Estimated reading time: 17 minutes
beginners guide to the Forbidden topic of menopause
Until recently, menopause has been the women’s health topic talked about the least.
Why is that?
Menopause is an inevitable part of a woman’s life.
The menopause happens to us all.
It will happen to you starting at some point in your 40’s, and you’ll begin to feel the effect on your body and, possibly, on your mental health.
Surprisingly many women don’t know the symptoms of the menopause
Here’s an example of how uninformed many women are.
I attended a family wedding not very long ago.
Time spent with my more distant family to catch up on their lives was priceless as it always is.
At this lovely family occasion, I had a stark reminder of how little some women know about the symptoms that indicate perimenopause.
And how little humour some women have when you suggest the ‘change of life’ may be happening to them.
During the day one of my sisters-in-law described, at some length, her fears over her mental health.
She told me about some distressing panic attacks she was suffering from and the onset of terrible migraines.
I immediately recognised the symptoms of perimenopause. I’d been through them all, and I expressed sympathy but explained that it was probably best to get a blood test just to set her mind at rest and get the help her doctor can offer to manage the symptoms if I was right.
The look of anger on her face was priceless! How dare I mention her and menopause in the same breath?
‘I’m only 44!”
‘Because you could be in perimenopause’ I said.
The look of horror on her face was a surprise to me. She was adamant that at 44, she is years away from menopause.
“No! These are panic attacks, and migraines and the other women at work know I’m suffering panic attacks and cover for me when I need to go outside to cool down.”
I found it shocking and quite upsetting that the thought of suffering a mental health problem was more comfortable for my sister-in-law than the possibility of approaching menopause.
I started to wonder why she found the thought of menopause so shocking?
Why is the number 1 women’s health consideration such a difficult thing to think or talk about?
It isn’t that difficult to understand her reaction.
After all, women ‘of a certain age’ are the butt of jokes. Office banter about ‘it’s her hormones’ doesn’t help either.
Then there’s the thought that you’re getting older.
Past child-bearing age.
Becoming middle-aged with all the connotations that go along with that.
Midlife – the time to put away the skinny jeans and move onto elasticated waistbands.
Menopause is a time to stock up on tin hats for our loved ones to wear while we regress to the irrational teenager phase, complete with bad skin and mood swings.
The effect menopausal symptoms can have on the lives of some women can be scary.
But it isn’t that way for everyone.
Firstly the symptoms of menopause or peri-menopause
To begin with, can I just say, that the list of symptoms below can make for unhappy reading.
My own experience would indicate that peri-menopause (the phase where most of the symptoms are experienced) isn’t as bad as the press articles would have us believe.
I must admit here and now that I suffered just 2-night sweats.
But I must also say that those two were truly unpleasant and left me feeling drained and uncomfortable. I was also in full apology mode with my husband, who felt the impact of changing drenched sheets at 3 in the morning.
It isn’t very newsworthy to say that, for many women, the menopause does not make their life a total misery.
For other women though, the symptoms are severe and can make their life almost unbearable.
Even if you have a number of symptoms, help is available to make life more manageable.
Your doctor is a great place to start as none of us are the same. We all have different health histories that mean dealing with symptoms may need to be tailored for the individual.
My online research shows that 77% of women reach menopause without reporting mood changes
That leaves 23% of women – almost a quarter – experiencing some mood changes, primarily during perimenopause.
That’s a significant number.
The physical changes and their effect on women’s health
My own experience – of having confirmation that I was menopausal – was liberating.
What I mean is, I finally understood why I had found the last couple of years so confusing and at times downright difficult.
The normal problems of life and work had been so much more difficult to deal with than before.
My working life was, at times, a nightmare. My performance reviews had been outstanding for years, but suddenly I found decision making difficult. I got my first average performance review, and I was devastated.
But with the news that I’d experienced menopause, I finally understood why I felt incapable of rational thought at times and making even simple decisions had been such a struggle.
Talking to my husband about why I was less patient and more emotional than the woman he married became easier with knowing what had caused my problems. It was liberating.
