Menopause – Symptoms, Causes, and Management

What is menopause?

Menopause is a natural life stage, not a disease, and managing menopausal symptoms is only one part of the bigger picture that encompasses women as they transition through these midlife changes.

The term ‘menopause’ is used to describe the time in a woman’s life when she has not had a menstrual period for 12 months.  The years leading to menopause are termed ‘perimenopause’, whereas the years after the last menstrual period are referred to as ‘post-menopause’. This transition is associated with reproductive hormone levels fluctuating, causing bodily changes.

What are the symptoms of menopause?

The symptoms of menopause are due to changes in reproductive hormone levels in your body, usually occurring in the time before menopause begins (called perimenopause).

Oestrogen and progesterone are hormones that regulate your menstrual cycle. When the amount of eggs in the ovaries start to dramatically decline, you will start experiencing changes to your menstrual period, such as cycle length (shorter or longer) and heavier or lighter periods.

Other symptoms can include

  • Hot flushes and night sweats (varying in frequency and severity)
  • Sleep disturbance and fatigue
  • Joint pain
  • Increased anxiety and mood changes  
  • Vaginal dryness and discomfort
  • Need to urinate more frequently
  • Loss of libido
  • Hair and skin changes

As perimenopause symptoms can last for four to six years, make sure you speak to your doctor if you are having difficulty coping with any symptoms.

What causes menopause?

Menopause is a natural part of the ageing process for women, caused by your ovaries running out of eggs to release during your menstrual cycle (ovulation). This leads to changes in your body’s reproductive hormones – progesterone, oestrogen and testosterone.

However, menopause may also occur spontaneously if you have:

  • One or both ovaries surgically removed, dropping your reproductive hormone levels
  • Spontaneously stopped your period (called primary ovarian insufficiency) either naturally or due to an underlying condition
  • Autoimmune conditions
  • Genetic conditions, or
  • Certain cancer treatments   

When does menopause occur?

Menopause is a normal transition that affects every woman naturally between the ages of 45 and 55.  However, early menopause may sometimes occur before the age of 45 years, while premature menopause may occur before the age of 40 if your ovaries naturally fail to produce eggs, or as a result of induced spontaneous menopause.

If you’re a smoker, menopause can occur between one to four years earlier than for non-smokers.

As a woman approaches menopause, her ovarian function declines, as does production of oestrogen and progesterone. It can take 2–7 years to transit menopause, and this stage of fluctuating hormones (and, hence, irregular cycles) is recognised by many as a time of ‘hormonal chaos’. During this time, up to 80 per cent of women will suffer from both physical and emotional menopausal symptoms, including hot flushes, sweats, anxiety and insomnia. The severity of these hot flushes and other symptoms will vary from person to person, and women may be looking for remedies or natural medicines to help manage the transition.

Menopause management, healthy living and natural remedies

Menopause can affect you emotionally and physically. Regardless of whether your symptoms are mild or severe, how you manage depends on your stage of life, relationships and overall wellbeing.

Your doctor may recommend certain therapies to help manage your symptoms by replacing decreasing levels of hormones.

You may also try managing your symptoms by layering clothing, keeping cool water or a fan handy, and avoiding certain foods that can trigger flushing, such as hot and spicy dishes, alcohol and caffeine. If you’re looking for help with your flushes and sweats, you may also find relief through evidence based natural medicines, acupuncture, hypnosis or mindfulness techniques.

While it’s helpful to exercise regularly to improve your bone strength, heart health and to manage your weight, make sure you time exercise for when it is not too hot, so it doesn’t affect your flushes.

Eating a diet full of phytoestrogens – including foods with soy, tofu and wholegrains – can mimic oestrogen activity in your body.

If you are a smoker, quitting will help reduce your risk of certain conditions and will maintain your bone, heart and cardiovascular health.

A few more menopause facts...

  • The average age when menopause occurs is 51
  • Once you have not had a menstrual period for 12 months, you are considered postmenopausal. However, if you have a period then the count to 12 months starts again

References available on request.

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Menopausal diet and lifestyle basics

  • Kickstart your day for better midlife mood: Get up early and take a brisk walk in the sunshine.
  • Keep hydrated: 2 litres or more of clean water per day is a good goal.
  • Stay cool: Layer your clothing, and sleep in bed linen made from natural fibres, such as cotton.
  • Rest up: Avoid unnatural light (TVs and computers) in the evening and go to bed early – you’ll wake up feeling and looking refreshed.