Your experience of the menopause will be affected by many different things, not just what’s happening in your body. The menopause may be one of many significant events happening in your life, such as your children leaving home or your parents needing more care. You may still be working full-time and having to juggle these new responsibilities.
Cultural differences can shape how you’re affected by the menopause too. Research shows that in societies where older people are respected, menopause symptoms are often less troublesome. But where younger women are admired more highly, going through the menopause can feel like a time of loss and being less valued by society. Menopause symptoms for these women can feel much worse.
However you feel about the menopause, you may find physical symptoms such as mood changes and hot flushes hard to manage. Don’t be afraid to talk about it and to ask for help if you need it.
What is the menopause?
The menopause is a natural biological process. Put simply, the menopause is when you stop having periods and are no longer able to get pregnant naturally. It happens when your ovaries age and naturally produce lower levels of reproductive hormones. If you’ve had a hysterectomy and had your ovaries removed, you will immediately reach menopause. This is known as surgical menopause and can happen to women of any age.
We often use the word menopause to describe when we notice our periods changing and we start to experience menopausal symptoms, which is called the perimenopause. The menopause itself is defined as the day when you haven’t had a period for 12 months.
The average age of menopause is 51 but it may happen sooner or later than this. Around one in 100 women experience the menopause before they reach 40.
What is the perimenopause?
The perimenopause is the time when your body starts transitioning towards the menopause and your ovaries slow down. It can start months or years before the menopause. You might experience irregular periods that are lighter or heavier than normal, hot flushes, mood swings, sleep problems and fatigue.
What are the symptoms of the menopause?
Eight out of ten women have symptoms in addition to their periods stopping. The type and severity of symptoms can vary, and some are the same as the symptoms that can occur during the perimenopause. Common menopausal symptoms include:
- hot flushes – short, sudden bursts of heat that can leave your skin sweaty and red
- night sweats – hot flushes that occur at night
- sleep problems
- mood swings
- brain fog, forgetfulness and difficulty concentrating
- loss of interest in sex
- vaginal dryness or pain
- aches and pains
- urinary tract infections (UTIs)
How are trans people affected by the menopause?
If you’re trans, how the menopause affects you will depend on which medical interventions you’ve undergone and whether or not you’re taking hormones. Speak to your doctor if you have any questions or concerns. Rock My Menopause has some information about the menopause and trans people.
How can the menopause affect my emotional and mental health?
Changing hormone levels can cause mood swings, low mood and anxiety around menopause. For some women, these are the first signs that they are approaching menopause.
Self-help measures such as getting enough sleep, eating well, taking regular exercise and practising yoga or meditation may help. You might also want to speak to your doctor about getting help. They may suggest talking therapy, medication or both.
Can antidepressants help?
The low mood you may experience with menopause is different from depression. NICE (the organisation that produces guidelines for healthcare professionals) is clear that you shouldn’t be offered antidepressants as a first line of treatment. Mood changes are caused by your changing hormones, so hormone replacement therapy (HRT) can help.
However, you may be prescribed a low dose of antidepressants to help with hot flushes and night sweats.
The menopause and mental health conditions
While the menopause isn’t a mental health condition, it can affect your mental health. Hormone changes during the menopause can sometimes make mental health conditions worse.
- If you have a history of depression, you’re more likely to be depressed during menopause.
- If you have bipolar disorder, you may experience more depressive episodes. This is likely to be linked to a decrease in oestrogen.
- If you have schizophrenia, you may find your symptoms get worse and you need a higher dose of medication.
Not all women are affected, but speak to your doctor if you’re finding your mental health condition harder to manage. Changes to your treatment may help you feel better.
Getting help with menopause symptoms
Speak to your doctor if your menopause symptoms are affecting your life. You don’t just have to put up with them – there is help available.
The main therapy is hormone replacement therapy (HRT). This replaces the hormones that are reducing in your body and is very effective at relieving menopause symptoms. It can also help with thinning of the bones, which is more common after the menopause. There’s no limit on how long you can take HRT, but most women stop taking it after their symptoms stop – usually after a few years. You may find your menopause symptoms come back for a while after stopping HRT. If they’re severe, speak to your doctor about managing them.
As with all medication, it’s important you weigh up the benefits and risks of taking HRT. Some women and doctors have been reluctant to use HRT because of studies that have focused on the potential risks. However, recent evidence shows the risks are very small and usually outweighed by the benefits. Talk to your doctor about any concerns.
It’s always your choice whether to take medication or not. Some women prefer not to take HRT and to manage their symptoms in other ways until this stage in their lives has passed.
Talking therapy such as cognitive behavioural therapy (CBT) can help with low mood, anxiety, stress and even hot flushes and night sweats.
The NHS website has more information on treatment and self-help for menopause symptoms.