Menopause symptoms and treatments: Everything you need to know – goodhousekeeping.com

When it comes to the menopause, we certainly wont all experience it equally. The reality is that for every woman who sails through unscathed, there'll be four others who find themselves in an unfamiliar world of hot flushes, aching joints, disturbed sleep, foggy brain and mood swings. One in four women say symptoms are severe enough to affect their quality of life and for some, it can persist for years.

Several studies have shown that, for some women, menopausal symptoms can last for a decade or longer after their last period. A 2002 Swedish study of 430,000 women found that 15% of those aged 66 and 9% of those aged 72 were still bothered by hot flushes. Meanwhile, a more recent US study of 3,000 women found that, although symptoms in those who had frequent hot flushes and night sweats persisted on average for more than four years after their last period, it was women who had symptoms pre-menopausally who were still suffering nearly 12 years after menopause.

According to GP and menopause doctor Dr Shahzadi Harper, it's not just hot flushes flat or low mood, loss of confidence, foggy brain, loss of libido and poor sleep can all persist as well.

The issues don't just start post menopause either. Some women experience years of symptoms before they reach their final period. Although many still think of menopause as something that happens in your 50s (51 is the average age for women to have their last period), for many, symptoms start in their mid or even early 40s, says Dr Harper. "I often describe peri-menopause as the brackets around the menopause," she explains. "Symptoms can last for as long as 10 years before and 10 years after your final period."

"Its easy to miss the early symptoms when youre busy and tired, especially as they can be quite subtle," she adds. The first signs you may notice, apart from small changes in your periods they may be a bit shorter, longer, be a little more or less frequent may be joint pains, hot flushes or night sweats, disturbed sleep, anxiety, irritability and low mood. Later symptoms include vaginal dryness, needing the loo more often and urinary tract infections.

All these menopausal symptoms are the result of the reduction in your bodys production of oestrogen, which starts to decline rapidly from the age of 40. There are oestrogen receptors in organs all over your body when oestrogen production declines and it can have a wide-reaching impact.

Some women are particularly vulnerable to having more severe and long-lasting menopausal symptoms.

"Women who have suffered from post-natal depression or bad PMS tend to have more severe symptoms and theirs tend to last longer post menopause," says Dr Harper. "These women seem to be more sensitive to hormonal imbalances, while symptoms can also vary according to other factors such as environment and life stresses, as well as the physical changes that are happening in the body."

A 2015 US study found that women who experienced long-term symptoms tended to be younger and have greater levels of stress, anxiety and depression.

What seems clear is how unprepared many women still are for menopause and the fact that symptoms may develop early and persist for years. A 2017 survey of 3,275 women aged 40-65 by Nuffield Health found that, despite symptoms like joint and muscle ache, hot flushes, irregular periods, night sweats, mood swings and poor memory, 45% of the women didnt recognise they could be experiencing menopausal symptoms, with just under half (42%) mistakenly believing they were either too young or too old for symptoms.

A quarter simply put their symptoms down to stress. Just over a third (38%) sought help from a GP; however, a quarter of those who visited a GP said the possibility of the symptoms being menopause related failed to come up.

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Menopause expert and psychotherapist Diane Danzebrink says we shouldnt blame GPs as many of them receive little training in menopause. Since Diane, 53, experienced a surgical menopause after a hysterectomy eight years ago, she has become a passionate campaigner for better information and GP training on menopause.

"No one explained just how critical oestrogen was," she says. "They just suggested I discuss HRT with my GP. But because I had heard horror stories I chose not to, which was a mistake. Three months on, I was having palpitations, I felt heavy and fatigued, I had panic attacks and couldnt stop crying.

"I thought I was going insane, which made me even more scared of going to the doctor. It was only when I was close to driving my car in front of a lorry that I went to see my GP who explained why I was feeling the way I was that the oestrogen deprivation was affecting my body, my brain, my cognition and my emotions.

"It was an enormous relief and, within a few weeks of starting HRT, the world stopped being so dark; the chinks of light came back. When I started researching, I found there were thousands of women suffering from undiagnosed and untreated menopausal symptoms often for many years."

Diane's experiences led her to set up Make Menopause Matter, which provides support and information to women, their families and employers. She is also campaigning to make menopause training mandatory for GPs, to provide menopause guidance in every workplace and to include menopause in the new relationships and sex education curriculum in secondary schools so that the next generation of women (and men) will grow up with more information and understanding about menopause something that will happen from this September.

Like Diane, Dr Harper meets many women who for years have struggled with menopausal symptoms after many years as a GP, she became a menopause specialist to try to address the need for these women.

"I also get older women coming to see me," she explains, "who feel theyve missed the boat for treatment and I see many women from diverse and different ethnic backgrounds. The women I see have often reached a tipping point by the time they come because they have been putting up with symptoms for so many years they are struggling at work, they are having relationship problems and their anxiety levels are so high they feel they are going crazy; hot flushes and sleep problems are the big issues."

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Menopause symptoms and treatments: Everything you need to know - goodhousekeeping.com

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