may also be caused by medical or surgical interventions.

Natural Causes

• Ageing and Hormonal Decline: As women age, the ovaries produce less oestrogen and progesterone, leading to the cessation of ovulation and menstruation.
• Perimenopause: The transition phase before menopause, where hormone levels fluctuate, often causing symptoms like irregular periods.

Medical Causes

• Surgical Removal of Ovaries (Oophorectomy): Leads to an abrupt onset of menopause due to the loss of oestrogen production.
• Cancer Treatments: Chemotherapy or pelvic radiation can damage the ovaries and trigger early menopause.
• Primary Ovarian Insufficiency: A condition where the ovaries stop functioning before the age of 40, leading to early menopause.

Symptoms of Menopause

Menopause symptoms vary in severity and duration, with some women experiencing mild discomfort and others having significant challenges.

Common Symptoms

• Hot Flushes: Sudden feelings of heat, often accompanied by sweating and redness.
• Night Sweats: Hot flushes that occur during sleep, disrupting rest.
• Irregular Periods: Cycles may become shorter, longer, or skip months before stopping completely.
• Vaginal Dryness: Can cause discomfort during intercourse or everyday activities.
• Mood Swings: Irritability, sadness, or increased anxiety.

Physical Changes

• Weight Gain: Hormonal changes can lead to weight gain, particularly around the abdomen.
• Thinning Hair: Hair may become brittle or begin to thin.
• Skin Changes: Reduced oestrogen can lead to drier, less elastic skin.
• Bone Loss: Increased risk of osteoporosis due to lower oestrogen levels.

Cognitive and Emotional Symptoms

• Memory Issues: Difficulty concentrating or recalling information.
• Fatigue: Persistent tiredness even with adequate sleep.

Diagnosing Menopause

Menopause is typically diagnosed based on symptoms and age, though medical tests may be used to confirm in certain cases.

Medical History
Your healthcare provider may ask about:

• The frequency and nature of menstrual cycles.
• The presence and severity of symptoms such as hot flushes and mood changes.
• Family history of early menopause or related conditions.

Physical Examination
A general examination may include assessing weight, blood pressure, and any physical changes related to menopause.

Diagnostic Tests

• Blood Tests: To measure hormone levels, including:
  • Follicle-Stimulating Hormone (FSH): Elevated levels indicate reduced ovarian function.
  • Oestrogen Levels: Typically lower during menopause.
• Thyroid Tests: To rule out thyroid dysfunction, which can mimic menopause symptoms.

Stages of Menopause

• Perimenopause: The transitional phase where symptoms begin, and periods become irregular.
• Menopause: The official stage marked by 12 consecutive months without a period.
• Postmenopause: The years following menopause, where symptoms may ease, but health risks such as osteoporosis and heart disease increase.

Treating Menopause Symptoms

While menopause is a natural process, its symptoms can often be managed through lifestyle changes, therapies, or medications.

Hormone Replacement Therapy (HRT)

• Oestrogen and Progesterone Therapy: Effective for reducing hot flushes, night sweats, and vaginal dryness.
• Risks and Benefits: HRT may increase the risk of certain cancers or cardiovascular issues; consult your doctor for personalised advice.

Non-Hormonal Treatments

• Antidepressants: Low doses of selective serotonin reuptake inhibitors (SSRIs) can help manage hot flushes and mood swings.
• Gabapentin: Used to treat hot flushes, particularly for women who cannot take HRT.
• Vaginal Moisturisers and Lubricants: Help alleviate dryness and discomfort.

Lifestyle Changes

• Diet: Eat a balanced diet rich in calcium and vitamin D to support bone health.
• Exercise: Regular physical activity helps manage weight, reduce stress, and strengthen bones.
• Sleep Hygiene: Establish a routine to improve sleep quality and combat night sweats.
• Stress Management: Techniques such as yoga, meditation, or counselling can improve emotional well-being.

Complications of Menopause

While menopause itself is not a medical condition, it can increase the risk of certain health issues:

• Osteoporosis: Loss of bone density increases the risk of fractures.
• Cardiovascular Disease: Oestrogen’s protective effect diminishes, raising heart disease risk.
• Urinary Issues: Increased risk of urinary tract infections (UTIs) and incontinence.
• Weight Gain: Hormonal and metabolic changes may lead to difficulty maintaining a healthy weight.

Preventing or Managing Menopause Symptoms

While menopause cannot be prevented, the symptoms can be managed effectively:

• Regular Check-Ups: Routine health assessments to monitor bone density, heart health, and overall well-being.
• Balanced Diet: Emphasise whole foods, lean proteins, and healthy fats while limiting sugar and processed foods.
• Hydration: Drink plenty of water to reduce bloating and dryness.
• Smoking Cessation: Reduces the severity of symptoms and improves overall health.

When to Seek Medical Attention

You should consult a healthcare provider if you experience:

• Severe or persistent symptoms that interfere with daily life.
• Unexpected bleeding after periods have stopped for 12 months.
• Symptoms suggestive of other conditions, such as extreme fatigue or weight changes.
• Concerns about long-term health risks such as osteoporosis or heart disease.

Menopause is a natural part of life, and with proper care and management, its challenges can be minimised. A tailored approach to treatment can help maintain quality of life during and after this transition. Always consult a healthcare professional for advice specific to your individual needs.