Menopause - The Change of Life

Most Australian women will reach menopause between the ages of 45 and 55. The average age is 52 years. Around 1% of women will have early menopause (before the age of 40). Menopause is a natural event that brings about the end of monthly periods and ovulation. It is often referred to as ‘change of life’. Menopause is confirmed when there has not been a period for 12 months.

As a woman gets closer to menopause her ovaries produce less oestrogen and progesterone. The decrease in these hormones causes the symptoms of menopause. How each woman is affected varies from individual to individual. You may get one of these symptoms, or all of them. The effects may be mild or severe. They may last a short while, or for years.

As hormone production is decreased, changes in the menstrual cycle become noticeable, such as shorter or longer cycles, irregular cycles, or heavier or lighter bleeding.

More than 80% of menopausal women get hot flushes - a sudden warm feeling over the chest, neck and face that can last a few seconds or several minutes. A hot flush can be accompanied by increased heart rate, palpitations, sweating, nausea or tiredness. Many women experience night sweats, waking up covered in perspiration.

Mood swings are considered by many to be a sign of menopause, but there is some debate as to whether they are due to falling hormone levels or not. Other causes could include lack of sleep, increasing age or major life changes, such as children leaving home, grandchildren arriving or ageing parents needing care.
Some women have sleep problems or insomnia. This can be caused by night sweats or the need to urinate more frequently. These interruptions also contribute to irritability.

A woman may also become less interested in sex during menopause. Some women also find intercourse uncomfortable due to vaginal dryness, which also increases the likelihood of irritation or infections. Similar changes in the urinary tract can increase the frequency of urination and the chance of infections.

Other physical changes around menopause can include aching joints, increased weight, dry and itchy skin, coarse hair and aching muscles.

So, what treatments are available to reduce the impact of menopause? You may have heard of Hormone Replacement Therapy, or HRT. This involves taking regular doses of oestrogen and progesterone to reverse the declining levels of oestrogen in the woman’s body. This can be done via tablets, patches or other delivery methods. For bladder or vaginal symptoms, HRT in the form of vaginal tablets, creams or pessaries can help.

The right dose of HRT can help reduce the effects of menopause in many women. But menopause affects each woman differently, so the amount of HRT, the hormones used and how it is delivered should be tailored to each individual. For example, women who have had a hysterectomy don’t need progesterone. Low dose testosterone is good for women with low energy or libido. There are some side effects to HRT, so if you are considering this treatment it’s a good idea to discuss it in detail with your GP or gynaecologist.

Some women prefer to have no treatment and let nature take its course. Natural and herbal treatments or lifestyle changes are useful for many. In some women, oestrogen treatment may be contra-indicated.

Menopause is something that each woman must go through. For some it may have little impact on their lives. For others it can be a major trial. You can be prepared for it by talking to people who understand the condition – your GP, your gynaecologist and other women who have been through it.