The Menopause

What is the menopause?

The menopause occurs when your periods stop because your ovaries no longer release eggs.

In the UK, the average age for a woman to reach the menopause is 52, although women can experience the menopause in their 30s or 40s. Menopause below the age of 45 is known as early menopause, and below 40 is premature menopause.

Usually as you approach the menopause, your periods will become less frequent, with longer intervals in between each one before they stop altogether.

What causes the menopause?

The menopause is caused by a change in the balance of the body's hormones, one of which is oestrogen. In the lead up to the menopause, the ovaries run out of eggs, oestrogen levels fall, periods become less frequent and then stop altogether. The fall in oestrogen levels is responsible for causing symptoms and body changes.

What symptoms might I experience?

For many women, the symptoms of menopause are mild, lasting only a few months. For others, symptoms may be more severe and long lasting, including:

  • Hot flushes and night sweats
  • Tiredness and sleep disturbance
  • Mood swings
  • Forgetfulness or lack of concentration
  • Loss of interest in having sex
  • Vaginal dryness and painful sex

What body changes occur after menopause?

No more periods – this may be good news, particularly if your periods were heavy or painful !
Loss of fertility – pregnancy can still occur after your periods stop, so it is important to use contraception for 2 years after your last period (if you are under 50) or for 1 year after your last period (if you are over 50)
Changes in bones – the bones become thinner & the risk of brittle bones (osteoporosis) increases. From the age of 50 years you should have regular bone health checks
Increased risk of cardiovascular disease – heart disease is more common – so it is important to have a healthy balanced diet and take regular exercise
Increased risk of breast cancer – so it is important to have regular mammograms every 3 years from the age of 50

What treatments are available for menopause symptoms?

Medication may not be necessary – the following lifestyle changes can help:
For hot flushes and night sweats:

  • take regular exercise
  • wear light clothing and keep your bedroom cool at night
  • avoid potential triggers, such as spicy food, caffeine, smoking and alcohol

For mood changes:

  • take regular exercise
  • try relaxation therapies, such as yoga and tai chi

For vaginal dryness

  • Apply vaginal moisturisers e.g. Replens
  • Water-based lubricant e.g. Sylk

Diet and supplements

  • Ensure healthy weight for your height (BMI)
  • In your diet – flaxseeds, whole grains, beansprouts, alfalfa, soya, dried apricots
  • Supplements - Novogen Red Clover

Hormone Replacement Therapy (HRT) can help many women, particularly those with severe or persistent symptoms – it is an effective treatment for hot flushes and vaginal dryness, and will prevent and treat bone thinning

HRT has benefits and risks. Pills, patches, gels and vaginal pessaries can be used.

Does having HIV affect the menopause?

Some studies from North America suggest that women with HIV go through a slightly earlier menopause and have more severe symptoms, but we do not know if this is true in the UK.

The Kobler Menopause Clinic?

If you have menopause symptoms that are troubling you, speak to your HIV nurse, doctor or GP. They may refer you to the Kobler Menopause Clinic, the only dedicated menopause clinic for HIV positive women in the UK
Where: Gynaecology Outpatient Clinic 2, 1st Floor, Chelsea and Westminster Hospital
Who: Dr Naomi Low-Beer, Consultant Gynaecologist
When: 2nd and 4th Thursday of every month

Further information

Chelsea and Westminster Hospital Menopause Clinic www.chelwest.nhs.uk/services/womens-health-services/gynaecology-services/menopause-and-pms-clinics/menopause
Menopause Matters www.menopausematters.co.uk

Also see
Thinking of having a baby
New Pregnancy
Sexual Health
The Menopause