Menopause

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• Women's Wellness
• Menopause

Medically Reviewed December 2023, by Dr. Susan Mayou (GMC: 2405092) - founder of the Cadogan Clinic and one of the world's leading dermatologists

What are the signs and symptoms of Menopause?

There are a number of menopause signs and symptoms, some which may be more familiar to you than others. A menopausal woman may experience one or more of the following:

• Hot flushes: A hot flush is a sudden feeling of warmth on the upper body, which may result in dizziness, sweating and the skin turning red, as if blushing. Hot flushes commonly affect the face, chest and neck. They often come on without warning. Sometimes after an intense hot flush you may feel coldness.
  Not all women experience hot flushes during menopause, although many do. There is nothing you can do to prevent a hot flush from occurring, but avoiding triggers that may make them more severe or more frequent can help. These triggers include spicy foods, caffeine, alcohol, stress and cigarette smoke.
• Vaginal dryness: Vaginal dryness is caused by a change in oestrogen levels which can affect vaginal lubrication. Vaginal dryness can make it difficult or painful to have vaginal sexual intercourse. Vaginal dryness can also cause itching.
• Urinary tract infections (UTIs): Falling oestrogen levels alter the pH levels in the vagina, increasing the likelihood of urinary tract infections developing.
• Reduced sex drive (reduced libido): A drop in levels of oestrogen and testosterone during menopause can often lead to a reduced sex drive. Some women find that they get less aroused during foreplay than before, which can also lead to a lack of interest in sex.
• Weight gain: Menopause affects how the body stores fat, which can lead to weight gain and a change in body shape. In menopausal women, excess weight settles around the stomach, rather than being evenly distributed around the body.
• Mood changes: Menopause can affect your mental health and wellbeing as well as your body. Fluctuating hormone levels may cause mood swings, anxiety or a general low mood.
• Difficulty sleeping (insomnia): This may be as a result of night sweats, another common menopause symptom. Broken or missed sleep can exacerbate other menopause symptoms, for example by making mood swings even worse.
• Memory and concentration problems: Menopausal women often find that they become more forgetful or struggle to concentrate and focus on certain tasks. This is often referred to as ‘brain fog’ and is a common menopause symptom.
• Skin changes: Collagen is the protein which gives our skin its elasticity. As we get older, our collagen levels drop, causing the skin to sag and wrinkle. During menopause, the skin gets a lot drier and more itchy.
• Palpitations: Menopause can cause palpitations, which is where your heartbeats suddenly become much more noticeable. Palpitations are often prompted by a hot flush.
• Headaches and migraines: It is common for women to experience headaches and migraines linked to their menstrual cycle. These usually occur when the oestrogen levels drop at certain points of the cycle. Hormonal headaches usually worsen as you approach the menopause because the hormone cycle is disrupted.
• Aching joints and muscles: Falling oestrogen levels can affect joints and the connective tissue that 'glues' the bones together, resulting in aches and stiffness in the joints and muscles.

What are the stages of Menopause?

There are three stages of menopause: perimenopause, menopause and postmenopause.

• Perimenopause: At the perimenopausal stage, you have started to experience menopause symptoms, such as hot flushes, sleep problems and mood swings, but you are still having menstrual periods, although these may be becoming more irregular. These changes may come on gradually and sometimes women experience them and do not necessarily associate them with perimenopause.  The average length of perimenopause is four years, but this figure varies from woman to woman.
• Menopause: Once you have gone for 12 consecutive months without a menstrual period, then you have officially reached the menopause.
• Postmenopause: Once a women has finished the menopause and the menopause symptoms may be improving, this is known as the postmenopause stage. Once you are postmenopausal, you are no longer ovulating and cannot get pregnant and women at this stage are at an elevated risk of certain health conditions, such as osteoporosis (brittle bones) and heart disease. Once you have entered the postmenopausal phase, you will stay there for the rest of your life.

What treatment options are available for Menopause?

There are a number of different treatment options available for women going through the menopause.