More women and those assigned female-at-birth (AFAB) are reporting depression during menopause, but can menopause cause depression? Here we explore the links between menopause and depression, how they influence each other, treatment options including lifestyle changes and medication and how to support a loved one struggling. Quick facts: Understanding menopause and mental health Menopause is a natural part of ageing. It’s when your ovaries stop making the hormones oestrogen and progesterone. It marks the end of your reproductive years—you can no longer become pregnant and your periods stop. Since your sex hormones, oestrogen and progesterone, affect so much of your bodily functions including how you think and feel, the hormonal shift can cause emotional and psychological symptoms. These shifts can put you at a higher risk of developing mood disorders like depression. Changes in mood and energy can be frustrating and can have a knock-on effect on your relationships, work, life and confidence. Potential psychological side effects of menopause can include: On top of this, having trouble sleeping during menopause is common, and lack of sleep can worsen other mental health symptoms. Can menopause cause depression? Lots of women experience difficulties with depression and their mental health during menopause, but what’s the link? In multiple studies, it becomes evident that if you’re perimenopausal (the years before menopause when your hormones take a dip and you start getting menopause symptoms), you’re more likely to experience depression.  Such an enormous shift in hormones can be life-changing. Many women feel hopeless, out of control, anxious and overwhelmed. Studies found that more women in their menopausal years experience depression compared to pre-menopausal years. Additionally, women and those AFAB who have a personal or family history of depression are also more likely to experience a relapse during menopause. One study suggests that those who have had premenstrual dysphoric disorder (PMDD), or postpartum depression are also more likely to develop depression during menopause. So what’s the cause behind the correlation between the increased risk of depression during menopause? Simply put, hormones have a lot to answer for. Primarily, a dip in oestrogen can cause depression, along with other menopause symptoms. Oestrogen plays an important role in mood regulation. Without it, neurotransmitters serotonin (known as the “feel good” hormone) and norepinephrine can be affected leading to depressive symptoms and mental health difficulties. It’s important to note that depression during menopause is not a given. Not everyone going through menopause will experience depression. Symptoms vary for each individual. There are lots of treatment options to reduce and prevent menopausal depression.If you or someone you know is struggling with menopause and mental health difficulties seek professional help from a Menopause Specialist or mental health professional. Identifying depression during menopause Signs and symptoms of depression during menopause include: These symptoms are not just related to menopause, they can overlap with other menopause symptoms, and be different for everyone. The risk of developing depression seems to decrease in the 2-4 years after your last period. Menopause is marked by a single point in time when it’s been a year since your last period. If you’re experiencing any of these symptoms, or want more support with depression or menopause symptoms, contact a menopause specialist who can advise you. Factors contributing to depression in menopause Depression during menopause can be influenced by several factors. A genetic or family history of depression could influence the probability of you experiencing depression. Your medical history can play a part too. Having at least one chronic health condition like cardiovascular disease or diabetes can also double the risk of experiencing depression during menopause. Studies say that potential biological risk factors for depression during menopause include vasomotor symptoms (VMS) like hot flashes and night sweats can increase the likelihood of depression.  These symptoms can feel debilitating, and paired with tiredness, poor concentration and fatigue from the lack of sleep, can affect confidence and self-esteem often resulting in feelings of sadness and depression. Getting enough sleep is key to mood regulation. If your roles change because of physical health problems that come with menopause, which, for example, cause you to take early retirement, some studies suggest that the risk of developing depression increases by 88%. The Fawcett Society, in their report Menopause and the Workplace, found that 1 in 10 women leave their jobs because of menopause symptoms. Sadly, women and those AFAB aren’t getting the support they need at work. Hertility aims to change this by encouraging more employers to become Reproductively Responsible™. Seeking help and treatment for depression Seeking help for menopause-related depression is key to overcoming it. There are lifestyle changes as well as medical treatments available. Natural treatment options for menopausal depression include making lifestyle adjustments. Well-balanced, gut-healthy nutrition and regular physical exercise can improve your mood and reduce the risk of depression during menopause, along with helping to alleviate other menopause symptoms. Eating a nutritious diet Firstly, eating well and often is important. Eating protein with every meal, staying hydrated and fuelling your body will keep your energy and mood stable throughout the day. Fibre with each meal will help to keep you fuller for longer and aid your digestion. Read our piece on ways your diet can help manage menopause solutions. Experiments suggest that your gut has close links with and could play a crucial role in depression (the gut-brain axis). Eating 30 different fruits and vegetables, ideally as many different colours as possible, each week is recommended by nutrition experts to support your gut health. Probiotics like live yoghurt, tempeh and kimchi also keep your gut happy. Getting regular physical exercise Incorporating regular physical exercise can help to reduce depression and anxiety during menopause. Exercise releases endorphins—the feel-good hormone. It’s also thought that physical exercise has beneficial effects on mental health through distraction and boosting self-belief. Getting regular physical exercise also supports your energy and boosts your general health and wellbeing. It keeps your heart healthy, helps you maintain a healthy weight, and reduces the risk of chronic health conditions. Bonus! Having […]

