Menopause occurs when a woman stops having periods for 12 months. Usually, 2 years prior, your periods may become irregular and start to skip

Menopause. Sign and Symptoms. Woman silhouette with highlighted internal organs.

months as the ovaries begin to slowly fail. You may also note a change in the characteristics of your period, as they may become heavier.

As you age the number of eggs in your ovaries diminishes significantly, and as that happens, the amount of estrogen produced falls also. When there are no eggs left, the ovaries cease to produce estrogen, leading to menopausal symptoms, discussed below. Menopause will usually occur between the ages of 45-55, with the Caribbean average being 49.

Around 1 in 100 women will experience premature menopause, thus facing symptoms before they reach the age of 40. Early menopause can occur for several reasons, including surgery to remove ovaries, chemotherapy, radiotherapy, or due to an underlying medical condition, such as Turner’s Syndrome.

During menopause, a woman’s hormone levels drop significantly, often causing several uncomfortable symptoms, the severity of which will vary from woman to woman. Menopausal symptoms usually first occur during the perimenopause stage – the months or years leading up to the end of the period. The first sign of menopause is a noticeable change to the normal pattern of your periods, such as becoming unusually light or heavy or varying in frequency. Eventually, they will stop completely. Common symptoms include:

  • Hot flashes & night sweats
  • Vaginal dryness & reduced sex drive
  • Sleep disturbance
  • Difficulty remembering things & difficulty concentrating
  • Mood swings, anxiety and in some cases, depression
  • Frequent urinary tract infections
  • Bladder weakness
  • Palpitations
  • Aching limbs or stiffness
  • Dry skin

Many women are able to manage their symptoms themselves, while others will find them exceptionally troublesome. Simple measures such as exercise, layered clothing and reduction in caffeine intake may be very helpful. Where these fail or symptoms are too severe, other treatment options are available.

Hormone Replacement Therapy (HRT) HRT is a highly effective treatment option, which involves replacing the hormones oestrogen and progesterone, which are significantly reduced during the menopause. HRT is particularly useful in alleviating several symptoms of menopause, including hot flashes, vaginal dryness, UTIs and reducing the incidence of incontinence. It can also help in preventing osteoporosis since oestrogen plays an important role in maintaining healthy bone density.

Though HRT has received some bad press over the years due to misinformation and conflicting advice, the majority of women who undergo HRT will find that it dramatically helps alleviate their menopause symptoms. There are two main types of HRT available:

  • Combined HRT (Oestrogen and progesterone) – for those who still have their womb in place.
  • Oestrogen-only HRT – for those who have had the womb removed through hysterectomy.

When deciding whether HRT is the right treatment option for you, your gynaecologist will assess the severity of your symptoms, your age, lifestyle, medical, personal and family history. It is recommended that you stop using these drugs at the age of 50 but if symptoms are severe they can be continued after review with your gynaecologist.

Lifestyle changes Regular aerobic exercise, such as running and swimming, may help, as may low-intensity exercise, such as yoga. Reducing your intake of caffeine and alcohol may also help to reduce hot flushes and night sweats. If you smoke or drink excessively, it is a good idea to stop, as they can increase the risk of heart disease, stroke, osteoporosis and cancer, whilst also increasing hot flushes.

Psychological treatments Cognitive behavioural therapy (CBT) is a type of psychological treatment. You may be offered CBT for low mood or anxiety related to menopause. This therapy involves talking about your symptoms and helps alter the way people think, by attempting to change behaviours and recognise distorted ways of thinking

Alternative methods Some women prefer to seek relief through alternative methods such as acupuncture, though this may not work for everyone. Herbal therapies such as Black cohosh and St John’s wort may also be of benefit.