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[Emma]

MENOPAUSE
The term "Menopause" means the last period. The average age of periods stopping is 51 years of age in the UK.

Periods stop naturally because ovaries run out of egg cells. The ovaries are then unable to produce the usual cycle of fluctuating levels of the hormones estrogen and progesterone which are dependent on the cyclical development and release of eggs. With resultant low hormone levels, the womb lining is not stimulated to be thickened and then shed as in the normal cycle, and so periods stop.

Consequences of the menopause are due to  estrogen deficiency and can be divided into early, intermediate (vaginal and bladder) and late (bone and heart health)

[Emma]

PREMATURE MENOPAUSE
Menopause can occur early and affects 1% of women under the age of 40, and 0.1% of women under the age of 30. Menopause under the age of 45 is known as early menopause and under the age of 40 as Premature Ovarian Insufficiency.

[Emma]

MENOPAUSE SYMPTOMS
Menopausal symptoms are not just about flushes and sweats. Many women experience mood changes such as low mood, mood swings, tearfullness and anxiety. Talk about it, explain how you are feeling so that your family, friends and work colleagues understand.

You can experience Menopausal symptoms even if you are still having periods. The phase known as perimenopause is when hormonal levels fluctuate and can trigger a range of symptoms. See: perils of the perimenopause

[Emma]

CONTRACEPTION

Contraception is still needed even after your periods stop; for another two years if periods stop under age 50, and for a further year if they stop after age 50.

No woman needs Contraception   after the age of 55. Even if still having periods then and so still having some ovarian function, it is believed that the egg quality will be very poor so that pregnancy is extremely unlikely to occur.

[Emma]

MENOPAUSE DIAGNOSIS

Blood tests are not required, and indeed are not recommended, to diagnose perimenopause or menopause in women aged over 45 and are rarely useful in women aged 40 to 45, though can be considered in this age group. Diagnosis should be made by history of symptoms and period pattern

[Emma]

HRT

Bioidentical hormone therapy from compounding pharmacies is not regulated or government approved. If hormone therapy is required, government approved preparations prescribed on NHS should be used. See Types of HRT and decision tree.

[Emma]

BLADDER MATTERS

Bladder function and risk of urine infections can be affected by menopausal estrogen deficiency. Symptoms are common and can respond to bladder training and vaginal estrogen treatment. See our bladder matters website.

[Emma]

PROLAPSE

Symptoms of prolapse are common in the postmenopause. Symptoms can be helped by carrying out pelvic floor exercises and maintaining healthy weight.

[Emma]

VAGINAL DRYNESS

Menopause can be associated with reduced interest in sex, which can be due to vaginal dryness and discomfort. Many women find it difficult to discuss this and might even hide the problem from their partner, making excuses not to have sex. Effective treatments are available.

[Emma]

VAGINAL DRYNESS AND DISCOMFORT

Many women still suffer from menopausal vaginal dryness and discomfort, often not realising that it is due to estrogen deficiency. Dryness and irritation can lead to pain during sex, but also during sitting and cycling. Self esteem, confidence and relationships can all be affected.
See the movie to help with understanding.

[Emma]

A to Z of MENOPAUSE and MEDICAL CONDITIONS

Many women with medical conditions are unsure as to whether or not the condition will be affected by the hormone changes of the menopause, and whether or not they can take HRT.
See our A to Z of Menopause and Medical Conditions.

[Emma]

HRT and "BIOIDENTICAL" HORMONE THERAPY

When considering treatments for menopausal symptoms, many women express concern and confusion around which hormone therapy is safe, and what is the differece between HRT prescribed from a GP, and "bioidentical" hormone therapy. See our previous magazine article to understand the differences.