Still, it was a surprise to find that I was through the perimenopause phase and now officially menopausal.
And I hadn’t even realised.
I lacked knowledge of the perimenopause phase and was woefully uninformed on what was happening to my body and emotions.
I didn’t know so I didn’t seek help.
Menopause is a natural part of a woman’s life and we need to talk about it more
The menopause is a natural part of the ageing process.
Although premature or early menopause can indeed occur at any age with no clear cause for why that happens.
Sometimes menopause is caused by treatment, such as surgery to remove the ovaries, or an underlying medical condition can bring it on.
Either way, it’s one of life’s inevitabilities and it affects women’s health in different ways.
There is some good news
“When it comes to mental health, menopause gets a bad rap.
It appears to be true that women who suffer from depression before menopause, or who have had premenstrual or postpartum depression, sexual dysfunction, are physically inactive or who have a lot of hot flashes are at more risk of depression as they enter menopause.
But women who are not dealing with any of these issues before they enter perimenopause will overwhelmingly transition into menopause without experiencing severe problems.
“Still, up to 23% of women do report some mood changes, primarily during perimenopause.”
Source: drmache.com/psychological changes during menopause
The majority of women may not report mood changes, but that doesn’t help much when you’re one of the people suffering from them, and they’re impacting your life.
The term ‘perimenopause’ has only been used for around the last 20 or so years.
On average, perimenopause will begin in your 40’s and lasts for between 2 and 8 years (although it can be longer and start much earlier) and is considered a transition phase.
During perimenopause, you can largely say goodbye to oestrogen as your ovaries gradually begin to make less. And perimenopause is the stage during which the most difficult symptoms of menopause are experienced.
Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs altogether.
In the last 1 to 2 years of perimenopause, the drop in oestrogen speeds up, so at this stage, all women have symptoms of menopause. At this time, people sometimes describe their feelings as a mid-life crisis due to mood swings, physical changes, and impacts on their daily lives.
Symptoms vary but may include:
- Hot flushes—a sudden sensation of heat in your face, neck and chest that may cause you to sweat profusely, increase your pulse rate and make you feel dizzy or nauseous. These can be self-diagnosed as panic attacks (remember my sister-in-law?). A hot flush typically lasts about three to six minutes, although the sensation can last longer and may cause you to lose sleep when they happen at night.
- Trouble sleeping – see point 1
- Irregular periods
- Breast tenderness
- Worsening or onset of migraines
- Mood swings
- Lowering of the sex drive
- Fatigue. Not surprising when you consider the list of symptoms!
But that is not the complete list
In my experience, the list is very long. You can add foggy memory and an inability to hold a thought for the duration of a conversation!
That was one symptom of perimenopause that no-one warned me about.
Add to that that I would dissolve into a human jelly when things got stressful at work instead of facing problems and thriving on the challenges. (How I missed my pre-menopausal self-confidence).
The effects on our skin are the subject of a separate post.
Perimenopause ends when a woman has gone 12 months without having her period.
The description of a woman being menopausal is when periods stop, and the chances of getting pregnant naturally disappear.
In the UK, the average age for a woman to reach menopause is 51, but it can occur between 45 and 55 as a woman’s oestrogen levels decline.
Around 1 in 100 women experience the menopause before 40 years of age.
Symptoms of the menopause
Most women will experience menopausal symptoms. Some of these can be quite severe and have a significant impact on their everyday activities.
Common symptoms include:
- Vaginal dryness and discomfort during sex
- Difficulty sleeping
- Low mood or anxiety
- Reduced sex drive (not surprising considering point 1)
- Problems with memory and concentration
This list of symptoms appears very similar to that shown above for perimenopause symptoms, except that periods cease completely in menopause.
Other problems are physical and include such things as the increased instance of urinary tract infections (UTI’s) and real pain during intercourse (not the ‘discomfort’ listed on websites – I think that grossly understates the problem).
My doctor explained to me that the skin in the vagina thins after menopause, and that exacerbates the problem.
As stated earlier in this post, the list of symptoms of menopause doesn’t make for happy reading.
