1. How will I know when my menopause begins?

Dr Louise Newson (menopausedoctor.co.uk) admits that despite being a menopause specialist, she didn’t recognise her own symptoms for months.

“I was tired, irritable, down, forgetful, unmotivated and my migraines were getting worse,” she says.

“My joints ached and I was sleeping terribly. I just put it down to working too hard.”

Many women tell similar stories of symptoms they had chalked up to other things, such as ageing, stress and overwork. Only in retrospect do they realise they were probably perimenopausal.

Common signs of perimenopause (the time leading up to the menopause) tend to be periods becoming increasingly erratic – lighter or heavier, more frequent or widespread and generally more irregular until they stop completely.

Feeling uncharacteristically anxious and finding it increasingly difficult to concentrate and remember stuff can also be key signs.

You can only really diagnose yourself as being postmenopausal retrospectively – by looking back and realising you have gone a full 12 months without a period – the official definition of menopause.

The average age of this happening is 51-52 but it can occur any time between the ages of 45 and 55.

Statistically, around a quarter of women sail through menopause with no or few symptoms. The majority don’t have such an easy time.

Menopause can make the simple activities of daily life much more stressful

 

2. I know about hot flushes and night sweats, but what else should I be looking out for?

Hot flushes might be one of the most common – and visible – symptoms of menopause.

They are caused by diminishing levels of the hormone oestrogen, but there are many more symptoms, including insomnia, tiredness, vaginal dryness and reduced sex drive.

What tends to blindside women more are the psychological changes, such as anxiety, paranoia, and loss of confidence and identity.

There are many other lesser-known symptoms, including an increased risk of gum disease, indigestion and/or acid reflux, heart palpitations, itchy skin, facial hair, and drier skin, hair, eyes and nails.

Migraine sufferers may find the problem gets worse.

Oestrogen also has a protective effect on cardiovascular and bone health, so declining levels can put you more at risk of heart disease, stroke and osteoporosis.

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This is why looking after your health becomes more important than ever.

3. How do I know if I need HRT?

If your menopausal symptoms are interfering with the quality of your life, then hormone replacement therapy (HRT) could help.

The government’s National Institute for Health and Care Excellence (NICE) and the British Menopause Society (thebms.org.uk) say it is the most effective treatment available.

Many women wax lyrical about how it has given them their life back.

That said, if your symptoms are mild and you are managing them with lifestyle changes, such as diet and supplements, you possibly don’t need it.

Some women are unsure about taking HRT after a series of large studies in the early 2000s linked it to an increased risk of stroke, breast and endometrial cancer, and gallbladder problems.

These findings have largely been discredited and the consensus is that HRT is not only statistically the most successful treatment for reducing hot flushes, but it also appears to help improve mood, sleep, muscle and joint pain, vaginal dryness and libido.

The NHS says HRT may not be suitable if you have a family and/or personal history of breast cancer, womb or ovarian cancer, a history of blood clots, high blood pressure or liver disease.

As a menopause treatment HRT is a good option but only for certain women

 

4. Can herbal supplements reduce my symptoms?

Many women say they help, although the scientific evidence is mixed. In a number of small clinical studies, women who took sage supplements were found to have a lower incidence of hot flushes and they  were less severe if they did occur. Try A.Vogel Menoforce sage tablets, £13.99 ( avogel.co.uk ).

Black cohosh is another popular choice, while soya isoflavones, a type of plant oestrogen, have been
shown to help reduce hot flushes and night sweats. Try Healthspan MenoSerene (£17.99, healthspan.co.uk ) containing plant oestrogens such as soy, isoflavones, flaxseed and sage.

In a clinical trial, Potter’s Herbals Memory & Focus Capsules (£14.75, amazon.com) have been found to improve working memory fivefold.

5. I can’t focus or concentrate – what can I do?

Up to 60% of menopausal women report disconcerting “brain fog”.

Research suggests that when oestrogen levels dip, it takes time for your grey matter to learn to function with less of the hormone.

