Slide Managing the
   menopause

The key stages

Menopause has a full range of symptoms and each woman has a different experience. So it can be difficult knowing what action to take if you haven’t identified which stage you are at..

PREMENOPAUSE

Begins as a woman enters her reproductive years defined with her first period.

PERIMENOPAUSE

Hormone levels begin to decline and fluctuate causing symptoms that can last for several years.

MENOPAUSE

The end of a woman’s reproductive life, marked by the absence of a period for 12 months or more.

POSTMENOPAUSE

The time following menopause to the end of life.

Symptoms

Please select a symptom from the list below to view more details and the recommended action to take, to help alleviate the symptom.

Details

This is the most common symptom, affecting sleep, relationships, work & life. Hot flushes generally last 3-5 minutes but each can last up to 30 minutes and continue for many years. They may also be accompanied with palpitations, dizziness, anxiety or headache.

Actions

HRT is an effective treatment for symptom, along with stopping smoking, watching your weight, reducing caffeine and avoiding spicy food (if they are a trigger). Also planning ahead, so wearing layers that can be easily removed, keeping cold water with you, a cooling face spray and a portable mini fan (mayne a very big bag!). Recent evidence suggests that CBT can help ease symptoms in some women.

Details

Fatigue and weakness can be worse when accompanied with heavy periods (possible anaemia), insomnia and hot flashes.

Actions

Take regular exercise, try to reduce stress where possible, reduce caffeine intake, eat a well-balanced diet and try to establish a good sleep routine..

Details

Feeling panicky, nervous, worried, tense. This symptom is often unexpected although common. Physical symptoms can include chest pain, shortness of breath, palpitations, shaking, nausea and trouble sleeping. If you have suffered with anxiety before, you are more likely to find symptoms reappear or are worse during menopause.

Actions

HRT, breathing exercises to focus the mind and body and being outdoors. A good sleep routine will also help along with exercise and reading to relax. Look at reducing your caffeine and alcohol intake.

Details

This is due to the imbalance of hormones.

Actions

Stay hydrated throughout the day, take regular exercise to balance your hormones, get plenty of fresh air and sleep.

Details

This occurs mainly due to the loss of oestrogen and testosterone which can lead to painful sex, loss of libido, low self esteem due to body changes, UTI’s and itchy/sore skin.

Actions

HRT, testosterone, regular pelvic floor exercises, managing stress (where possible!), exercise (which can help with confidence), vaginal oestrogen, taking time with your partner to talk about sex and explore new ways to achieve sexual pleasure.

Details

Moods can change from day to day becoming erratic. you can experience low mood, tearfulness, anger, frustration, sadness and irritability.

Actions

HRT is very effective along with regular exercise, a healthy diet and a good sleep routine. These can all have a positive impact on your mood.

Details

Unable to control reactions, resulting in angry outbursts and snapping at people.

Actions

HRT, a good sleep routine, a healthy diet, exercise, fresh air and stay hydrated.

Details

During menopause, many women struggle to fall to sleep, stay asleep, have poor quality sleep because of their other menopause symptoms, or wake early. The decline in progesterone may also contribute. This has an impact on your day too causing fatigue which can effect your mood and concentration.

Actions

HRT. lavender, CBT, relaxation techniques and exercise (but not too late). Creating the right sleep environment i.e. right temp, dark, quiet, avoiding screen time at least an hour before bed (tv incl), reading or listen to music will help. Avoid caffeine and meals later on.

Details

Approx a third of women will develop some level of hair loss after menopause. Facial hair may appear, mostly chin and upper lip, plus light hair fuzz on cheeks.

Actions

Try to avoid any harsh products or treatments, reduce use of straightners and hairdryers, wash your hair less frequently and brush your hair softly. Laser treatments to permanently remove unwanted hair.

Details

Brain fog, feeling forgetful or finding it difficult to concentrate can be a very worrying and frustrating symptom.

Actions

Keep your body hydrated and your brain active with number puzzles and crosswords. Read something challenging, learn something new, make lists, be organised and if in doubt, take notes. Lack of sleep may also be connected with symptoms.

Details

Oestrogen effects where we store fat, moving it from our hips and thighs to our waistline. Along with losing muscle mass and a slower metabolic rate can lead to weight gain.

Actions

Eat a healthy diet, avoid processed food and cut back on alcohol, fruit juices and fizzy drinks. Establish a good exercise routine including cardio, strength training, circuits and mind & body yoga and pilates to increase flexibility and balance.

Details

Women can experience episodes of palpitations, irregular heartbeat or a pounding pulse due to decline in oestrogen. These are often accompanied with hot flashes or anxiety.

Actions

HRT, stop smoking and reduce your intake of alcohol and caffeine.

Details

This is due to the imbalance of hormones and can be similar to morning sickness.

