How do I know if I am in the menopause?

It is so easy to miss the signs of Menopause as few women are already equipped with the knowledge about the range of symptoms that can emerge during this transition.

Menopause is what we call a “retrospective diagnosis” which means we can only say a woman is menopausal 12 months after her last menstrual period.

Dr Sloan adds:
“We (GPs) need to think flexibly and look at an individual’s symptoms carefully and be active around treating that individual, rather than waiting 12 months allowing them to suffer unnecessarily.”

Perimenopause starts anywhere up to 10 years before your periods stop and are associated with early signs of menopause (see graph)

Why am I only realising I am struggling now?

We all have busy lives, juggling many challenges whether it be a demanding job, young children, teenagers or elderly relatives.

Many of us could easily miss our early symptoms and signs of perimenopause or menopause.

Dr Sloan talks about her experience of being a GP treating patients:

“It is no wonder that women miss the signs of perimenopause. GPs also can!
Many of the symptoms can be put down to life’s stress or other matters.

Coupled with that if a patient is still having periods then the diagnosis of perimenopause could be completely clouded.

As doctors we receive very little training on menopause (a great travesty) during our medical school years and as doctors in training. I am ashamed to say that in my early days as a GP I am sure that I missed signs of perimenopause or menopause in my patients. That has all changed now as a result of more awareness and specialist medical training.”

What are the symptoms of menopause?

Almost every system in the body is affected by low Oestrogen levels. Each individual tends to experience different symptoms which vary in severity. Studies indicate that if you suffered with PMT or had post-natal depression you are more likely to experience difficulty through your menopause. For example, hot flushes generally affect 80% of women, but not everyone has them. Some women have hot flushes for 10 years and others for 6 months.

THe most common symptoms are:

  • hot flushes and / or night sweats
  • heart palpitations
  • muscle pain
  • joint pain
  • urinary symptoms
  • reduced libido
  • vaginal dryness
  • anxiety
  • low mood or flat mood
  • memory problems
  • fatigue or extreme tiredness
  • feeling very low and joyless
  • irritability
  • poor sleep
  • headaches
  • not identifying as you anymore

Dr Sloan adds:

“The list of symptoms can go on and on. It’s easy to identify some of the more obvious symptoms such as hot flushes and your periods stopping (or becoming more infrequent). However, a large proportion of women experience more subtle signs in perimenopause such as tiredness, headaches, tingling in the arms or itchy skin whilst still having periods. It is completely understandable how a person (or GP) may not identify that hormone levels might be to blame.

Headaches, aching bones, severe fatigue, anxiety and brain fog are all symptoms that many women experience and there are all too many examples in my experience where patients have told me that their careers have had to be put on hold or completely shelved, or they have decided to reduce their hours, or change to less challenging jobs. Others have found that they have completely lost their self-confidence and experience panic attacks, and it is not uncommon for women to even stop driving due to their increased anxiety.

It can be really rewarding to treat someone with HRT and they get relief from these issues that are making their day to day lives very difficult.”

What causes the Menopause?

We are born with a certain number of eggs in our ovaries and the natural process happens where over time we start to run low on eggs until they eventually run out.

There is the reproductive stage in life (pre menopause) where we are supposed to release one egg per month. As our lives go on towards our post reproductive stage, we will start to produce less and less eggs and ovulate less times per year.
Women then go into perimenopause where hormone levels start to fluctuate and over time oestrogen levels decline (as do the other hormone levels).
Changes happen to the pattern of periods. Periods become more frequent, or less frequent or irregular. Some women start to notice heavier periods than before. Perimenopause generally starts to affect women in their 40’s. During perimenopause hormone levels become erratic and are difficult to measure accurately using blood tests. Many women notice more mood swings, agitation or less tolerance and patience than before.

The average age of menopause is 51 years old in the UK. This known as “post reproductive period.” Once a person is in menopause, their hormone levels will be very low for the remainder of their lives. Symptoms can be ongoing for on average 7 years and will change over time. Some women can go onto have symptoms for decades.
Vaginal dryness is a common symptom especially in post-menopausal women who keep suffering with bladder dysfunction and get miss treated with antibiotics rather than with oestrogen creams.
Oestrogen is important for bone density and older women are more at risk of osteoporosis and fragility fractures.

Does menopause only affect older women?

No, young women can suffer with ovarian failure called premature ovarian failure or through surgical removal of their ovaries, or from drugs such as chemotherapy.

Talk to us

If you would like to find out more about the menopause and its symptoms, why not get in touch with our team today!