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Combine this with other problems, such as disrupted sleep, and you’re likely to feel all the more befuddled.

HRT can help, but for those who don’t or can’t take it, experts advise eating little and often to keep blood-sugar levels balanced, and drinking plenty of water. Evidence shows even very mild dehydration leads to difficulty focusing.

There is some evidence that inhaling peppermint and/or rosemary essential oils can temporarily increase concentration, while taking ginkgo biloba has been shown to help stimulate memory.

DHA, one of the compounds found in oily fish, has also been shown to help short-term memory. Be reassured that this issue is temporary.

Business colleagues going over a report in an office
The symptoms of menopause can interfere with your work

6. I am having a hard time coping with my symptoms at work. Should I tell my boss?

Ruth Devlin, author of Men… Let’s Talk Menopause (Practical Inspiration Publishing) regularly gives talks on the subject in the workplace, and says: “For far too long, women have traditionally had to shut up and put up with their symptoms, but whether you tell your boss largely depends on how responsive and receptive your managers and HR department are and whether they have a menopause policy in place.”

Things might be changing slowly, not least because the number of women of menopausal age in work has risen by over 50% in the last 30 years.

Yet many employers remain oblivious of the impact symptoms can have on their menopausal workforce. Shockingly, nine out of 10 women say they don’t feel able to talk to their managers about their symptoms.

Ruth adds that whether we choose to tell our employers or not we can all help ourselves practically by keeping a fan on our desk, wearing layers that can be easily removed should we start overheating and keeping well-hydrated.

For more information, go to letstalkmenopause.co.uk .

7. Can your diet improve your menopause experience?

What you eat and how you eat it – for example small, regular meals to keep blood-sugar levels stable and reduce mood swings – can go a long way to improve symptoms.

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Caffeine, alcohol (particularly red wine) and spicy foods all appear to be triggers for hot flushes.

Research shows that women who follow a typical Mediterranean diet with plenty of vegetables, wholegrains, fish, garlic, herbs, olive oil and moderate amounts of alcohol are around 20%
less likely to experience menopausal symptoms.

Japanese and Chinese women also suffer less than British women, which is largely attributed to diets rich in soy foods such as tofu and edamame beans.

Soy is an isoflavone, an oestrogen-like plant compound which has been shown to reduce hot flushes and vaginal dryness.

8. Is it inevitable I will put on weight?

Our metabolism and ability to burn calories tend to slow with age, and even women who have managed to stay slim all their lives report that their weight often becomes distributed differently (particularly around the waist) at this time.

Menopause also typically occurs at a time when we are possibly more sedentary, and symptoms such as achy joints and fatigue can make exercising harder.

A loss of muscle tone and becoming bloated during the menopause can add to feeling “fatter”.

Menopause does not have to mean the end of excitement and intimacy

9. Is it true I will go off sex?

The majority of women going through menopause do report a loss of desire. Your diminishing oestrogen levels can potentially leave you feeling tired and sweaty, with achy joints and sore, tender boobs. An increasingly dry vagina can make it harder to become aroused and orgasm.

Keeping yourself fit and healthy with a good diet and exercise can help you feel better about yourself generally.

There are also many effective vaginal moisturisers available, such as Sylk Natural Intimate Lubricant & Moisturiser (£9.99, sylk.co.uk ) and YES lubricants ( yesyesyes.org ).

If you don’t want sex, try not to push your partner away without explanation. Make it known it is not him. Reassure him you are still attracted to him and that this phase is temporary.

10. Are there any positives to come out of the menopause?

Yes. For starters – no more PMS and no longer having to worry about whether your period is going to start in the middle of your holiday, as well as enjoying a contraceptive-free life.

Psychologist Dr Megan Arroll
(drmegarroll.com), co-author of The Menopause Maze (Jessica Kingsley), says the time is right to change our whole thinking about menopause.

“Don’t think of these as your ‘lost years’ but rather as a new and exciting phase when life should be grabbed by the horns,” she says.

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