The symptoms have been reproduced here using information obtained from the internet and different sources such as the UK’s NHS Choices website.
Taking care of your health in menopause
Bone loss can speed up after the menopause
It’s normal for women to gradually lose bone density from the age of about 35.
In menopause, bone loss speeds up. For example, women can lose up to 20% of their bone density in the five to seven years after menopause. This makes menopausal women more at risk of osteoporosis (weak bones) and fractures.
The female hormone oestrogen causes the rapid dip in bone density (yes, that again). Oestrogen helps to protect bone strength.
Osteoporosis is more common after menopause, but women often aren’t aware that they have it as osteoporosis doesn’t cause any symptoms until there’s a fracture.
While you can’t halt bone loss entirely after menopause, there is plenty you can do to slow it down.
Here are some simple steps you can take before or after the menopause to protect your bone health.
It’s never too late to begin to exercise. Even if you haven’t been physically active before, adopting an active lifestyle during perimenopause and after menopause will protect your bones.
There’s so much conflicting advice about how much exercise you should take per day or per week.
What is agreed is the need to include weight-bearing exercises and resistance exercises in your routine to improve bone strength and help to prevent osteoporosis. That’s because resistance-based exercise places stress on the muscles and bones, which in turn helps to strengthen them.
Weight-bearing exercises are those where your legs and feet support your weight.
High impact weight-bearing exercises, such as running, skipping, dancing and aerobics, are all great for strengthening muscles, bones and joints, and can be part of your exercise routine.
My own particular favourite is yoga plus resistance band sessions.
Zumba is also fun and will help you burn off some calories while you get your body moving.
Yoga uses your own body weight to provide resistance making it portable for holidays too.
With resistance exercises, you use your muscle strength to work against resistance.
Government guidelines recommend this type of activity twice a week.
Examples of exercise types that provide resistance include press-ups, exercising with weights or stretchy resistance bands, or using weight equipment at a gym.
The action of muscles pulling on the bones boosts your bone strength.
A great source of information
Exercise is helpful for several reasons. There are resources out there to inform, and this one covering exercise for menopause was particularly helpful for me.
Eat a balanced diet
A healthy, balanced diet that includes calcium and vitamin D will help maintain healthy bones after menopause.
Food rich in vitamin D, rather than supplements, have also been found to be good for heart health.
You can find all the latest information I’ve collated by clicking here.
Can eating soy help a woman’s health in menopause?
To be honest the jury is out on the benefits of soy in reducing the severity or number of hot flushes.
I believe firmly that soy milk helped me.
I base that on the experience of my sisters to my own in terms of hot flushes. My sisters, who haven’t included soy in their diets long term, have all suffered severe hot flushes.
That’s a very limited survey to be sure – but it’s my contribution to the debate.
I have an allergy to cow’s milk and egg yolk. That means that most of my adult life (since my doctor diagnosed my allergy), I have replaced cows milk with soy milk for cooking. And as I said earlier, I suffered only 2-night sweats. I did suffer hot flushes in the day time, but they didn’t limit or affect my life to any noticeable degree.
While the jury’s out on how effective soy is for treating menopause symptoms, soy has other potential health benefits.
It’s packed with nutrition
Soy is low in saturated fat and calories. It’s also high in these beneficial nutrients:
- omega-3 fatty acids
Soy may help to reduce your risk of heart disease
The soya bean, or Edamame, is used as a vegetarian and lactose alternative for many foods. The soya bean is the basis for soya milk, tofu, miso, tempeh and soy protein.
Soybeans contain protein, and some studies have found that women with a soy-rich diet may have a lower risk of developing breast cancer.
Eating tofu and other soy-based foods a few times a week can help you cut back on some animal-based protein sources, such as steak or hamburger, that are high in saturated fat and cholesterol. Reducing saturated fat and cholesterol can lower your heart disease risk, which increases as you reach menopause.
Soy might strengthen your bones
Estrogen plays a role in preserving bone strength.
That’s why your risk of developing osteoporosis increases during menopause.