Actions

Avoid fatty foods and avoid wearing anything tight around your waist. Eat smaller meals more frequently, take sips of cold water, get plenty of fresh air and drink ginger or peppermint tea.

Details

Women who suffer from hormonal headaches and migraines find they can get worse during menopause. The fluctuations of oestrogen can trigger migraines.

Actions

HRT (patch or gel) can help reduce migraines by replacing and providing a steady supply of oestrogen. Acupuncture is also know to be very beneficial. Look out for triggers.

Details

Hormones are closely linked to your immune system, so women may start with new allergies or existing allergies may get worse.

Actions

Antihistamines, cleaning your nasal passages and using a nasal spray should all help alliviate your symptoms. Vitamin C is also known to help.

Details

Periods can become erratic during perimenopause, they can be become shorter, longer, lighter or heavier.  This can be frustrating and unsettling if they appear when you least expect it. Women may also experience PMS without bleeding.

Actions

Download an app to track your periods, wear panty liners or sanitary towels as a precaution, make notes of anything unusual.

Details

A drop in oestrogen can result in the skin becoming thinner, which leads to water loss and dry, itch skin.

Actions

Moisturise your entire body, not forgetting your feet, stay hydrated and keep skin covered when cold or windy. Eat a healthy diet including vitamin C, try to avoid stress and protect your skin with sunscreen.

Details

Commonly affects your joints but it can be anywhere and can wake you up in the night if particulary bad. Women can also experience general muscle stiffness.

Actions

HRT, take a hot bath, stretch and exercise regularly, eat a healthy diet and practice mindfulness and meditation.

Details

Changes in oestrogen levels can effect your brain and emotions. It is not uncommon for women to have periods of low mood and feelings of depression during menopause.

Actions

Always speak to your GP if you feel low, sad or depressed. HRT, testosterone and CBT (Cognitive Behavioural Therapy) can help symptoms. Looking at your lifestyle and making positive choices will also help incl a balanced diet, regular exercise, good sleep and plenty of water. Try to reduce any stress you may have, reduce alcohol intake and stop smoking.

Details

Lower oestrogen levels and dehydration can leave nails dry and brittle.

Actions

Stay hydrated, moisturise your hands and nails, avoid nail treatments that damage your nails.

Details

The digestive system is very sensitive and changes to hormones can lead to indigestion, bloating, diarrhoea and constipation.

Actions

Cut down on fatty and spicy foods, exercise, stay hydrated and reduce stress where possible. Take time to relax your mind and muscles with meditation.

Details

Loss of oestrogen effects the bladder, urethra and pelvic floor and getting older also means the bladder becomes smaller with less elasticity. Along with incontinence, women suffer with UTI’s and weaker pelvic floor muscles.

Stress Incontinence is more common. This is when you experience leaks due to coughing, sneezing, laughing, exercising.

Urge Incontinence and an overactive bladder is when you expel some or all of your bladder contents randomly, have to go to the toilet frequently, urgency and waking frequently in the night to use the toilet.

You can have one or both conditions.

Actions

Practice your pelvic floor exercises daily, stopping smoking helps with urinary and general health, cut back on caffeine, keeping drinking water as normal, only go to the toilet when you need to (not just ‘to check’) and try to keep a healthy weight to prevent additional pressure on the bladder.

Details

Loss of oestrogen changes the urethra and bladder as well as the vagina, which can lead to frequent UTI’s, cystitis, pain passing urine and more frequency.

Actions

Vaginal/topical oestrogen appears to be very effective. Your GP or pharmasist can advise on the correct treatment. Stay hydrated.

Details

Women can experince dryness, pain, itching, discomfort and burning due the vaginal tissues becoming thinner and dryer, mainly due to the loss of oestrogen. Sex can also become painful.

Actions

Vaginal/topical oestrogen appears to be very effective. Avoid using any products that will irritate and wear cotton underwear. Use vaginal lubricants and vaginal moisurisers to help ease symptoms.

Details

Osteoporosis is a progressive condition in which bones become structurally weak and are more likely to fracture or break. Menopause significantly speeds bone loss and increases the risk for osteoporosis.

Actions

Lifestyle changes can promote healthy bones; resistance, balance and weight bearing exercises, a healthy diet incl Vit D and calcium, sunshine, preventing obesity, avoiding smoking and imiting alcohol.

Details

Not common but a tingling sensation can appear anywhere in the body due to hormone fluctuations affecting skin receptors.

Actions

Eating a healthy diet including B12, regular exercise, accupunture and massages are known to help.

Details

Due to hormone changes.

Actions

Wear a well fitted bra and a soft bra at night. Anti-inflammatory gel can also help.

Details

Periods become unpredictable as hormones fluctuate. Women can skips periods, or they may become lighter or heavier.

Actions

HRT is effective and also the Mirena coil which provides progesterone.

