The menopause - a timeline

There’s been a 37% increase in search for the menopause the last three years, with some of the biggest ranking searches last year relating to symptoms, age to expect it and treatment. Women are suffering from a lack of resources and taboos around discussing the subject still exist - even between mothers and daughters.  

Women are left underprepared when the menopause does take place, in a process that can begin as early as their 40s and take-up up to twenty years to resolve.   

Health & Her®, a new website designed to cut through the confusion around female health, with trusted and qualified menopause opinion from the UK’s top experts, wants to change this.  

Health & Her Co-Founder, Gervase Fay explains, “We’ve talked to hundreds of women about their menopause and how much it impacted on daily life. We found that symptoms are causing women to question their relationships, their self-worth and ability to do their job.  

“For taboos around the subject to fall away, we need to provide support and information to these women and all women, starting with the fundamentals: explaining what menopause actually is.” 

Health & Her experts has created a timeline of what to expect which features insight from a diverse range of experts including gynaecologists, womb yoga experts and everything in between, to explain everything women need to know about the menopause cycle.  

THE MENOPAUSE: A TIMELINE OF WHAT TO EXPECT 

The menopause takes place in three stages: peri-menopause; menopause; post-menopause. 

STAGE 1: PERI-MENOPAUSE 

Health & Her  expert, consultant gynaecologist Anne Henderson, describes the average peri-menopause as: “In the developed world, the ten years between 45 and 55 where women still have periods and hormonal activity, but egg reserves have declined and ovulation is less frequent.” 

AGE RANGE: 45 to 55 

DURATION: Anything from two to 10 years 

SYMPTOMS INCLUDE:  

  • Periods become erratic. One of the first symptoms women notice is that periods can become closer together or further apart. They’re often more painful and usually heavier. Eventually periods may only happen two to three times a year.  
  • Your moods and ability to cope with stress may change. These are symptoms people don’t physically see and so can often be difficult to deal with. They can include: low mood, anxiety, irritability, panic attacks, feeling tearful, low self-esteem, mood swings and poor concentration (brain fog).  
  • Your body, skin and sex drive could start to change.  These physical symptoms, usually associated with the later menopause stages can, for some women, actually be at their most intense in the peri menopause phase. 

Health & Her expert, consultant gynaecologist Anne Henderson, gives her advice on tackling the peri-menopause, “I think women should get themselves in as fit and healthy a state as possible in their early 40s, as they approach the peri-menopause. Bone and muscle loss are the two key health problems of menopause and there’s a lot women can do themselves to prevent problems. Weightbearing and weightlifting exercise are absolutely vital.” 

EXAMPLES OF HOW TO MANAGE SYMPTOMS INCLUDE: 

  • Plenty of exercise: Regular aerobic exercise and practicing yoga boost energy and improve sleep. Exercise also releases endorphins, the ‘happy hormones’ that help stabilise mood.  
  • Cognitive Behavioural Therapy (CBT): A well-recognised treatment for stress, anxiety and low concentration that includes techniques to improve mental health, relaxation, mindfulness and sleep hygiene.  
  • Good food choices: What we eat can have a dramatic effect on the way we feel. Eating wholegrains and legumes, seeds and nuts, tofu, eggs, meat, poultry, fish and seafood, for example, help our bodies to produce the ‘feel good’ hormone serotonin.

STAGE 2: MENOPAUSE

DURATION: Think of the menopause as a moment in time. 

Health & Her expert, consultant gynaecologist Anne Henderson clarifies“A loose definition of menopause is when a woman has gone two years without a period if they’re under the age of 50, or one year, if they’re over 50. However, this can be a bit old-fashioned and it may be more helpful to base whether you’ve been through the menopause on actual symptoms.”

SYMPTOMS INCLUDE: 

  • Periods have stopped. Your body is no longer releasing an egg every month so menstruation (the release of the body’s preparations for an egg to be fertilised) ends.  Some women feel a relief to be rid of the burden of periods.
  • You may experience hot flushes. Hot flushes happen to 70 – 80% of menopausal women. They can start in the peri-menopause stage and may increase in the final one-to two-years before menopause.  Often described as intense warmth through the body and face, they can range from mild heat once or twice a day to raging inferno every fifteen minutes. Add heart palpitations – another symptom – into the mix and it can be challenging. 
  • You could notice joint aches. One of the less common menopause symptoms, joint aches occur as decreasing oestrogen affects the levels of collagen in our joints.
  • You may find sex more painful. Vaginal and anatomical changes can lead to poor lubrication, as well as changes to the shape of your vagina – it can actually become shorter, narrower, and less stretchy. All these can make sex feel uncomfortable and even painful.

