Definitions and Symptoms

Menopause

Menopause is the stage in a woman’s life when she has not experienced a natural menstrual period for a continuous year (unless medication is used to suppress periods). The average age for menopause in the UK is around 51, but it is considered normal for it to occur anywhere between ages 45 – 55.  After menopause, a woman is referred to as postmenopausal.

Perimenopause

This is the period during which menopausal symptoms start to appear while you are still menstruating, although your periods may become more frequent, less frequent, lighter, or heavier. This phase can extend for up to a decade and concludes once you have experienced 12 consecutive months without a menstrual cycle

Surgical Menopause

Surgical menopause occurs when a woman’s ovaries are surgically removed, typically during a bilateral oophorectomy. This leads to a sudden onset of menopausal symptoms due to the abrupt decrease in oestrogen and testosterone levels.

Medical Menopause

Medical menopause can be induced by treatments like chemotherapy, radiotherapy, or certain medications, resulting in the cessation of ovarian function and the onset of menopausal symptoms.

Early Menopause

Early menopause refers to menopause occurring before the age of 45.

Premature Ovarian Insufficiency

Premature ovarian insufficiency is a condition where menopause sets in before the age of 40. It affects approximately 1 in 100 women. It is crucial for women diagnosed with early menopause or POI to consider hormone replacement therapy (HRT) to safeguard their heart and bone health, even though some may have concerns about it.

Symptoms

Hormone-related symptoms can vary widely among women and can affect various parts of the body. These symptoms can include: irregular periods; hot flashes; night sweats; sleep disturbances; migraines; palpitations; fatigue; muscle and joint discomfort; vaginal dryness; urinary issues; decreased libido; breast tenderness; skin and hair changes; mood swings; cognitive difficulties; and more. It’s important to note that not all women experience the same symptoms, and they can persist for several years, with an average duration of about 7 years.

