The menopause is defined as the point in a woman’s life when the ovaries stop producing follicles, which are the fluid filled cysts in the ovary that contain eggs and burst during ovulation. Once ovulation has stopped your periods will also stop and after 12 months without periods the menopause is confirmed. This usually happens around the age of 52 but can be as early as 40 years or as late as 60.

Ovarian function. The reason the ovaries have stopped producing follicles is that they have become less responsive to the hormones that stimulate the development of follicles. This then means that the amount of oestrogen your ovaries produce decreases as well. Once the oestrogen levels in your blood are low enough the lining of the womb is not stimulated to grow and your periods stop. It is this low level of oestrogen that causes the typical menopausal symptoms you may have experienced- hot flushes, night sweats, mood swings and vaginal dryness.

During your reproductive years your ovaries also produce progesterone, which is important for the control of your menstrual cycle and periods. The ovaries also produce small amounts of the male sex hormone, testosterone. This testosterone contributes to your sex drive and energy levels and so the decreased levels following the menopause can lead to a lack of interest in sex and low energy levels.

Symptoms. The falling hormone levels, in particular oestrogen, at the time of the menopause tend to give symptoms. The length of time these symptoms last is quite variable but usually resolve within 2-5 years of the menopause. The typical symptoms are:

  • Vasomotor symptoms
    • Hot flushes
    • Night sweats
  • Psychological symptoms
    • Low mood
    • Anxiety
    • Irritability
    • Lack of energy
    • Memory & concentration problems
  • Genital & urinary symptoms
    • Vaginal dryness
    • Genital itching and soreness
    • Pain during sex
    • Urinary frequency, urgency and incontinence
    • Urinary and vaginal infections
  • Sexual symptoms
    • Decreased sexual desire and sexual satisfaction
  • Sleep disturbance

Long Term Consequences. Life expectancy has increased significantly over the last century but the age of the menopause has stayed about the same. This means that women spend as much as a third of their life after the menopause. Unfortunately the chance of certain diseases goes up as you get older and also as a result of reduced hormone levels following the menopause. After the menopause it is increasingly important to consider these diseases and to reduce any risk factors you may have to minimise your risk.

Management. The menopause can be a distressing time in your life when a great many things are changing and significant symptoms may have developed. Some women have very few symptoms and manage the menopause easily but others find the onset of these symptoms quite debilitating and experience a significant reduction in their quality of life. If you are finding your symptoms difficult to cope with there are likely to be ways to treat your symptoms or minimise them to make them easier to cope with. This may be simple lifestyle advice or may involve medical treatment such as hormone replacement therapy (HRT). Whatever your menopausal experience we would like to support you to find the right way to manage your symptoms.

The menopause also coincides with a time in your life when the risks of certain diseases start to increase. The fall in hormone levels contribute to these risks, in particular the risk of cardiovascular disease. As such this is a good time to consider ways to prevent disease, increase life expectancy and improve quality of life.

Please find your specific menopausal advice under the following headings:

  1. Menopausal Symptoms that affect Quality of Life.
  2. Hormone replacement and alternative therapy.
  3. Cardiovascular disease: ischaemic heart disease and stroke
  4. Blood clotting: deep vein thrombosis
  5. Bone health: osteoporosis
  6. Cancer risk
  7. Urinary problems and prolapse
  8. Mental health: memory, depression, cognitive decline and dementia.

Thank you.

The Manage my Menopause team.