What is the menopause?

The menopause is a woman's last menstrual period and the average age is 51 in the UK.
1 in 100 women will have a premature menopause under the age of 40.
This happens naturally or can be a result of surgery (both ovaries removed) or cancer treatment eg chemotherapy and radiotherapy.After the menopause oestrogen is no longer produced by the ovaries and the risk of heart disease and osteoporosis increases.

What is the perimenopause?

This is the transition between normal ovarian function and regular periods to the menopause and can take months or years.It is very common for women to start experiencing symptoms in the early 40s and it often goes unrecognised.Periods can become irregular - more or less frequent and heavy bleeding is common.Symptoms can come and go as hormone levels fluctuate.

What are typical menopausal symptoms?

Not all women have symptoms!
75% of women have some symptoms and 25% have severe debilitating effects on their quality of life.
Common complaints include hot flushes, night sweats, anxiety, low mood, palpitations, headaches, joint pains, insomnia, loss of libido, vaginal dryness, poor memory and concentration.

What is the most effective treatment?

Not all women need treatment.
Lifestyle modification can be helpful and the menopause is a good time to reassess your health.For many women symptoms will settle with time but some women experience symptoms in the longer term.
Women with premature ovarian insufficiency or early menopause should be advised to take Hormone Replacement Therapy (HRT ) for the hidden benefits of bone and heart protection even if asymptomatic.
HRT is the most effective treatment option as the symptoms are due to lack of oestrogen in the body.There are myths and misconceptions about HRT but benefits outweigh the risks for the majority of women.

All women should be given accurate information and assessment to make an informed choice about the management of their menopause.

Your first port of call for help and advice should be  your GP and there are specialist NHS  GPs in women’s health your GP can refer you to if necessary.Each HSC Trust in NI has a gynaecologist with an interest in menopause for complex referrals.

Premature Ovarian Insufficiency (POI)

If you experience menopausal symptoms, irregular or no periods, or have had induced menopause by cancer treatment or surgery below the age of 40 it is recommended you take HRT  as it is normal for your body to have oestrogen at this age ,and there are hidden benefits for your heart,bones and brain.There is no increased risk of breast cancer taking HRT under the age of 50.
Your GP should consider referring you to your local menopause clinic for specialist advice.
The Daisy Network is a useful website for more information.