Increasing allergies and skin sensitivities
Menopause is associated with a decrease in oestrogen levels. This hormonal shift can lead to changes in the skin, making it more sensitive and prone to dryness and irritation. Some women may develop allergies to skincare products or cosmetics during this time. Hormone Replacement Therapy (HRT): Women undergoing hormone replacement therapy (HRT) as part of menopausal management may experience changes in skin sensitivity. HRT aims to balance hormone levels, which can help alleviate some skin-related issues associated with menopause.
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Brain fog
Some women may experience cognitive changes, often referred to as "brain fog." This can include difficulties with memory, concentration, and mental clarity, which can be emotionally distressing.. Female hormones, like oestrogen and progesterone, can impact cognitive function. Hormonal fluctuations during the menstrual cycle, pregnancy, and menopause may contribute to brain fog, characterised by memory lapses, difficulty concentrating, and mental clarity issues. Oestrogen can have a protective effect on cognitive function, while changes in hormonal levels can affect neurotransmitters and brain function. Managing hormonal fluctuations and adopting lifestyle strategies can help alleviate brain fog in women.
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Changing body shape
During menopause, hormonal shifts, particularly a decrease in oestrogen levels, can lead to fat accumulating around the abdomen rather than in the hips and thighs. This can result in a more "apple-shaped" body..
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Dry eyes
Female hormones, such as oestrogen, can influence eye health. Hormonal fluctuations during the menstrual cycle, pregnancy, and menopause can lead to dry eyes and changes in tear production. Oestrogen can have a protective effect on eye tissues and tear film stability. Reduced oestrogen levels, as seen in menopause, may increase the risk of dry eye syndrome. Managing hormonal changes and seeking appropriate eye care can help alleviate dry eye symptoms in women.
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More emotional
Small stressors may trigger stronger emotional responses. Female hormones, such as oestrogen and progesterone, can significantly impact emotions. Hormonal fluctuations during the menstrual cycle, pregnancy, and menopause can lead to mood swings, irritability, and changes in emotional well-being. These hormones influence neurotransmitters and brain function, affecting mood and emotional stability. Managing hormone-related emotional changes may involve lifestyle adjustments, medical treatments, or therapy.
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Feeling less able to cope
Hormones help women cope by regulating mood, managing stress responses, supporting reproductive health, and influencing bonding and caregiving. Hormonal fluctuations and imbalances can affect individuals differently, so seeking healthcare guidance and emotional support is crucial for managing their impact on well-being and coping mechanisms.
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Hair changes
Hormones can impact hair changes by influencing hair growth and texture. Changes in hormonal levels, such as during puberty, pregnancy, menopause, or hormonal disorders, can affect the growth cycle, leading to hair loss or changes in hair thickness and texture. Hormonal fluctuations can also affect oil production, potentially contributing to oily or dry hair.
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Headaches
Hormones can have a significant impact on headaches in women, and these fluctuations are often associated with specific stages of a woman's reproductive life. Women who undergo hormone replacement therapy (HRT) during menopause may find relief from menopause-related headaches. HRT aims to balance hormonal levels, including oestrogen, which can help alleviate some menopausal symptoms, including headaches.
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Increased anxiety
Female hormones, particularly oestrogen and progesterone, can influence anxiety levels. Hormonal fluctuations during the menstrual cycle, pregnancy, and menopause may contribute to heightened anxiety symptoms in some women. Oestrogen can have a mood-stabilising effect, while changes in hormonal levels can affect neurotransmitters linked to anxiety. Managing hormonal fluctuations, adopting stress-reduction techniques, and seeking medical advice can help alleviate anxiety symptoms in women.
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Itching skin
Hormones can influence skin sensitivity and itching. Higher levels of oestrogen, for example, can enhance skin's moisture and thickness, reducing itchiness. Conversely, hormonal imbalances may lead to dry skin and increased itching. Proper hormone balance and skin care can help alleviate itching..
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Joint pains
As oestrogen, which has anti-inflammatory properties, decreases in the body, joint discomfort may intensify, and recovery time from injuries may lengthen. Female hormones, like estrogen, can impact joint health. Higher estrogen levels during the reproductive years may provide some protection to joints by promoting cartilage health and reducing inflammation. However, hormonal fluctuations during the menstrual cycle, pregnancy, and menopause can lead to joint discomfort or pain in some women. Lower estrogen levels, as seen during menopause, may increase the risk of joint problems. Proper joint care, including exercise and a balanced diet, can help manage joint-related issues influenced by female hormones.
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Intrusive thoughts
Intrusive thoughts, including thoughts of self-harm or suicide, can be unsettling symptoms. If you experience such thoughts, it is crucial to confide in someone, whether it's your partner, family member, friend, or by contacting organisations like the Samaritans at 116 123. Female hormones, such as oestrogen and progesterone, can influence mental health, including the occurrence of intrusive thoughts. Hormonal fluctuations during the menstrual cycle, pregnancy, and menopause may contribute to changes in mood and thought patterns. While oestrogen may have a stabilising effect on mood, shifts in hormonal levels can affect neurotransmitters linked to mental well-being. Managing hormone-related mental health symptoms may involve therapy, medication, and stress-reduction techniques.
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Irregular periods
Hormonal imbalances can disrupt the regular menstrual cycle. High or low levels of hormones like estrogen and progesterone can lead to irregular periods, causing missed or frequent menstruation.
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Irritability
Changes in hormone levels can make some women more prone to irritability and frustration. Small stressors may trigger stronger emotional responses.
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Increasing injuries
Female hormones, particularly oestrogen and progesterone, can influence injury risk and recovery. Oestrogen may protect joint health and bones but may affect ligaments and tendons. Hormonal fluctuations can also impact muscle mass and strength, potentially affecting the risk of muscle injuries. Additionally, hormones can influence pain perception and tissue healing. However, individual responses vary, and other factors play a significant role in injury risk and recovery. Maintaining a healthy lifestyle and injury prevention strategies are essential.
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Loss of confidence / imposter feeling
There can be a loss of confidence in your abilities, especially at work, and you may find some situations more stressful than before. These changes can influence your self-perception and interactions with others.
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Low self esteem
