All women will go through the menopause at some stage with the average age of menopause being 51 in the UK. Menopause affects everyone including our partners, friends and work collegues. It's really important to be aware of the menopause in order to support each other through what can be a challenging time for some.

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Symptoms of the menopause and peri-menopause

Anyone with any of the following symptoms could be experiencing the peri-menopause (the time around menopause).

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• A change in your periods – less often, more often, heavier, lighter, more painful.
• Feeling hot – “flushes” of heat, sweating at night.
• Mood changes – feeling more anxious or worried by things that might not have bothered you before.
• Struggling to sleep.
• Achy joints.
• Feeling more tired or fatigued.
• Dry skin or hair changes.
• Reduced sex drive.
• Struggling to lose weight or weight gain, particularly around the middle.

Over the age of 45, no tests are needed to diagnose the peri-menopause if some of the above symptoms are present.

Under the age of 45 a blood test can be helpful – speak to your GP for a review.

1 in 100 women will experience premature menopause, which is before the age of 40. If you have any concerns regarding your periods alongside experiencing the symptoms listed then please book a review with your GP.

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Management of the menopause

^{Lifestyle changes can really help!}

• Eat healthily

• Exercise moderately – for 30 minutes 5 times a week ideally.
• Stopping smoking.
• Wear cool clothing to bed.
• Join a yoga or pilates class or do online videos from home.

^{This time of life is a good opportunity to review your overall health!}

• Review your weight – your BMI should be between 20-25 (Calculate your BMI).
• Review your blood pressure (BP). Buying a monitor for home is a good long-term option. Ideal blood pressure should be 135/85 or below and this should be checked at least once per year. Please do book in for a review if you persistently get higher numbers than this. We can also check your BP in an appointment with one of our healthcare assistants.
• If you have any symptoms that are worrying you please do book in for a review with your GP who may suggest some further tests.
• The peri-menopause can also be a good opportunity to review your cholesterol, so please do discuss this with your GP too.

^{What can your GP offer for the peri-menopause and menopause:}

• A review of your symptoms to help decide whether this is the peri-menopause.
• An overall health check, which may include blood tests.
• A discussion of treatment options – these will include lifestyle changes, non-hormonal treatment and hormonal treatment.

Non-hormonal treatment options

• These may be your preference, or may be the best option if you have had previous breast cancer.
• Anti-depressants can help with both anxiety and flushes (in about 50% of women).
• Simple painkillers can help the aches and pains.
• Moisturisers can help with dry skin.
• Vaginal moisturisers and lubricants can help with discomfort and dryness.

Hormone Replacement Therapy (HRT)

• Many types of hormonal treatments exist, and you can ask your GP about what might be best for you.
• If you still have your womb, then you will need to have two hormones (oestrogen plus progesterone). The progesterone is used to protect your womb from whilst you are taking extra oestrogen. This may not be neccesary if you are fitted with the Mirena (hormone containing) coil.
• If you have had a hysterectomy (operation to remove your womb) then you can usually have just oestrogen.
• If you suffer with migraines, you can still have HRT but this should be given as a patch to reduce fluctuations in your hormones which can make migraines worse.
• HRT is available is several forms including tablets, gels and patches.

Risks of HRT

The main risk to discuss around HRT is the small increased risk of breast cancer. Modern forms of HRT are much safer as the hormones are structurally the same as our own bodies would produce pre-menopause. In women aged 50-59, taking combined HRT causes a further 4 cases of breast cancer per 1000 women. Forr comparison, being overweight or obese, causes a further 24 cases of breast cancer per 1000 women (Learn more). The risk is therefore small but important to consider alongside your family history. We encourage all women to check their breasts regularly for lumps and to see the GP urgently if they find any, and to attend their mammograms when offered from the age of 50 onwards.

Other risks

• Blood clots – this is only with tablet HRT, so we encourage HRT via the skin where possible.
• Cancer of the lining of the womb (endometrial cancer). This risk is prevented by the use of progesterone hormone in those women who still have their womb. This is why it is important to always take both hormones when they are prescribed.

Benefits of HRT

• Feeling better.
• Improved bleeding patterns.
• Improved sex drive.
• Improved urinary symptoms.
• It can keep your bones strong and prevent osteoporosis.
• It is thought to improve your heart health when taken below 60, or within 10 years of the menopause (your last period).

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Further resources

Here are some good resources where you can do your own reading on managing the menopause:

• Rock my menopause
• patient.info