Ask any woman who’s been through it and she’ll tell you that you can’t miss it, but this is one of the most misunderstood, misdiagnosed and mistreated conditions in medical history.

Simply put, it’s the period, normally between the age of 45-55, when a woman’s ovaries cease to perform their reproductive functions and her periods stop. For a very few women menopausal symptoms can appear in their thirties or even twenties and some cancer treatments can also bring on menopausal changes to the body. Finally, many but not all hysterectomies create an immediate menopausal as a result of the removal of the ovaries.

Symptoms of menopause

One of the complicated factors of the menopause is that experiencing it is very subjective. While there are some symptoms that many women experience, there are others that are rare or may not be recognised as part of the natural process of the menopause. For example:

• Three quarters of women experience the infamous ‘hot flush’ for which our club is named – but that means a quarter of menopausal women don’t!
• Common symptoms such as sleeplessness, irritated skin, low mood and increased rate of urinary tract infections can all be missed or not attributed to the menopause.

So given the range of symptoms – which also includes night sweats, vaginal dryness, weaker urinary continence, loss of interest in sex, reduced skin elasticity and bone density – it’s not surprising that many women don’t feel they get the help and support they need as they travel through this natural, but often challenging, phase of life. The classic ‘neurotic middle-aged woman’ might now be only a feature of embarrassing old comedy shows that we cringe to watch today, but sadly her ghost hovers over many women who go to their GP with a range of symptoms that can be either misdiagnosed or for which they are still sometimes told, “There’s not much to be done, you’ve just got to get through it”.

Menopause jargon busting

• Climacteric – sadly, not anything to do with having a climax! This is the period of transition from a reproductive state to a non-reproductive one
• HRT – the highly controversial hormone replacement therapies are all designed to relieve menopausal symptoms in the short term but recent studies suggest that benefits may be outweighed by risk factors
• Perimenopause – this is the period during with oestrogen production declines, it often starts in a woman’s forties and lasts until menopause, which is when the ovaries stop releasing eggs

Confirming the menopause has taken place

Given everything we’ve already said, you won’t be surprised to discover that diagnosing the arrival of the menopause is also a little hit and miss! Although there is a test, it isn’t definitive. While women may be offered a blood test that measures the level of follicle stimulating hormone (FSH) the test isn’t a guarantee of menopause and so the test isn’t considered necessary to diagnose the perimenopause in women over 45. Instead a GP will usually look at the date of the last recorded period, along with symptoms (hot flushes etc) and the woman’s medical history. Family history may also be a factor so knowing if the women in your family reach the menopause early (or late) can help diagnose your own menopausal position.

Treatments for menopause

For more information on HRT you may find the following links from Dr Annie Evans and Dr Renee interesting.

https://youtu.be/I1RtnxKy8TI
https://youtu.be/6AxY4hvK0x4
https://youtu.be/2CY4D9qfCiU
https://youtu.be/eMTwTuvSVT0