Menopause – your common questions answered
The menopause is a natural part of life but menopause experiences vary widely. That means it can be hard to know if your physical or psychological symptoms are linked to the menopause or not. It can be even more confusing if you’re noticing signs of the menopause earlier than you expected.
Here, I explore some common questions including what you might expect and when.
When does the menopause usually start?
The first phase of the menopause is called perimenopause. This typically occurs in your forties, and it’s when you’re likely to start noticing symptoms. You’re said to have reached the menopause if you haven’t had a period for at least 12 months. The average age for this to happen is 51.
You’ll probably start having some menopause symptoms whilst still having periods. This earlier stage can last from a few months to a few years. Your ovaries will gradually produce less oestrogen, progesterone, and testosterone (hormones). This change will accelerate as you start the menopause.
What are the early signs of menopause?
There are many possible menopause symptoms. Each person’s experience is personal to them. But typical perimenopause symptoms might include:
- heavier and less frequent periods
- hot flushes in the day
- night sweats and disturbed sleep
- difficulty concentrating and remembering things (‘brain fog’)
- vaginal dryness and discomfort during sex
- a drop in libido
- mood swings which could make you feel stressed, irritable, anxious, or depressed
- weight gain
- joint and muscle aches
Around 1 in every 10 people find their periods stop abruptly without any noticeable changes in their cycle before that point. This is a problem if you’re trying to get pregnant and don’t realise that you’re going through the menopause.
1 in 4 of those affected will have severe menopause symptoms. This might mean recurrent urinary tract infections (UTIs) caused by vaginal dryness, hot flushes that leave you unable to cope, or unpleasant psychological symptoms. It’s best to see your doctor, because a range of treatments is available.
What about premature or early menopause?
If you’re concerned that you might be having menopause symptoms younger than you expected, this could be either of the following.
- Early menopause – This affects about 1 in 20 people, and it’s when your periods stop before the age of 45.
- Premature menopause – Also called premature ovarian insufficiency, this affects about 1 in 100 people under the age of 40 and 1 in 1000 people under 30. It can even happen as early as your teens or twenties.
You might go into premature menopause because you’ve had surgery to remove your uterus and/or ovaries. Or if you’ve had treatments such as chemotherapy or radiotherapy . This can mean that you’re plunged into menopause not only earlier than expected, but also very suddenly. The symptoms can be more severe.
Is there a menopause test?
Your GP might suggest a blood test if you’re:
- between 40 and 45 and they suspect the menopause
- under 40 and your GP suspects the menopause
This test will measure the amount of follicle-stimulating hormone (FSH) in your blood.
If you’re over 45, FSH levels become more unpredictable, so a blood test isn’t meaningful. The National Institute for Health and Care Excellence (NICE) suggests that if you’re older than 45, diagnosis should be based on menopause symptoms alone.
How long do menopause symptoms last?
Menopausal symptoms can last for up to 12 years. Most menopause symptoms will settle in time, but some may continue to affect you. These can include:
- vaginal dryness
- recurrent urinary tract infections (UTIs)
- changes in how often you pee
Menopause treatments such as HRT and taking steps to stay healthy may help with ongoing menopause symptoms.
Can I get pregnant during perimenopause?
Potentially, yes. If you’re over 50, you may be able to get pregnant up to 12 months after your last period. If you’re under the age of 50, you may be able to get pregnant up to two years after your last period. So, if you need to use contraception , you should continue using it during this time.
However, if you’re taking a hormonal contraceptive, it can be difficult to tell when your last period has happened. If so, you’ll need to use contraception until the age of 55. Your GP can give you advice about different contraception options. They can also help you with any of the menopause symptoms I’ve mentioned in this article – I do encourage you to talk to them.
If you’re experiencing menopause symptoms, you don’t have to face them alone. With a Bupa Menopause Plan, you can discuss symptoms with a specially trained GP, get a personalised care plan based around your needs with access to 24/7 support via Anytime HealthLine.
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Sources Sources
- Menopause. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised March 2017
- Menopause and its management. Patient – Professional Reference. patient.info/patientplus, last edited 29 January 2018
- Menopause. MSD Manual Professional Reference. www.msdmanuals.com, last full review/revision December 2019
- Menopause and diet. The Association of UK Dietitians (BDA). www.bda.uk.com, published May 2019
- Mood changes and depression. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk, accessed 10 November 2020
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