Your questions about menopause, answered

In this guide, we'll take you through the most important things you need to know about menopause - when it happens, why it happens, the most common symptoms to experience, and how to treat it.

What is menopause?

An individual is considered to have reached menopause 12 months after their last period. Menopause is a natural part of ageing that usually occurs between 45 and 55 years of age, as oestrogen levels decline.
When does menopause start?

In the UK, the average age for menopause to begin is 51, although anywhere between 45 and 55 is completely natural. During the menopause, an individual's menstrual cycle will discontinue due to hormonal changes inside the body, most significantly a drop in oestrogen levels.

The hormone oestrogen is predominantly made in the ovaries and affects each of the key process involved in a woman's reproductive and sexual health journey. For example, oestrogen levels rise during puberty, peak in the days preceding ovulation to help facilitate pregnancy, and finally drop to trigger the end of a woman's menstrual cycle.

Find out more about:
Early or premature menopause and how do you know if you have it

How long does menopause usually last?

Menopause symptoms typically last between four and five years, although this does vary. While some women may only have symptoms for a matter of months, others can continue to experience them as long as 14 years after menopause begins.

Menopausal symptoms can vary in severity, but often have an impact on an individual's daily life. Some can have a big impact on a person's quality of life too. Several lifestyle factors, including smoking, race, ethnicity, family history (for example, your mother's age at menopause), and the age at which it began can determine the length of a woman’s menopause. Any time after menopause is known as post-menopause.

Find out more about:
The stages of menopause and what to expect with each one
What signals the end of menopause and what happens when it's over

What are the symptoms of menopause?

Usually, the first sign that the menopause is starting is a change in a woman's normal menstrual period pattern. This change represents any sudden shift in a woman's monthly cycle; namely irregular periods (they become more or less frequent) and unusually light or heavy periods.

As well as changes to a woman’s monthly periods, there are some common and completely normal menopause symptoms that can affect daily life. Don't forget, there is no one common symptom and each person will experience menopause in their own unique way.

Physical symptoms can include:
- Changes in skin condition, oiliness or the development of acne
- Hair loss or thinning
- Headaches and migraines
- Joint stiffness, aches, and pains
- Vaginal dryness and astrophic vaginitis (thinning and inflammation of the vaginal wall)
- Recurrent Urinary Tract Infections (UTIs) and urinary incontinence
- Heart palpitations
- Hot flashes or hot flushes (a sudden feeling of heat)
- Night sweats
- Pain during sex
- Memory loss
- Weight gain
- Dry skin and dry mouth
- Bone loss
- Sleep disturbances or sleep issues
- High blood pressure
- Reduced blood flow to the genitals

Emotional symptoms are also common. Increased anxiety, low mood, irritability, reduced sex drive (libido), mood swings or feeling a loss of self are all associated with the menopause.

Find out more about:
The symptoms of menopause and what to expect

What is a 'hot flush' or 'hot flash' and how to manage them?

Symptoms like hot flushes are very normal to experience at some point during your menopausal period. They are reported to affect 70-80% of people going through menopause.

You may have heard hot flushes described as hot flashes - they're both the same thing and can be used interchangeably.

Hot flushes are brief, periodic increases in body temperature, often described as a sudden unpleasant sensation of intenseThey can occur for many reasons, and are not solely ascribed to menopause. Their exact cause is not fully understood, however they are thought to come on due to changes in the hypothalamus.

Your hypothalamus, a structure deep in your brain, acts as your body's smart control coordinating centre. Its main function is to keep your body in a stable state called homeostasis. It does its job by directly influencing your autonomic nervous system or by managing hormones.

Read our guide to hot flushes here

What's the best support and treatment for menopause symptoms?

If your company does not have a menopause policy in place or menopause support through us at Fertifa, we would recommend speaking to your GP about getting treatment and support to help with the symptoms.

Alternatively, talking therapy such as counselling, CBT or even menopause cafes provide a safe space to share experiences, and can be hugely beneficial to mental health at a time when lots of people struggle with their mental health.

Hormone replacement therapy (HRT) is a perfectly safe and effective treatment which can be used to relieve menopause symptoms. Common menopause symptoms such hot flushes, low libido and night sweats are unpleasant, however HRT can offer both short-term relief and prevent longer term medical conditions such as osteoporosis. If you are considering menopausal hormone therapy, please talk to your GP or a health professional.

If you're a Fertifa patient looking to understand more about HRT, get in touch via the app. Our doctors and nurses can talk you through HRT and give you a prescription if they agree it's suitable for your menopause symptoms.

By minimising the weakening of bones and stabilising emotions, vitamin D supplements also help relieve symptoms caused by declining oestrogen levels. If you are particularly suffering from urinary incontinence and/or pain during sex, practicing Kegel exercises will help strengthen your pelvic floor muscles and can help tackle these symptoms.

According to NHS guidance and the guidance of our in-house clinical team (led by Dr. Gidon Lieberman), the risks of HRT are minimal, with little to no increase in the probability of developing breast cancer, blood clots or heart disease following hormone therapy.

You can read our guide to HRT here.