Hot flashes, sleep problems, and mood swings â€” these are the symptoms that many people may be familiar with when it comes to menopause.
Yet there is so much more to this biological transition that anyone who has periods goes through. When a person has stopped having periods for 12 months, they have officially gone through menopause.
The time leading up to this point is called perimenopause, and many experience a range of symptoms during this time. How long people will spend in perimenopause varies greatly from person to person.
To find out what everyone should know about menopause and why, as a society, we find conversations around womenâ€™s health so difficult, I spoke to broadcaster Rachel New, who recently wrote a Through My Eyes piece about her experience of menopause for ishonest.
Joining us in conversation was Dr. Louise Newson, a general practitioner (GP) in the United Kingdom and menopause specialist. Louise is the founder of the free balance app, which allows users to track symptoms and changes in their periods. The app also provides information about menopause.
To hear more about menopause, including the latest on hormone replacement therapy (HRT), listen to the accompanying podcast:
The list of symptoms â€˜can go on and on and onâ€™
We started our conversation with Louise taking us through what happens during menopause.
â€œMost of us go through the menopause as a natural process. Our hormones deplete because our eggs run out in our ovaries. And when they run out, [the] hormones associated with them go down,â€ she explained.
â€œSome women have their menopause forced on them,â€ Louise continued.
For some, menopause happens as a result of a medical procedure, such as the surgical removal of the ovaries, or certain drugs or treatments.
â€œThe average age in the U.K. is 51, but around 1 in 100 women under the age of 40 have an early menopause. My youngest patient is 14, [and] my oldest is 92, so it can affect all women [of] all ages,â€ Louise said.
And what about perimenopause? Louise told us that perimenopause can last several years, a decade, or even more.
â€œ[The] symptoms can start sometimes just for a few days before each period, and then it can be a week or 2 weeks, and then all the time. Itâ€™s quite a transient process that often worsens with time,â€ she said.
She listed the range of symptoms that a person can experience:
- low mood
- memory problems
- feeling very low and joyless
- poor sleep
- heart palpitations
- muscle pain
- joint pain
- urinary symptoms
- reduced libido
- vaginal dryness
â€œThe list can go on and on and on, actually, and symptoms can vary between women and actually sometimes vary between the days and months.â€
â€“ Dr. Louise Newson
Some have â€˜symptoms for decadesâ€™
For some people, menopause means the end of their symptoms. But this is not the case for all.
Once a person has gone through menopause, their hormone levels will be low for the rest of their life. In some, this is accompanied by ongoing symptoms.
â€œThe average length of time for symptoms is about 7 years, but I certainly have seen and spoken to many women who have symptoms for decades,â€ Louise explained. â€œBut symptoms change.â€
â€œA lot of women find that their hot flashes and sweats improve. And then when you talk to them, theyâ€™ll say, â€˜Now Iâ€™ve gone through my menopause, I donâ€™t have any symptoms.â€™ But then they will say, â€˜Oh yes, but my sleepâ€™s rubbishâ€™ or â€˜I have some joint pains, and I canâ€™t exercise the same wayâ€™ or â€˜Iâ€™m just a bit more irritable,â€™ so these symptoms often do linger,â€ she continued.
Rachel told us that she can trace back the beginning of her menopause to when she was 51. But prior to that, she had experienced problems with her sleep throughout her 40s.
â€œI was having vaginal problems, but I kept thinking I had thrush. I was getting urinary tract infections. But it was only when I was 51 that those problems started to really bother me. I kept going to the doctor [and] being put on antibiotics for urinary tract infections,â€ Rachel said.
â€œSex was becoming painful at the same time. My periods were getting closer together and heavier. Iâ€™d always had quite heavy periods, but now, I wake up [and] Iâ€™d flood the bed [â€¦] But I didnâ€™t know this was the perimenopause. Iâ€™d never heard of perimenopause.â€
â€“ Rachel New
Other symptoms that Rachel experienced included itchy skin all over her body. Her GP did not mention menopause or perimenopause to her at the time.
â€œIt was only when I went and had a Mirena coil fitted for my really heavy periods [that] the gynecologists talked to me about perimenopause,â€ Rachel told us.
Her experiences led her to set up her own podcast about menopause, called â€œOn My Last Eggs.â€ Rachel told us that she feels her experience mirrors that of many others. Faced with perimenopause, she sought out Louiseâ€™s YouTube videos.
â€œI [thought], Oh my gosh, this is whatâ€™s wrong with me. I felt like I had finally found someone that I could trust the advice of,â€ Rachel explained.
Missing the signs
I asked Rachel why it is so challenging for women to find information about menopause. â€œWomen of menopausal age are very different from women of menopausal age in the past,â€ she said.
â€œOften, a woman may be in her perimenopause, [and] she may only have a 5- year-old child. She doesnâ€™t equate herself with a menopausal woman â€” she may be at the peak of her career. She doesnâ€™t look like our menopausal mothers or grandmothers looked like, and so I think often we just donâ€™t understand,â€ Rachel continued.
Few women are equipped with the knowledge about the breadth of symptoms that can accompany perimenopause. Add busy lives to the mix, and it can be easy to miss the fact that these symptoms must have a cause.
Louise added that there is a gap in menopause education among doctors.
â€œI feel very embarrassed that I have probably missed thousands of women whoâ€™ve come to see me as a GP, telling me they have headaches, or they feel low, or theyâ€™re tearful, or theyâ€™ve had palpitations, and Iâ€™ve never thought about their hormones, because I didnâ€™t really know,â€ she shared with us.
Louise missed the signs of her own perimenopause. â€œI was busy developing and writing the content for Menopause Doctor, and I was also lecturing other healthcare professionals, saying, You must not miss the other symptoms of the menopause,â€ she told us.
â€“ Dr. Louise Newson
â€œSo I had a lot of reason to be tired, irritable, and low mood, poor sleep, back-to-back migraines, etc. Not once did I think about my own hormones,â€ Louise explained.
Time to change the narrative
â€œWe need to be so much more open about womenâ€™s health,â€ Rachel advocated. She called for conversations about reproductive health, including periods, fertility, and endometriosis.
Louise pointed to the lack of menopause research and suggested a change in narrative.
â€œIf weâ€™re not going to listen to women talking about symptoms, then we need to think about the health risks, and we need to think about the risks to the economy,â€ she said.
Louise explained that around 20% of women either consider leaving their job or do so due to menopause. In addition, poor memory, anxiety, and fatigue are very common symptoms and can impact workplace productivity.
â€œItâ€™s affecting the health economy, because 1 in 3 women will have an osteoporotic hip fracture, which costs the NHS Â£3 billion a year,â€ she added.
Rachel encouraged everyone to arm themselves with information about menopause. She was also keen to bring vaginal health into the spotlight.
â€œI would say to women, You deserve to have a healthy, happy, comfortable vagina [â€¦] and donâ€™t take any kind of fob off for an answer. Everyone deserves to have a lovely, happy, useful vagina that they can carry on having sex with and enjoying, and so donâ€™t be battered away from that.â€
â€“ Rachel New
To Louise, menopause should be on everyoneâ€™s radar. â€œA lot of the work that needs to be done about awareness is [that] not just middle-aged women need to be aware,â€ she said.
â€œWe all need to be aware: men, women, children, adults, everyone. Because we all know women, [and] recognizing [menopause] within our friends or family or work colleagues can be really important,â€ she added.
Weâ€™re new to audio on MNT and want to make sure weâ€™re doing it right. Let us know what you thought of our In Conversation podcast by emailing us at mnt_editors@https://www.ishonest.com/.
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