Details

Skin can become dry, sensitive and tired with wrinkles and sags due to falling levels of oestrogen.

Actions

HRT is effective as it replaces the lost oestrogen. It is also important to keep your skin well moisturised with a good SPF to avoid any further damage. Avoid using anything harsh on your skin and stay hydrated.

Details

Oestrogen regulates levels of moisture in the body so fluctuations in oestrogen can effect the quality and amount of saliva you produce. This can cause issues with swollowing, chewing and talking and it can also cause dental decay. Some women experience a burning sensation inside the mouth.

Actions

HRT can be effective. Chewing sugar free gum/boiled sweets, staying hydrated, and reducing caffeine & alcohol can also help relieve symptoms. It is important to look after your oral health.

Details

Changes to hormones can affect your nervous system, sending neurologial messages around your body. Typically these happen before a hot flush.

Actions

Ensuring you have enough vitamin B in your diet has been linked to easing symptoms.

Actions

Once you’ve recognised the symptoms of menopause, it’s time to take positive action. There are many ways to do this.

Details

HRT replaces the hormones that naturally decline during and after menopause alleviating many of the symptoms. Many women see a benefit within 3-4 weeks. HRT can be given in different ways including patch, gel, cream, tablet or pessary.

Details

Is a hormone that has many roles in the body some of which affect your brain, bones, heart and skin.

Details

Is a hormone mainly produced in the ovaries that helps prepare the uterus for pregnancy and maintain your period cycle.

Details

Is a hormone that contributes to sex drive and orgasm, muscle and bone strength, mood and cognitive function.

Other treatments & therapies

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Looking after yourself and taking regular exercise can help relieve many menopausal symptoms. It can be difficult to make changes to your lifestyle when you are feeling worried or fatigued or have no time, but taking time out for yourself to make positive changes could help you feel much more like yourself.

  • Regular exercise
  • Positive outlook
  • Healthy diet
  • A good bedtime routine

Cognitive behavioural therapy (CBT) has been shown to help with a number of menopausal symptoms, including low mood, anxiety, insomnia, hot flushes and night sweats. It is a talking therapy, with a key focus on negative thought patterns. It looks at how you think and behave, your attitudes and beliefs and helps you develop coping strategies for dealing with problems.

Many women find yoga helps improve some of the symptoms of menopause. As yoga relaxes the body and mind, it can help reduce stress and anxiety and for some women help reduce hot flushes too. Yoga stretches and tones the muscles (including the pelvic floor) helping reduce aches and pains and gives you the space and time for a clearer and calmer mind.

Acupuncture is derived from ancient Chinese medicine. Fine needles are inserted into the skin at specific points and various depths. By inserting the needles, it is said to bring the energy flow back into balance. Acupuncture is generally used to treat migraines, headaches and musculoskeletal pain but many menopausal women have found significant relief from symptoms.

There is a huge number of herbal remedies available online and in health shops. Always look for the THR marking which is the Traditional Herbal Registration, and talk to your GP before buying online or over-the-counter medicines.

Can help reduce stress and anxiety and leave you feeling relaxed and refreshed. Deep breathing is good for both your physical and mental health, so it’s a great exercise to incorporate into your daily routine and can be practised almost anywhere.

You’re not alone…

At 51 I started to feel very unmotivated, lost interest in lots of things and some days just can’t be bothered to do anything. I almost have to force myself. At the start I also suffered with panic attack symptoms and crying spontaneously. The hot sweats have also started in the last six months which are very debilitating.

The worst part I’ve found is those occasions when I just don’t feel like me! For someone who is generally quite calm, rational and relatively controlled, this I find the hardest bit to deal with.

At 44 came the first signs, hormonal acne followed by hormonal headaches a few days before my period was due and then a very sensitive stomach. The biggest hurdle of all was coping with my mental health. Some great days, some not so great days, a bit like throwing all your emotions into a lottery machine and not knowing what’s going to come out.

When I started this ‘peri’ journey I thought I was getting off lightly. Due to me having a subtotal (ovaries kept) hysterectomy at 40. The first was a burning face, not too uncomfortable but at times a little embarrassing as I would glow like a traffic light on STOP! Then came the aches, mostly at night coupled with anxiety and panic attacks. Thankfully because I knew there was no danger I was able to control them but they were scary at first.

My symptoms started when I was 46 but coincided with a new job, so I put my anxiety and fatigue down to that. As time went on my mood was really low and I was really struggling. I became depressed and couldn’t cope. The doctor prescribed HRT and within a couple of weeks, my mood completely lifted. I have never looked back since.

I suffer with night sweats, joint pain, brain fog/loss of memory and itchy skin. I find doing regular Pilates 3 times a week really helps with the joint pain and a weekly acupuncture session keeps the hot sweats at bay. It’s not something I had anticipated dealing with at 37.

Together we can really Change it Up!
and remove the stigma
around the menopause!