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. 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’.

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.
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. Also, it can cause some hairiness.

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.

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. 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.

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.

Hairiness. Annoyingly, hair may become more obvious on other parts of the body (such as the face).

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 lapses, weight gain, vulval pain, urinary incontinence, vulval itching, genitourinary prolapse and breast pain.