What is Menopause?

Menopause occurs a year after a woman experiences her last menstrual period. Therefore, it is only a term that is used in hindsight.

The menopause marks the end of a woman’s reproductive lifespan. A woman is born with a fixed number of eggs in her two ovaries and with each menstrual cycle and over time, the number of eggs will decline and menopause occurs when there are no more useful eggs left in the ovaries.

The ovaries release hormones, namely estrogen, progesterone and testosterone, as a result of developing eggs in the ovaries, therefore when the eggs run out, a woman will experience symptoms due to a deficiency in these hormones. In fact, even before a woman reaches the menopause, she is likely to experience symptoms as a result of changing hormone levels.

What are some Common Symptoms seen in the Perimenopause and Menopause?

• Changes in frequency of menstruation: some experience a delay in periods, whilst others may experience more frequent menstrual periods
• Changes in period flow: some experience a lightening of the periods, whilst others experience very heavy bleeding that can result in anemia
• Increase in premenstrual symptoms: there may be breast pain and swelling, bloating, water retention, headaches, mood swings, hot flushes and sleep difficulties before the periods
• Sleep difficulties: either a difficulty falling asleep or difficulty with sleep maintenance
• Tiredness
• Poor concentration and memory loss
• Weight changes and changes in weight distribution: more weight around the middle and the hips
• Decline in sexual interest and vaginal dryness
• Hot flushes, night sweats

I have some of the above symptoms and have had my blood measured for hormones before and my doctor tells me that the hormones are normal. Can these symptoms still be because of my hormones or are they all in my head?

Common blood tests done include FSH (follicular stimulating hormone) and LH (luteinizing hormone) which are hormones from the pituitary gland, as well as estradiol and progesterone. These hormone levels vary with the menstrual cycle and must be interpreted in context of the menstrual cycle. Relative levels of estradiol and progesterone are more important than absolute levels. Symptoms are often a much more reliable indicator of hormone imbalance or insufficiency than blood results.

If Menopause is a normal occurrence, when do I need to see a doctor?

• To get more information about keeping healthy through the menopause and beyond
• Unsure if symptoms are related to menopause
• Symptoms are bothersome and affecting your sleep and performance