Natalie McIvor

What's Your Therapy?


Why Menopause Matters?

The fact is 100% of the population will be affected by menopause one way or the other and it can have a dramatic impact on family life, relationships and in the workplace. Menopause affects women differently but for many it comes with unpleasant physical, emotional, and psychological symptoms.

There has been a shift in attitude over the last 5 – 10yrs around menopause and this is largely down to celebrities sharing and talking openly about their menopause journey such as: Davina McCall, Meg Matthews, Lisa Snowden and Liz Earle.  Menopause activists such as Dianne Danzebrank and Dr Louise Newson are working with government to change legislation around menopause especially in the work place. Dr Louise Newson appears regularly on This Morning and the Lorraine show sharing her knowledge and expertise on subjects such as hormone replacement therapy (HRT).  She recently developed an app called the Balance App which helps women navigate their menopause and understand their symptoms.  Menopause was even featured as part of the story line in the latest series of 'Sex and the City' with Charlotte experiencing flooding during a day out.  The more we normalise menopause the less shame women will feel about this stage of life.

We need to encourage education around hormones, so our boys and girls better understand the impact they have on physical and mental health.

The word menopause literally means when your period stops. Meno refers to your menstrual cycle and pause refers to the cycle stopping. The medical definition of menopause is when you haven't had a period for one year.

The menopause occurs when your ovaries no longer produce eggs and as result the levels of hormones called oestrogen, progesterone and testosterone fall. The hormones oestrogen and progesterone work together to regulate the menstrual cycle and also the production of eggs. Menopause is a natural process that every woman will eventually go through, like it or not. How a woman experiences this journey is greatly influenced by body type, family history and lifestyle.

Stages of menopause:

  1. Pre-menopause
  2. Peri-menopause
  3. Menopause
  4. Post-menopause
  5. Premature Ovarian Insufficiency (POI)
  6. Surgical menopause

Pre menopause begins with puberty and stops at the first indication of perimenopause.

The term perimenopause is often used to describe the time before the menopause when you experience menopausal symptoms but are still having periods. These periods typically change during the perimenopause and may occur further apart or closer together; they can be more irregular and heavier or lighter in flow.  During your perimenopause, hormone levels fluctuate greatly, and it is often the imbalance of these hormones which leads to symptoms of the menopause occurring. For some people, symptoms only occur for a few months and then their periods stop completely. However, others experience symptoms for many months or even years before their periods stop. Often when you read about menopausal symptoms, it also includes perimenopausal symptoms as they are the same, and both are due to your hormones changing.

Menopause, when a woman has gone 12 consecutive months without a bleed. The average age is 51yrs old in the UK.

Post menopause is defined by the menopause transition being complete. Technically, a woman is postmenopausal from the day menopause occurs until the end of her life.

Premature ovarian insufficiency (POI) occurs when the ovaries no longer work, and you are under the age of 40 years. Your ovaries no longer produce normal amounts of oestrogen and therefore may not produce eggs. This means that your periods stop (become irregular) and you may experience menopausal symptoms.

Surgical menopause. If you have had your womb (uterus) removed i.e. hysterectomy, before your menopause, you may experience early menopause even if your ovaries are not removed. Your ovaries will still make some oestrogen after the hysterectomy, but it is common that your level of oestrogen will fall at an earlier age than average due to reduced blood flow. As periods stop after a hysterectomy, it may not be clear when you are in ‘the menopause’, however you may develop some typical symptoms when your level of oestrogen falls.

Did you know there are 34 Symptoms?

All too often women experience depression, anxiety and a feeling they are losing themselves, a result of decreasing hormone levels. Historically many women have been prescribed anti-depressants by GP’s at this time of life, when hormone replacement therapy (HRT) is often a more suitable course of action. Menopause is not a linear process and it’s important to note that every woman will experience it differently. If we cast our minds back to puberty, the mood swings, and the physical changes in our bodies, it is comparable to the menopause and can be just as overwhelming.

Hormone Replacement Therapy

It is commonly believed that the most effective way to treat symptoms of perimenopause and menopause is to replace the hormones that your body is no longer producing.

Oestrogen can be taken in the form of a tablet similar to the contraceptive pill, a gel (Oestrogel) that is applied daily rubbing into an arm or a thigh or vaginally via pessary.

Taking oestrogen on its own can thicken the lining of the womb and increase the risk of uterine cancer; taking a micronized progestogen (Ustrogen) keeps the lining thin this and reverses this risk.  It comes in a capsule that you swallow, occasionally progesterone can be used vaginally.

Testosterone (Tostran) can be used if you're experiencing symptoms such as fatigue, brain fog and lack of libido, it can help bring about further improvements of these particular symptoms. It is available in a gel, cream, or implant and while it is not currently licensed as a treatment for women in the UK, it is widely and safely used by menopause specialist doctors and some GPs.

Loss of libido can be one of the most difficult symptoms of menopause to manage, often because a woman might not understand how and why she has lost the desire to be physically intimate with her partner. It is important to recognize that loss of libido during menopause is common, affecting as many as 20 - 40% of women.

Learning more about loss of libido, its various causes, and how it can be managed can not only bring peace of mind, but it's also the first step towards resolving this complex symptom of menopause.

Grief and Loss

Many women experience feelings of grief and loss when they're transitioning through the menopause.

Women often feel a sense of loss during menopause, as if their body doesn't feel the same. They don't feel right. They feel less attractive more irritable and experience mood swings. Some women feel like they’ve completely lost their purpose in life. They feel they’re losing their beauty, their sex appeal, how they’ve valued themselves as a woman. It’s a massive adjustment and navigating it alone can be isolating and some experience feelings of shame. When a woman doesn’t know what’s going in her body and she feels she’s simply going mad, it can be difficult and impossible to communicate this.

Menopause is not the death of who you are; quite the contrary, it can be the start of something much more beautiful!



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