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Menopause

The ‘menopause’ literally means the last menstrual period. For most women, it occurs in the early 50s, but some women notice changes in their menstrual cycle for some years before this. The menopause is caused by a fall in the amount of the hormone oestrogen that is produced by the ovaries.

Hot flushes

Many women have hot flushes (sometimes called ‘hot flashes’) around the menopause. These may begin a year or two before the last period. Usually, they occur for a year or two, but if you are unlucky they may persist for 10 years, or even longer. In fact, about a third of 60-year-old women are still having hot flushes (Lancet 2008;371(9614):760–70). Some women have them only occasionally, perhaps a few times a month, but most women experience them much more frequently, often many times a day. 

If you have hot flushes, you know what they are like. Sometimes there is a slight feeling of faintness beforehand. Then your face, chest and back become burning hot, red and sweaty. This is more likely to happen if you are already anxious, such as in an important meeting or interview - which is just when you don’t want it to happen. Flushes can also be triggered by being in a hot environment, or by hot foods and drinks. Flushes are also common during the night - ‘night sweats’. 

For advice on hot flushes, go to Flushing at the menopause.

Sleep disturbance

About half of all women going through the menopause say they do not sleep well. This is probably mainly due to hot flushes and night sweats.

Vaginal and sexual problems 

Vaginal dryness is very common at the time of the menopause and afterwards. This means that sex can be very uncomfortable or painful. Use a lubricant, and ask your doctor about an oestrogen cream to apply to the vulval and vaginal area. It may take a month or two before it has an effect. For more advice on vaginal dryness, go to Dry vagina

You may find that the menopause has no effect on your sexual feelings, or you may find you have less interest in sex, or perhaps more sexual desire than before. If a loss of sexual desire is bothering you, or causing problems in a relationship, talk to your doctor about it. A patch containing the hormone testosterone might help. However, there have been worries about a slight possible increase in breast cancer risk with this treatment; more research is needed (Med J Aust;2009:134–5). Also, it can cause some hairiness.

For more information on how ageing can affect sex, go to Sex and ageing

Cystitis

If you tend to be affected by cystitis, you may find that the menopause has made it happen more often. Discuss a vaginal oestrogen cream with your doctor; this reduces urine infections. For advice about reducing bladder infections and discomfort caused by cystitis, go to Cystitis in women: preventing further attacks. 

Skin and hair changes

Ageing skin. Several months after menopausal symptoms begin, many women report that their skin suddenly seems to have aged. The menopause triggers thinning of the skin; in fact, scientists say that skin loses 1.13% of its thickness each year after the menopause (Clin Interv Aging 2007;2:283–97). Skin also becomes dry and less elastic, wrinkles appear, and it eventually becomes fragile and bruises easily. 

There is not much that you can do about these changes. Obviously, it is important to avoid sun exposure, and to use a moisturizer containing sunscreen. Be aware that your skin is more easily damaged than when you were younger, and look after it. For more advice on caring for older skin, go to Ageing skin

Hair thinning. After the menopause, hair on the scalp becomes thinner. There are fewer active hair follicles, and each hair is finer. Shampoos and conditioners specially formulated for older hair are readily available, and worth using. For more information, go to Thinning of the hair.

Hairiness. Annoyingly, hair may become more obvious on other parts of the body (such as the face); for more information, go to Hairiness in women

Other symptoms

Every woman experiences menopause differently. The most common symptoms are listed above, but there are many other embarrassing problems that women may experience to differing degrees. These include memory lapsesweight gain, vulval painurinary incontinence, vulval itching, genitourinary prolapse and breast pain.

Dr Phil Hammond explores the menopausal symptoms that are hard to discuss in his embarrassing-busting guide After the menopause. He also explores the embarrassment surrounding body hair  and sweating in his informative video guides.
 

Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Monday, November 12th 2012

 


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Comments on this article

Posted by Milkica on 04/09/2014 at 01:55

I am currently going through Manapause and havent had my period for the last 4 or 5 months. I have noticed that since going through Manapause when having sex and after orgasm I feel out of breath and I start really stressing is this normal.

Posted by Optionalrachel on 03/09/2014 at 10:33

i am getting hot flashes but i am all so getting blister like bumps on my face from time to time .

Posted by Optional on 23/11/2012 at 03:47

It is amazing that women are expected to tolerate this horrible experience. I refuse to do it. I'm using horones and feel like a woman who isn't in menopause. The biggest killer of women is not breast cancer but heart disease which becomes common during untreated menopause.

Posted by Optional on 04/06/2012 at 02:06

I am 51 and going through menopause I am on an anti depressant and right one my nipples don't get hard during sex and my clitoris has no feeling... So horrible because I enjoyed sex before. Please help

Posted by Optional on 23/11/2011 at 01:12

I AM FINDING THE MENOPAUSE VERY INTRESTING, BECAUSE i DO NOT HAVE ANY OF THE SYMPTOMS BUT MY BLOOD TEST CAME BACK POSITIVELY MENOPAUSAL. i AM SEXUALLY ACTIVE AND I STILL WORRY ABOUT GETTING PREGNANT.

Posted by Optional on 16/11/2011 at 03:45

I Thankyou for telling me about chiease treatments as i am very worried about doctors medications die to there mudering side affects this has got to be the worst thing any person can deal with but have to deal with regardless as it can have a big effect on loved ones. god was Defo a man.

Posted by sharon on 03/05/2011 at 03:46

Both my brests hurt,i had hysterectomy when i was 41,ovaries were left in,so its hard to know if im going through the menopause,but ive had alot of the symtoms like hot flushes,anxiety,restless legs,painful joints etc,my breats have been tender before maybe once every 3 months or so,but its been like this for 2 weeks,i am in constant agony,i have to hold them when walking,when i take my bra of that is well unbearable,i have to hold my brests and take my bra of as best as i can,even laying down its as bad,whats happerning??

Posted by rzimm64 on 15/09/2010 at 07:41

I went into sudden menopause about 1 year ago (at age 45). This past year has been hell. I've had hot flashes, sweating all day & night, deep body aches, restless legs, painful joints, memory problems, anxiety, extreme fatigue, difficulty urinating, fluid retention in my feet, legs and hands, shortness of breath & weight gain. Some articles and forums I have read pretty much confirm that menopause can cause any of these symptoms. I even see some of these symptoms mentioned in your article above as related to menopause. None of my doctors will listen or believe that menopause can cause these problems/symptoms I'm having. I keep getting the brush-off from doctors saying they don't know what could be causing this agony. I've had every blood test they can think of plus, neuropsychological testing and a sleep study. Every test comes back normal. Which leads doctors to stop right there and say, "All of this can’t be related to menopause. You must have fibromyalgia and/or chronic fatigue syndrome". I think it's too much of a coincidence that both menopause and a bunch of these symptoms occurred suddenly over the same 2-3 days last year. I'm convinced that, because my ovaries shut down so suddenly, it created some huge hormone (and maybe other chemical) imbalances in my body that sent it into a tailspin. I think I need more hormone testing although I don't know if there are other tests to try or not. I'm at my wits end feeling so lousy for a whole year now. I've missed out on a lot of my life this year because I'm so tired or in pain that I can't function.

Posted by Optional on 03/09/2010 at 04:14

I found the mood swings one of the most difficult things to deal with even though I was classed as perimenopausal. Having tried HRT despite still having periods and then being prescribed antidepressants, I found the greatest relief with traditional Chinese acupunture. It provides an amazing sense of calm. Cautionary note, always choose a fully qualified traditional practioner as there are so many people out there offering this service now.

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