Menopause

The menopause is the end of monthly periods. After this, a woman can no longer have children because no more eggs are released. The whole process usually lasts for a few years.

For many women, the timing of their periods becomes unpredictable and the amount of blood loss changes too. Most women (80%) experience hot flushes and/or sweating. A small proportion notice vaginal dryness, which can make intercourse difficult.

Some find their moods changeable. Much later on, maybe not until their 70s, up to 30% of women may have problems with osteoporosis (brittle bones) partly because of changes at the menopause.

The average woman is 50-51 years old when she finally stops having periods, but anywhere between 45 and 54 is common. Smokers are more likely to have an early menopause than non-smokers.

Symptoms

Often signs of the menopause (like erratic periods) appear three or four years before periods stop for good, and go on for a year or two after the last period. In some cases, the lead up to the last period can take up to 10 years.

Hot flushes

What is a hot flush?
The skin becomes hot and red for about 15 seconds or one minute, then gradually calms down again. This flushing can happens on and off throughout the day and night, and may be very mild or very strong. Although it can be annoying, its not harmful.

What about night sweats?
Some women have bouts of sweating, especially at night, with or without flushes. The sweating can be so heavy that it can be quite frightening for those who dont realise what is happening.

Can I do anything to reduce hot flushes?
Try avoiding alcohol, tea or coffee and spicy foods.
Wear several layers of light clothing so you can quickly take them off and on as your temperature changes.
For night sweats, try lying on a large towel so that you dont have to change the sheets every time. Use cotton night clothes and cotton sheets.

Ask your doctor if any drugs you are using cause flushing or sweating, as it may be possible to change your prescription.

If the problem is really getting you down, there are helpful treatments from the doctor you can use, for example hormone replacement therapy.

Sexual intercourse

Will I lose interest in sex?
If you enjoyed sex before the menopause, you should continue to enjoy it afterwards, but sex may become painful because of vaginal dryness.
To counteract this, you can use lubricating jelly, which is available over the counter in most chemist shops. Your doctor can also prescribe an oestrogen cream or hormone replacement tablets.
There are other reasons for losing interest in sex, such as thyroid problems, diabetes and some drugs for high blood pressure.

When can I stop using birth control?

As a general guide, doctors advise women over 50 to wait until they havent had a period for a year before stopping birth control. For women under 50, they advise waiting two years, but you should ask your doctors advice.

HRT - Hormone replacement therapy

HRT is designed to give women extra oestrogen to keep the level of hormones in the blood fairly constant, topping up the bodys natural supply. It is usually taken in tablet form, though it can be implanted under the skin or applied as a cream to be absorbed through the skin of the vagina.

Many women worry they might be pregnant when there are long gaps between periods which often happens during the menopause. If there is a chance you might be pregnant, ease your mind by getting a pregnancy test.

HRT can reduce flushing and sweats, prevent vaginal dryness and reduce the risk of osteoporosis (brittle bones) in later life.

Because of the hormone levels in HRT, you will experience monthly bleeds when taking it, unless you have had a hysterectomy (where the womb is removed).

Keeping healthy

Keeping active with regular exercise is one of the key steps you can take to good health. The idea is to do a total of 20-30 minutes energetic exercise daily, or at least two or three times a week anything which makes you mildly out of breath, but means you can still carry out a conversation.

Some everyday activities are energetic, such as brisk walking, polishing floors, digging the garden, washing clothes by hand, active love-making, climbing up and down stairs, walking or cycling to work and taking the dog for a walk.

Try to eat plenty of fibre-rich foods (wholemeal bread, pasta and rice, fruit and vegetables, potatoes and porridge) and less fat, especially the saturated kind. Calcium-rich foods are also important for keeping the bones strong before and after the menopause.

Good sources of calcium include milk, cheese and yoghurt, green leafy vegetables and fish complete with bones, like sardines.