Hot flushes, night sweats, mood swings, vaginal dryness, weight gain - they've all been linked to the menopause. But how do you know what's in store and how can you stop your symptoms from interfering with your life?
Most of the changes that happen around the menopause are due to changes in hormone levels, particularly dropping levels of the female hormone oestrogen. The 'average' age periods stop is 51, but any time from 45 is 'normal'. See your doctor if your periods stop earlier.
Some symptoms of the menopause - particularly hot flushes and vaginal dryness - are almost always a direct effect of the menopause (although If you get fevers and weight loss along with night sweats, see your doctor to exclude other medical conditions). However, it can be difficult to tease out whether it's the menopause itself, or other events in your life happening around the same time, that are mainly to blame for some other symptoms. For instance, if hot flushes are stopping you sleeping, you may feel more tired and miserable. Mood swings or depression around the menopause can affect your appetite, making you prone to weight gain.
Hot flushes are the 'classic' menopausal symptom we all know about. Three in four women get some hot flushes, where you suddenly a wave of heat spreading over your upper body, neck and face. You may feel giddy, weak or sweaty, go red and feel your heart beating very fast or very hard. The flushes usually last for several minutes, and can vary from an occasional mild feeling of warmth to periods of intense heat 15 or 20 times a day. Night sweats are just what they sound like - one minute you're nicely cosy, the next you're drenched in sweat and throwing off the bedclothes.
We used to say that hot flushes lasted, for most women, for just two or three years around the menopause. However, a study last year suggested they may last much longer than that - an average, in fact, of seven years, starting up to three years before your last period. In some women, hot flushes start around the time of their last period, and in these women the average length of hot flushes is about three and a half years.
Vaginal dryness is another common problem - as well as making sex uncomfortable, it can make you prone to urine infections, vaginal soreness and sometimes incontinence. Unlike hot flushes, vaginal dryness doesn't tend to settle with time. Topical HRT (in cream, pessary or flexible vaginal ring form) can be extremely effective. Because the dose is so small, the risk of side effects is very low. Non-hormonal vaginal moisturisers (your pharmacist can advise) are an alternative.
Many women do put on weight around the menopause, but it's not inevitable and your weight shouldn't keep going up. It's estimated that the 'average' woman puts on about 5lb after the menopause, but it doesn't all go on straight away. Certainly your metabolism does tend to slow down as you get older, so you burn up fewer calories. However, with small adjustments in your diet, you may well be able to avoid putting on weight.
The bad news is that even if you don't put on weight, you might find that the menopause does cause your shape to change. There is evidence that you tend to shift more towards an 'apple' rather than a 'pear' shape around the menopause, with excess weight stored around your midriff. This can increase your risk of heart attack and type 2 diabetes.
HRT is very effective at treating hot flushes. It protects against osteoporosis, too, although the benefit depends on how long you take it for and drops off once you stop. Taking HRT slightly increases your risk of getting (but not dying from) breast cancer while you're taking it, but this depends on how long you take HRT for, and the risk goes down when you stop treatment. The risk of deep vein thrombosis (DVT) and pulmonary embolism (clots on the leg or the lung - link to PIL) is increased by some forms of HRT but not others. Your GP can advise on the specifics of risks and benefits for you, depending on your medical history.
There are lots of lifestyle tips to cut the impact of hot flushes and sweats too, including avoiding woolly jumpers and polo necks; cutting out alcohol and caffeine; switching to a thinner duvet; and wearing several thin layers you can take on and off. Increasing the amount of soya you eat and drink may also relieve flushing, as can herbal remedies like Menoherb® or red clover.
Regular exercise can relieve hot flushes, protect your heart and help keep weight down. It can also protect against osteoporosis and type 2 diabetes - and all drug-free!
With thanks to 'My Weekly' where this article was originally published.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.