Posted by Dr Michelle Wright
Menopause symptoms and health implications
Menopause symptoms and health implications are the subject of this week’s Health Matters podcast. Dr Michelle Wright explains in the first of two episodes about menopause what the typical symptoms and health effects of menopause are.
As a natural part of aging, all cisgender women will go through menopause at some point. But because menopausal symptoms and consequences are caused by hormone fluctuations, they can also affect trans men and non-binary people.
Menopause is much more than the hot flushes and mood swings people first think about. Untreated, it can lead to many disabling symptoms affecting physical and mental health. I think there’s a general lack of awareness around menopause, and also misinformation about the treatment and support available. It’s such an important change that people face, and one of my missions is to help people understand menopause better so that they can feel empowered to take control when the time comes.
Most people go through menopause between the ages of 45 to 55. Menopause literally means the ‘ceasing of menstruation’, but periods don’t just stop overnight. They start to become less frequent over a few months or years before they stop altogether, and we call this transition period the perimenopause. During the perimenopause, levels of oestrogen, progesterone, and testosterone hormones fluctuate and eventually fall. And its these hormone changes that are responsible for the symptoms.
In terms of typical symptoms, the list is long. I think hot flushes, night sweats, mood swings, and general aches and pains are the most well-known. All of these can impact sleep, but even if they don’t, tiredness and fatigue can still be a big problem.
Oestrogen is important for healthy skin and hair, so as levels drop, skin can become dry, and hair can become thinner and less shiny. Vaginal dryness caused by lower oestrogen levels can lead to itching and inflammation and pain during sex. The bladder is also more sensitive to infection. Over time, low oestrogen can lead to thinning of the bones – osteoporosis – and an increased risk of fractures.
And just thinking about this year’s theme for World Menopause Day being cardiovascular disease – oestrogen also protects blood vessels and helps keep cholesterol under control, so when levels drop, this is why the risk of cardiovascular disease increases.
Mental Health is affected
But it’s not just physical health symptoms that can be a problem during menopause and perimenopause, it can also affect mental health. Oestrogen helps to regulate the mood-boosting hormones serotonin and dopamine, and when levels drop or fluctuate, mood can be impacted. It also helps to sharpen thinking skills and so as levels decline, this can lead to forgetfulness and ‘brain fog’.
At the same time, falling progesterone levels lead to irritability, mood swings and more ‘brain fog’. And as ovarian function declines, testosterone levels drop as well. This can affect mental stamina, sleep, thought clarity and concentration with knock on effects on stress levels and general well-being. Declining testosterone levels also impact sex drive.
With all these changes going on, more than 50% of perimenopausal people experience feelings of low mood and anxiety. People can find they have reduced motivation, drive, and energy levels. Even activities they previously enjoyed doing may provide little pleasure. This lack of motivation and drive may affect work performance, as well as confidence, self-worth, self-value, and self-esteem.
We know that around 60% of people experience menopause-related symptoms with 20% experiencing symptoms that have a significant impact their quality of life. So, with that in mind, it’s important that those going through the menopause don’t suffer in silence and they get the treatment and support they need.
What positive steps can we take?
In the next episode of Health Matters, I’ll be looking at some positive steps people can take to help them through this period of change in their lives.