Hormonal changes, such as those during puberty, pregnancy, or menopause, can influence self-esteem. These changes may affect body image and emotional well-being, potentially impacting self-esteem positively or negatively. Additionally, hormonal imbalances can contribute to mood swings and other emotional factors that influence self-esteem.
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Low mood/ mood swings
If you've ever experienced mood swings or irritability before your menstrual period, you are familiar with the influence of hormones on your mood and overall well-being. Oestrogen plays a role in regulating hormones that have mood-enhancing properties, such as serotonin, norepinephrine, and dopamine. It also contributes to mental sharpness, and a decrease in oestrogen levels can lead to "brain fog" and lower mood. Progesterone has a calming effect on mood, promotes sleep and relaxation. When progesterone levels decline, it can result in increased irritability and mood swings. Testosterone is believed to impact mental stamina, sleep quality, clarity of thought, concentration, and mood stability. During perimenopause, as oestrogen, progesterone, and testosterone fluctuate and decline, these hormonal changes can significantly affect your mental health and overall well-being, impacting your daily life and relationships.
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Metabolic changes
Hormone Replacement Therapy (HRT) can impact metabolic changes in women by potentially promoting a healthier body composition, improving insulin sensitivity, positively influencing lipid profiles, preserving bone density, and preserving or increasing muscle mass.
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Migraines
Headaches and migraines can become more severe, frequent, or even develop for the first time in a woman's life.. Hormone Replacement Therapy (HRT) can help with migraines, particularly those triggered by hormonal fluctuations. HRT can stabilise hormone levels and reduce the frequency and severity of hormonal migraines. However, the response to HRT varies among individuals, so consulting with a healthcare provider is essential to determine the most suitable approach for migraine management.
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Mood changes
Hormonal fluctuations, particularly a decrease in oestrogen, can lead to mood swings. Women may experience periods of irritability, moodiness, and emotional highs and lows during perimenopasue and post-menopause.
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Muscle mass
Aging and hormonal changes can contribute to a decrease in muscle mass, known as sarcopenia. Reduced muscle mass can lead to a loss of muscle tone and a shift in body shape towards a less defined appearance. Oestrogen supports lean muscle mass.. Female hormones, particularly oestrogen and progesterone, can influence muscle mass. Oestrogen supports muscle integrity and may help maintain muscle mass. However, hormonal fluctuations, such as during the menstrual cycle, can affect muscle performance.
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Painful sex
Oestrogen plays a vital role in maintaining the health of the vagina, vulva, bladder, and pelvic floor. During periods of low oestrogen (such as perimenopause, menopause, breastfeeding, or while on the progesterone-only pill), the vagina gradually loses its natural lubrication. This leads to thinning and reduced elasticity of the vaginal walls, causing pain during penetration and an increased risk of tearing during intercourse. Additionally, the bladder and urethra also undergo thinning, leading to more pronounced openings and a higher susceptibility to urinary tract infections. The labia at the vaginal entrance lose fat, become thin and sensitive, and can fuse together, resulting in itching and soreness. Scars from childbirth may lose collagen and elastin, becoming more sensitive and often causing pain during sex.
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Palpitations
An increased awareness of your heartbeat, often associated with hot flushes and night sweats. Female hormones, particularly oestrogen and progesterone, can impact palpitations. Hormonal fluctuations during the menstrual cycle, pregnancy, and menopause may lead to palpitations in some women. Oestrogen can influence heart rate and blood vessel function, while progesterone may have a calming effect on the heart. Managing hormonal fluctuations and addressing underlying causes can help alleviate palpitations in women.
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Poor concentration
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Reduced sex drive
A lack of interest in sex is frequently reported during this period. Decreased levels of oestrogen and testosterone can affect sexual arousal, receptiveness, and pleasure, causing distress.
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Plantar fasciitis
Hormones do not directly cause plantar fasciitis, but hormonal changes, such as during pregnancy or menopause, can indirectly affect factors like ligament laxity and foot structure, potentially increasing the risk of developing plantar fasciitis.
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Poor memory
Brain Fog: This encompasses various symptoms, including poor concentration and memory, difficulty finding words, forgetfulness, and problems retaining information. Many women fear they may be experiencing early onset dementia.
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Poor sleep/ insomnia
Female hormones, like oestrogen and progesterone, can influence sleep. Hormonal fluctuations during the menstrual cycle, pregnancy, and menopause can affect sleep patterns. Oestrogen can promote better sleep quality, while progesterone may induce drowsiness. Balancing these hormones is crucial for healthy sleep, and lifestyle adjustments and medical guidance may be necessary for managing sleep disturbances in women..
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Tiredness
Female hormones, particularly oestrogen and progesterone, can influence tiredness. Hormonal fluctuations during the menstrual cycle, pregnancy, and menopause can lead to fatigue and changes in energy levels. Oestrogen can have an energising effect, while progesterone may contribute to sleepiness. These hormonal shifts can affect sleep quality and circadian rhythms, impacting tiredness in women.
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Worsening PMS
If you've dealt with premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), or postnatal depression previously, you may also be more vulnerable to mood changes during hormonal transitions in perimenopause and menopause.
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Urinary symptoms
Oestrogen receptors in the bladder, vulva, and pelvic floor rely on oestrogen for normal bladder control and function. As oestrogen levels decrease, structural changes can lead to urinary frequency, urgency, and recurrent urinary tract infections.
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Vaginal infections
Female hormones, such as oestrogen, can influence vaginal health. Higher oestrogen levels, typically seen in the reproductive years, help maintain a healthy vaginal environment by promoting a balanced pH and encouraging the growth of beneficial bacteria. Lower oestrogen levels, as seen during menopause, can lead to vaginal dryness, thinning of vaginal tissues, and a higher risk of vaginal infections, including yeast infections and bacterial vaginosis. Hormone therapy may be used to alleviate these symptoms by restoring oestrogen levels and promoting vaginal health.
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Vaginal dryness
The lack of lubrication, arousal, and painful intercourse can result in reduced sexual activity, less satisfying sex, and avoidance of intimacy due to fear of discomfort. This can strain relationships, as partners may misinterpret these symptoms as a lack of attraction or interest. Many women mistakenly believe these symptoms are a natural part of aging. Approximately 70% of women experience these symptoms, yet only a minority receive proper treatment.
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