With trusted and qualified menopause opinion from the UK’s top experts, answering the biggest ranking questions posed by women online, Health & Her® features articles from gynaecologists and leading psychologists, as well as womb yoga teachers and everything through to career coaches and celebrity make-up artists. 

Designed to support women to take control of their menopause, the site offers a free and secure Menopause Symptom Tool & Tracker to help individuals understand and improve their menopause experience in three simple steps; as well as hand-picked products, carefully curated and recommended by woman who have been there.

Health & Her® expert, consultant gynaecologist Anne Henderson comments: “Little leaks may have historically been a normal part of growing older for many women, but they needn’t be these days. I’d urge women to get help if they’re developing these symptoms in their 40s and 50s as they will not improve as time goes by. These kinds of issues occur as declining oestrogen affects bladder lining and muscles.” 

EXAMPLES OF HOW TO MANAGE INCLUDE:

Talk to someone: Seeing a sex therapist can give you support to address any underlying relationship issues that may be there; a lack of sex can put strain on a relationship, particularly if you haven’t explained things to your partner and they assume you’re no longer attracted to them.  Support good sleep through diet and supplements: GABA, the brain chemical that calms us and helps us sleep is created using magnesium. You can top up magnesium levels by taking a warm bath with a cup of magnesium-rich Epsom Salts twice a week. Eating foods like leafy green vegetables, Jerusalem artichokes, berries and apples also promote gut health; important as 90% of serotonin (the chemical that produces the hormone that helps us sleep) in your body is produced in your gut.  See a specialist physio: Pelvic floor physiotherapy can improve bladder incontinence issues and there are bladder drills and ways of timing drinks to minimise getting caught out. Anne Henderson continues,“Consider HRT. Local treatment goes directly onto the area and can have an immediate benefit on the bladder area, without systemic treatment.”

STAGE 3: POST - MENOPAUSE

AGE RANGE: The average age to enter post-menopause is 51

DURATION: A woman is in post-menopause for the rest of her life. However, according to the NHS it typically takes four years for symptoms to stop but can be anything up to ten years. 

SYMPTOMS INCLUDE: 

You may notice a loss of sex drive: Menopause can make sex feel less enjoyable and contribute to decreased desire. Dealing with hot flushes and night sweats can also leave you too exhausted to initiate sex.  Changes to the water works: Little leaks, increased frequency or urgency around going to the loo and incontinence can all happen in the run up to and around menopause. Difficulty falling and then staying asleep: Women in all stages of the menopause can find it hard to fall asleep and can be prone to night time or early morning wakening. This poor sleep has a knock-on effect and can make other symptoms feel worse or harder to manage. Don’t just put up with it: Don’t let embarrassment stop you getting help with symptoms such as painful sex or vaginal dryness. Both arecommon and something as straightforward as using a good lubricant can make all the difference. 

Health & Her® expert Jane Dowling, personal trainer behind the award-winning blog Meno & Me, explains how exercise can help: When we are younger, we have fluid in our joints like runny honey, but the older we become the more it’s like glue. The positive thing is exercise can make that glue become more like honey again! Shoulder rolls, feet circles, squats, side bends and head twists are all great for lubricating your joints and helping with aches and stiffness. Stretching is also important, each muscle in the body crosses a joint - if that isn’t stretched you’ll feel stiff in the joint and the muscle.”

EXAMPLES OF HOW TO MANAGE INCLUDE: 

Hormone Replacement Therapy (HRT): Health & Her® expert, GP Shilpa McQuillan explains, "HRT is a treatment designed to replace the hormones in your body that you no longer make around the menopause.  The type and dose of hormones you need varies between women – HRT is tailored to your individual needs. HRT mainly aims to relieve symptoms related to oestrogen deficiency such as hot flushes, urogenital irritation (bladder and vaginal area), joint pains, headaches and mood disorders.”

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