Menopause + Perimenopause

Here at TMCK we believe that we should make ourselves as useful to you as we can and so we provide you with much of the information you will need.  We obviously cannot tell you everything you need to know in this way, but what follows is designed to deal with the most important aspects of this particular condition. 

Each woman's journey through the menopause is unique. We're here to give you the advice and support you need to reduce your symptoms and boost your health and vitality as your body changes. Thanks to excellent medical care and a growing awareness of healthy living choices, the menopausal years need no longer be difficult - and many women celebrate a new lease of life with a sense of freedom and strength.

Our Consultant Gynaecologists, Dr Etienne Horner and Ms Claudine Domoney, take a special interest in the menopause.   Either can work with you to build a clear picture of your body's hormone balance and help you find the medical treatment and lifestyle changes that suit you best. The aim will be to reduce your menopause symptoms and make your transition as smooth as possible.

We also offer expert nutritional guidance, from Dr Marilyn Glenville and her Team, and very personal support from Psychotherapists and Psychologists. 

Menopause...What Is It?

The official definition of menopause is the natural end of menstruation and the end of a woman's reproductive years. The ovaries' production of the female hormones, oestrogen and progesterone, declines significantly.  The word menopause has its roots in the Greek pausis, meaning 'end', and men, meaning 'month'.

The true end of menstruation - your last period - only becomes evident in retrospect, when you have not had a period for 12 months. Periods may be irregular or widely spaced for some time before this.

The end of menstruation is not a sudden event: hormone output from the ovaries changes in the years leading up to menopause. This affects your whole body. Symptoms can continue for years before the menopause, the 'pre-menopause' years.

Peri-menopause is the term used to describe the years leading up the menopause, and one or two years beyond (peri means 'around').

When does the menopause happen?

The average age for menopause is around 51 but it can occur any time roughly 8 years either side of this, with premenopausal changes occurring for several years before the true end of menstruation. Most women begin to notice changes to their cycle, or their menstrual symptoms, in their mid-40s. Menopausal symptoms can occur earlier when ovulation ends before age 40.  This is Premature Ovarian Failure (POF) and you can find more information about this condition in our library.

What Are The Perimenopause And Menopause Symptoms?

Some women experience very few symptoms.  For others, symptoms may be mild and intermittent.  Others experience a range of severe symptoms.  They tend to include one or more of

Physical Symptoms

• Irregular periods
• Heavy vaginal blood loss
• Hot flushes best described as feeling, suddenly, incredibly hot, sometimes accompanied by sweating, typically at night
• Dry skin
• Reduced sexual desire (low libido)
• Reduced vaginal lubrication
• Increased susceptibility to vaginal and urinary tract infection
• Headaches  or migraines
• Breast tenderness
• Weight gain + bloating
• General aches
• Urinary incontinence

Emotional Symptoms

Mood changes are very common. They range from mild mood swings to periods of intensely strong feelings such as anger or irritability, or feelings of ineptitude and low self-esteem; some women liken it to depression or severe Premenstrual Tension/Premenstrual Syndrome

• Increased stress
• Forgetfulness
• Fatigue

The emotions of the perimenopause can be partially attributed to hormonal changes; but there is always a bigger picture. For some women the end of fertility needs to be mourned. The menopause may also coincide with significant life events such as children leaving home, or the loss of a parent. If menopausal changes leave you feeling less able to cope, medical treatment, as well as emotional support, may be extremely helpful.

Can I Avoid Menopause Symptoms?

The menopause is a natural stage of a woman's life.  To increase your chances of minimal symptoms, we recommend you visit your gynaecologist regularly for a Well Woman Check from the age of 45 onwards. This will help you keep your health on track and take measures that boost your wellbeing in the run up to your menopause, and may help reduce symptoms.

How Can Pre And Perimenopause Symptoms Be Reduced?

Your doctor will go through a range of options that are commonly used to reduce symptoms.

Hormone treatment is often recommended to reintroduce balance. There is a wide choice of products on the market, and a variety of applications including cream, pills, patches and implants. Your doctor will go through the options with you in detail and the choice will depend on your personal needs: finding the right approach is best done in consultation.

Can Nutrition Help Reduce Menopause Symptoms?

Your nutrition, including what you eat, and how your body is able to absorb the goodness from your food, can help your body cope with the changes in hormone levels. Your diet is important if you need to combat difficulties such as fatigue or weight gain, and it is also a powerful tool in offering some protection against osteoporosis (women are more susceptible to osteoporosis once oestrogen levels fall).

No two women have the same needs, so we do recommend you visit for tests including liver function tests, levels of Vitamin D, calcium and other minerals, omega fatty acids and cholesterol etc.

The ideal approach is to ensure your diet is nutritious and supports your hormonal balance for many years in the run up to the perimenopause period.

Dr Marilyn Glenville, one of the UK's leading women's health nutritionists, offers personal consultations at The Medical Chambers. Her many books include Natural Alternatives to HRT, and she will expertly guide you through a nutritional, supplemental and eating plan to suit you.

Natural And Complementary Treatments For The Menopause

Your doctor will give you advice about medical treatments based on your personal symptoms. If you would like to follow natural treatments such as herbal medicine, it is important to continue having regular medical checks to assess your general health, cholesterol levels, bone health and breast health (link to well woman check).

When Menopause Comes Early...Surgical Onset Of Menopause And Premature Ovarian Failure

For a minority of women menopause occurs early. The reasons for altered hormonal output from the ovaries vary from an early end of ovulation (Premature Ovarian Failure or POF) to dysfunction or abnormal function of the ovaries and ovarian follicles.  You can find a more detailed explanation of POF elsewhere in this Library. 

A full hysterectomy, where the ovaries as well as the uterus are removed, causes the onset of menopause, since the ovaries are no longer present to produce hormones.

For early menopause, whatever the cause, hormonal medication is frequently advised. The impact of low oestrogen and progesterone levels on health - including increased risks of osteoporosis - is significant, and the medication helps to reduce this, as well as tackle symptoms. 

Post-Menopause...What Can I Expect?

In the post-menopausal years, women do feel different but how you personally feel depends on many factors. These include your body's response to change in hormone levels, what else is happening in your life such as the support you have, how fulfilled or stressed you feel, your diet and lifestyle, and any medication you take.

After the menopause, because your ovaries are producing less of the female hormones oestrogen and progesterone, this has an impact on your bone density, and as bone density declines you are at risk of developing osteoporosis. Your doctor will send you for a bone density scan to assess your bone health.

To reduce your susceptibility to bone loss, osteoporosis and hip fracture, it's important to take measures to protect your bones. Some hormonal treatments used to reduce menopausal symptoms may help to reduce bone density decline; in combination with exercise and sufficient intake of calcium and vitamin D. A personal consultation is important for you to find out what level of supplementation is useful for you. 

You're advised also to keep an eye on your cholesterol - because high levels are one of the highest causes of cardiovascular (heart) disease; and the risk of heart disease does increase with proportion to age. Your doctor will monitor your heart health and advise on treatment; our cardiovascular specialists at The Medical Chambers are available if you would like further advice or treatment.

We invite you for regular well woman checks once a year, with vaginal examination and a cervical smear. This will help you keep an eye on your liver and heart health, blood pressure and gynaecological health and discuss any concerns with your doctor.