Managing the symptoms of menopause
Published in Medicinewise Living
Date published: About this date
Often referred to as 'the change', menopause tends to be viewed as an unwelcome disruption in a woman's life. However, with better management of the symptoms, this doesn't have to be the case.
Most women going through menopause have a few symptoms, some of which may be severe. About 1 in 5 women have no problems at all.
If menopause is affecting your health or quality of life, there are lifestyle changes you can make — and treatments available — that can help you to manage the symptoms.
What is menopause and when does it happen?
Menopause describes the phase in a woman's life when her ovaries slow their production of the female sex hormones oestrogen and progesterone, and eventually stop releasing eggs.
Most women will move naturally into menopause between the ages of 45 and 55 years, with the average age in Australia around 51 years.
Menopause can occur at a younger age for a small number of women. It is described as 'premature' menopause when this happens before the age of 40 and 'early' menopause before the age of 45. Sometimes there is no apparent cause to explain why this happens. In other cases, the ovaries may have been surgically removed or affected by medical treatment such as chemotherapy or radiation.
How will I know I am going through menopause?
Changes to your menstrual cycle (period) are often the first sign that you may be entering menopause. During this time you might find your period becomes irregular, or is lighter or shorter than normal. This phase, known as perimenopause, can continue for many years. Women are considered to be in menopause once they have not had a period for 12 months or more.
In addition to changes in your period, reduced levels of oestrogen and progesterone can produce other symptoms including:
- hot flushes and night sweats
- joint aches and pains
- vaginal dryness
- reduced sex drive (libido)
- urinary problems
- sleeping difficulty
- mood changes
- poor concentration.
The type of symptoms you may get, when they start, and for how long you experience them can differ from other women.
Can menopause cause complications for women?
Having low levels of oestrogen can affect your bone health and increase your chance of developing osteoporosis (a condition where bone loses strength and density). On average, women lose up to 10% of their bone mass in the first five years after menopause. Low oestrogen levels have also been linked to an increased risk of heart disease and related conditions such as stroke.
While in perimenopause, there is also a chance you could become pregnant. So if contraception is being used it needs to be continued until menstrual bleeding has been absent for at least 12 months.
What lifestyle changes can help me to manage menopause?
Eating a healthy diet, exercising regularly and quitting smoking can help to reduce menopausal symptoms and lessen the risk of osteoporosis. Making these lifestyle changes can also lower your chance of developing other long-term (chronic) conditions including heart disease, stroke, type 2 diabetes and certain cancers.
Some other steps to help you manage menopausal symptoms:
- avoid possible triggers for hot flushes (e.g. caffeine, alcohol, spicy foods)
- drink plenty of water
- wear clothing in layers that can be removed as needed
- reduce the temperature in your bedroom or sleep in a cooler room
- practise relaxation therapy
- reduce stress.
Could hormone replacement therapy be an option for me?
If you have menopausal symptoms severe enough that they interfere with everyday living, then short-term use of hormone replacement therapy (HRT) can be helpful. Clinical trials of HRT have also shown that these medicines can reduce the risk of osteoporosis or bone fractures for some menopausal and postmenopausal women who are at particularly high risk.
However, HRT is not suitable for all women. Clinical trials have reported that some women may be at increased risk of serious side effects, such as blood clots and breast cancer, if they use HRT after a certain age, or for a long period of time.
So before prescribing a HRT medicine, your doctor will need to consider your complete personal and family medical history. They can also discuss suitable options with you, as there are many different types, doses and forms of HRT. For example, some are oestrogen only, others contain oestrogen with a progestogen — and are available as tablets, patches, pessaries, gels or creams.
What other medicines can help to treat menopause symptoms?
Non-hormonal prescription medicines such as tibolone and certain antidepressants may be suitable options for some women who are unable to have HRT.
Many women also use treatments containing natural or 'bioidentical' oestrogen and/or progesterone. However, the long-term safety of these products is unknown. They have not been as rigorously tested as conventional HRT medicines and may have safety risks.
Other natural and herbal medicines for menopause (e.g. black cohosh, red clover, soy isoflavones) are also used; however, clinical trial evidence supporting their use is inconclusive. Complementary medicines can have side effects and may interact with other medicines.
Where can I get help when going through menopause?
If you are concerned by symptoms that you think may be related to menopause, check with your doctor or other health professional. They can help by discussing treatment and management options with you.
Points to discuss with your health professional about menopause and management options may include:
- your personal and family history of menopause and other health issues (e.g. heart disease, breast cancer)
- lifestyle changes that can help to relieve menopausal symptoms
- the potential benefits and risks of HRT in your situation
- any other medicines you are taking or thinking about taking, including over-the-counter, natural or herbal medicines.