Feminine Health

Menopause: Everything You Need To Know

Getty Images © Happy older woman smiling and using weights outdoors

What is the menopause?

The menopause is the phase in a woman’s life cycle where her periods stop and she becomes unable to have children,” says Dr Riccardo Di Cuffa, founder and GP at Your Doctor (your-doctor.co.uk).

What age does the menopause start?

The average age of the start of menopause is around 45, with many women hitting the peak of their menopause symptoms at age 50. “It starts with the body producing less oestrogen and fewer eggs than before,” says Dr Riccardo Di Cuffa. “Women start by experiencing hormone level changes – these may manifest as mood swings, irritability and anxiety, rather than just hot flushes and night sweats,” says Dr Marilyn Glenville (marilynglenville.com), one of the UK’s leading nutritionists specialising in women’s health. 

So how long does the menopause last? Unfortunately symptoms can last between seven to 14 years, and you’ll know it’s finished once all your symptoms come to an end. Some women also experience light bleeding after the menopause. If you have any concerns, you should always contact your GP.

What are the first signs of menopause?

It can be easy to get the perimenopause and menopause muddled. Many women believe pre-menopause symptoms begin with hot flashes and finish with your menstruation ending. Signs of early menopause will be when your symptoms are experienced whilst you’re still menstruating; this is known as the perimenopause. 

“Perimenopause can begin years before women start to experience the menopause,” explains Dr Kathryn Basford, GP at Zava UK (zavamed.com). “This is the point when the ovaries gradually begin to make less oestrogen. Women typically start to experience this from their late 30s to early 40s. There is some overlap in the symptoms of the menopause and perimenopause: women often experience hot flushes, worsened premenstrual symptoms, diminished sex drive and fatigue.”

Menopause symptoms

What are the 34 symptoms of menopause? The menopause can be a stressful time, and you can experience many uncomfortable symptoms, including hot flashes, vaginal dryness, mood swings and joint pain. According to research by the British Menopause Society, over half of women say that the menopause has had a negative impact on their lives. Sadly, many women going through it believe that the menopause is not something to be talked about with others, particularly in the workplace, but we don’t think this should be the case. 

Menopause and weight gain

“The hormonal changes of menopause might make you more likely to gain weight, and it may be harder to lose it, but hormonal changes alone don’t necessarily cause weight gain,” says Dr Riccardo. “Instead, weight gain is usually related to ageing, as well as lifestyle factors such as a lack of exercise, unhealthy eating and not getting enough sleep. Genetic factors can also play a part. 

“Muscle mass typically diminishes with age, while fat increases. Loss of muscle mass decreases the rate at which your body uses calories, which can make it challenging to maintain a healthy weight. If you continue to eat as you always have and don’t increase your physical activity, you’re likely to gain weight.”

Hot flashes and menopause diets

Hot flashes in menopause can be one of the most uncomfortable symptoms, but changing what you eat can reduce them. “Ever noticed that those hot flashes and night sweats increase after having steak and red wine for dinner?” asks women’s health acupuncturist and The Luna Hive expert, Kerry Woodham (tlcacupuncture.co.uk). “Red meats and alcohol, in addition to caffeine and chocolate, can increase your body temperature. Ensuring that these elements are not consumed within one meal can be beneficial. Adding cooling yoghurt or a yoghurt-based dip balances the heating aspect of many warmer dishes – and yoghurt is a great replacement for sour cream in lots of savoury meals and dips.”

“Adding oily fish to your diet, such as salmon, mackerel and sardines can do more for your hormones than you might think,” says Dr Marilyn Glenville. “Research has shown that eating oily fish could delay the menopause by three years,” says Marilyn. In addition to oily fish, a daily 90g portion of legumes have also been shown to delay the arrival of the menopause by a year, according to a study carried out by the Journal of Epidemiology and Community Health. 

Phytoestrogens, which are found in peanuts, peas, carrots and broccoli are particularly vital for women around menopausal age. “Add phytoestrogens (dietary oestrogens) to your diet, as these foods will help your hormones as you go through the menopause,” says Marilyn. “We know that women who eat a diet rich in phytoestrogens have significantly fewer hot flushes, up to half the amount experienced by women who eat too few phytoestrogens, so make sure these are included in your diet and opt for variety.”

The stages of menopause and your hormones

“Oestrogen is the major female hormone and most of it comes from the ovaries, with small amounts also being produced in the fat cells and adrenal glands,” says Dr Shirin. “It’s important for sexual development, reproduction and menopause, but it also affects a huge range of aspects of the body, from the brain and the cardiovascular system to hair and bones. It’s also thought to help maintain energy, so if your oestrogen levels are low, you’ll feel tired and exhausted.”

“During your monthly cycle, your oestrogen levels go up and down,” Dr Shirin explains. “In the first two weeks they increase, resulting in you having higher energy, and in the third week, they drop, leading to a dip in energy levels as a result. The most common causes of low oestrogen for women are too much exercise, a lack of food, early menopause and other medical conditions.”

Menopause supplements

While we may endeavour to get all of the nutrients we need through our diet alone, when you’re looking for menopause relief, supplements could be the way to go. GP and founder of The Women’s Hormone Clinic (thewomenshormoneclinic.co.uk), Dr Rebecca Poet suggests that supplementing omega 3, 6 and 9 fatty acids helps to maintain optimal hormone production. “A supplement of vitamin B complex can be a good way to ease anxiety and irritability, while 100-300mg of magnesium taken in the evenings calms your nervous system ready for sleep, and is a great way to deal with insomnia,” she adds.

With such a wide range of supplements available to buy, it can be tricky to decide where to invest your money. Try to look at the individual ingredients printed on the label before you purchase a supplement, and always go by the recommended amounts on the back of the packaging, as over-supplementing comes with its own health risks.

Hormone therapy for menopause

The most common menopause treatment that you’ll be likely to discuss with your GP is HRT. “HRT stands for Hormone Replacement Therapy and there are different types and doses,” explains menopause specialist Dr Louise Newson (menopausedoctor.co.uk). “The most important hormone is oestrogen, and the safest way of obtaining this is through the skin as a patch or gel. If a woman still has her womb, then she also needs a type of progestogen. The best way of having this is either as a capsule of micronised progesterone, or having a Mirena coil.”

“The benefits of taking HRT usually outweigh any risks, and it can lower your future risk of heart disease, osteoporosis and type 2 diabetes. The risk of breast cancer with HRT is very small and studies have not even shown it to be significant. At its worst, the increased risk is similar to an increased risk a woman has if she drinks a couple of glasses of wine or is overweight. It’s very important that women receive the optimal dose and type of HRT for them, so all women should receive individualised consultations.”

Do men go through the menopause?

The term male menopause has been used a lot in the media, however using the phrase menopause for men can be misleading as it suggests that there could be a sudden drop in testosterone levels in middle age, similar to what occurs in the female menopause. However, this is inaccurate. What actually happens for older men – and what is classed as the symptoms of ‘male menopause’ – is that during their late 40s and early 50s, some men can develop depression, loss of sex drive, erectile dysfunction, and other physical and emotional symptoms.