Probably the only certainty about the menopause is that all women will have it sooner or later. The average age at which women go through the menopause is in their early 50s. (However, some women can have an early menopause, in their thirties and early forties, and in rarer cases, even earlier.)
The menopause is caused by a drop in your oestrogen levels. Oestrogen is the hormone that governs women’s periods. The reduction in your oestrogen levels means that your ovaries stop producing eggs – something that would normally happen every month.
Hormone levels don’t necessarily drop suddenly; they can fluctuate in the early stages of the menopause – known as the perimenopause. This can start anywhere from four to ten years before you have your last period. The first changes you may notice are that your periods become lighter or heavier, and become less frequent and unpredictable.
Once a year has passed since your last period, you’re regarded as being postmenopausal. However, that doesn’t always mean that your menopausal symptoms will stop.
Is it the menopause? Find out more about perimenopause
What are the symptoms of menopause?
About 70% of women have menopausal symptoms. These can vary, with very mild symptoms that are barely noticeable, at one end of the scale, to strong symptoms that can affect sleeping patterns, and concentration and cause severe mood swings.
Hot flushes and night sweats are symptoms many women experience. In a study carried out by researchers from Kings College, London, scientists studied data from 10,000 postmenopausal women, aged from 54 to 65. The women were asked detailed questions about their medical history, lifestyle, mood, weight and height. Three and a half years later, they completed a follow-up questionnaire.
Previously, medical experts had considered the average length of the menopause to be between two and five years. However, this study came up with a much longer average timescale.
Most women had hot flushes (86%) and night sweats (78%) at some point. But more than half the women (54%) continued having hot flushes and night sweats, for up to 10 years after their last period.
How to ease the symptoms of menopause
A hot flush – a common and characteristic symptom of the menopause - is when you feel a sudden rush of heat, starting in your chest, neck or face, and spreading outwards. Your skin may become red in patches; you may sweat and may also feel a change in your heart beat (palpitations). This can be uncomfortable and embarrassing, but doesn’t usually last very long.
Up to 85% of menopausal women have hot flushes, but some women have them many times a day. They usually last for about three to five minutes, and continue for, on average, two years. However, they can continue for two years or more.
Hot flushes that happen at night are known as night sweats. These can disrupt your sleep – sometimes on a nightly basis. You may also have trouble sleeping if you feel worried or anxious. Unfortunately the knock-on effect of poor sleep is that you may feel irritable the next day, and may have trouble concentrating.
Aches and pains in your joints are also quite common at this time. However, because other joint problems, such as osteoarthritis are also more common at this age, these pains may not always be linked to the menopause. See your GP for advice.
Hot flushes: what works?
Painful sex during menopause
The drop in your oestrogen levels, can affect your vagina, making it feel dry and sometimes itchy or burning. This is known as vaginal atrophy. Between 25 to 50% percent of women experience this in the years after the menopause. As well as being generally uncomfortable, this can make sex difficult or even painful. This won’t get better on its own, and may become worse, so it would be a good idea to speak to your GP. They may suggest using local vaginal oestrogen, or a non-hormonal vaginal moisturiser. You can also use vaginal lubricant to make sex more comfortable.
The change to your oestrogen levels can also affect your bladder. The result can be leaking urine when you cough or sneeze, and repeated bouts of urinary tract infections (UTIs). This is another good reason to see your GP.
Other physical symptoms can include tender breasts, thinning hair, and hair growth in unwanted places (such as your face), dryer, thinner skin, that bruises more easily and may feel itchy.
Is it normal not to want sex?
Psychological symptoms of menopause
These can include anxiety, depression, an inability to focus or concentrate, mood swings and a lack of energy. And these aren’t helped if your physical symptoms contribute to trouble sleeping, which leaves you feeling tired all the time.
Read our guide to easing the effects of symptoms of menopause.