But some research suggests that soy may help bone health in those who’ve gone through menopause.
If you’re interested in exploring soy’s potential health benefits, consider adding some of these foods to your diet:
- edamame beans (great on salads)
- soy flour
- miso soup
- soy milk
- soy yoghurt
You can also take soy isoflavones in supplement form. The North American Menopause Society recommends starting at a dose of 50 milligrams a day.
Keep in mind that it could be several weeks to months before you start to notice any change in your menopause symptoms.
The menopause is quite literally life changing
When I began to speak to other women about their mid-life approach, including their understanding of the physical changes that will occur, I was surprised by how many women knew what menopausal meant being but didn’t know the signs symptoms they could expect to experience.
But the great news is that women in midlife who have gone through menopause report some positive changes.
Time for the good news about women’s health in menopause
There are lots of benefits to being post-menopausal
From personal experience, I can tell you hand on heart that being post-menopausal is full of benefits.
Your memory will return to normal
Many people seem to think that forgetfulness as an inevitable part of ageing. The good news is that there’s strong evidence to suggest our memories will return to pre-menopause levels.
Around 60% of women suffer a temporary decline in memory during the menopause.
The keyword to hold onto is ‘temporary’. Researchers found that learning capacity had returned to pre-menopausal levels after menopause.
Sleep quality improves
Apart from the menopause blip in middle-age, our all-around sleep quality actually appears to improve as we grow older. A University of Pennsylvania study of 150,000 US adults found the fewest sleep complaints among the over-70s.
Feelings of happiness increase
Feeling down and disheartened during the menopause? Don’t worry: you’re set to cheer up very soon.
According to a study at the London School of Economics, our satisfaction levels reach their lowest point during our mid-50s but start to rise again soon after – peaking at the age of 69.
You’ll have reason to feel optimistic
Here’s another cheering statistic from that London School of Economics study: at 68, people underestimate their future happiness by 4.5 per cent. Or, to put it another way: we think our future will be slightly worse than it actually turns out to be.
It seems that as we age, we don’t have the expectations that come with being in our 20’s & 30’s when we think anything is possible.
Age teaches you acceptance and appreciation, and to be satisfied with your lot.
That’s the wisdom that comes with age and experience I guess.
You’ll feel much calmer
An end to menopause means an end to the often debilitating mood swings triggered by hormonal changes.
And if you’d spent the previous 40 years suffering from PMS every month?
Then you’ll be even more relieved to finally see the back of your periods.
You’ll suffer fewer headaches
Headaches – and migraines in particular – can often be triggered by hormone fluctuations and stress. Both of which were prevalent throughout menopause.
The good news?
According to Migraine Action, around 67% of women find their migraines go away entirely or improve significantly after menopause.
It’s possible you’ll have the best sex of your life
I hope that’s caught your attention!
Think your most satisfying times between the sheets are over?
Not necessarily so!
According to an Age UK survey, more than 60% of over-65’s enjoy fulfilling sex life. And a recent study at the University of San Diego found that 67% of sexually active older women achieve an orgasm ‘most of the time’ or ‘always’.
Your confidence will improve
Coping with menopausal symptoms such as hot flushes, mood swings, and disturbed sleep can knock your body confidence for six.
But once things settle down again, there’s a good chance you’ll feel a lot better about your appearance.
After all, experience has told you how to look your best.
You’ll have fewer colds
As we age, we spend less time fighting off the sniffles simply because our immune systems learn to deal with familiar viruses.
And while we’re on the topic of sniffles, you’ll be pleased to hear you’re less likely to suffer hay fever as you grow older, too.
You’ll have more freedom
Reaching retirement age means you have more time to do the things you enjoy doing. Unencumbered by menopause symptoms, of course.
Now’s the time to see more of your friends, travel the world, take up new hobbies, start a side hustle business to keep your interest and generally enjoy yourself.
All of which are huge benefits.
If you want to find a new direction or finish your working life, you’re going to feel fit and active and ready for it.
Provided you take care of your overall health that is.