Whilst it might be tempting to want to predict the age you may experience menopause, calculators and predictions are generally not thought to be medically accurate. But there are a few things you can do to prepare for menopause. Read on to find out.  Quick facts: Can you predict menopause? It’s normal to be curious about the age at which you’ll reach menopause. We get it—you want to feel prepared and plan ahead for big life changes. Despite advances in technology and science, there’s no definitive menopause age calculator or test that can predict the age you’ll reach menopause with any certainty.  While there’s more research being carried out into predicting the age of menopause, there’s simply no one-size-fits-all approach as menopause is so dependent on your individual hormonal make-up. Since multiple factors contribute to the onset of menopause, a menopause age calculator won’t be accurate. There are, however, some factors that can affect when in life you may reach menopause—like your genetics, lifestyle choices and medical history. If you’re experiencing symptoms that may be related to menopause or perimenopause, then book an appointment to speak to one of our Menopause Specialists who can provide advice, and guidance as well as HRT prescriptions. What is menopause? You reach menopause once you have not experienced a period for more than 12 months.  It’s a natural biological process that marks the end of your reproductive years.  Biologically, your hormones are shifting, and most notably, there’s a massive dip in oestrogen —the hormone that plays a key role in regulating your menstrual cycle and supporting your reproductive health. This hormonal change can bring on physical and emotional symptoms such as hot flashes, vaginal dryness, mood changes, problems sleeping and irregular periods.  These changes can start happening years before you even reach menopause. This phase is called perimenopause. There are ways you can offset and support your perimenopause symptoms. During perimenopause, your body is adjusting to the hormonal changes and you will gradually stop producing the hormones that control and bring about your periods, causing your periods to eventually stop altogether.Once your hormones rebalance post-menopause, many report feeling like they’ve got a new lease of life. This is why menopause is often nicknamed “the second spring”—a chance for new beginnings, which is often welcome after a time of massive change in the perimenopause. The myth of menopause prediction Just like each one of us is unique, the age we reach menopause is too.  Limited research in this area means that not even the experts can determine the age you’ll reach menopause. It’s easier to want to turn to a definitive answer, but more often than not, this oversimplified prediction isn’t backed up with scientific evidence. There are too many individual variations for them to be reliable. Menopause age calculators also don’t take into consideration any external factors that are difficult to measure, for example, exposure to pollutants and other environmental factors, or exposure to stress. Ultimately, any factors that can impact your hormones can impact the onset of menopause. Average age for menopause The average age for the onset of menopause in the UK is 51, with most people reaching menopause between the ages of 45-55. A small percentage experience early menopause or premature menopause (premature ovarian insufficiency) before the age of 40. Factors that influence menopause timing Three key areas may indicate when you start menopause: your genetics, your medical history, and your lifestyle. Genetic influences Research suggests that you can roughly predict the age you’ll reach menopause according to when other females in your family like your mother or sister reached theirs.  Studies suggest there may be a familial pattern and even certain genetic markers that indicate the age of menopause onset. However, while genetics play a crucial role, other factors, such as your medical history and lifestyle factors come into play too. For example, you may have a different upbringing from other female relations in terms of where you live, whether you have any underlying health conditions and what you’ve consumed in your diet and lifestyle over the years. Lifestyle and medical history  Lifestyle choices, such as whether you are overweight or underweight (or have a low or high BMI) from nutrition and exercise patterns, or whether you smoke or drink alcohol impact the age you reach menopause. This is because poor lifestyle choices can negatively affect your reproductive and overall health. They can impact your ovarian reserve and hormones and bring on menopause sooner. Biological factors can impact your menopausal age including: The wide variation of genetics, lifestyle and medical history amongst individuals makes it difficult to predict the age you’ll reach menopause. Understanding your body’s signals Becoming attuned to your body’s signals can help you predict when you’re approaching menopause. A key factor, often coined “the fifth vital sign”, is your menstrual cycle. Your menstrual cycle is considered regular if your cycle lasts roughly the same amount of days, e.g. between 21 and 35 days each cycle.  Irregular periods are one of the first signs of perimenopause you might notice, along with things like hot flashes, trouble sleeping, lowered sex drive and vaginal dryness. To find out what’s going on inside, you could take a Hertility Hormone and Fertility Test. This will give you a report indicating your hormone levels, and you can speak with a Menopause Specialist to make sense of your results and discuss your next steps. If you have questions about the age of your menopause, it’s best to speak with a healthcare professional for the most reliable information. They can advise you on your individual menopause experience with as much support as possible instead of focusing on predicting the age you’ll get there. Preparing for menopause Maintaining health and well-being is crucial for navigating menopause with ease. Adopt a healthy lifestyle with balanced nutrition and regular exercise to improve your mood, maintain a healthy weight and support your vitality. Limit alcohol and smoking, manage stress and make sure you’re getting enough sleep to balance your […]

Most of us have heard of the hot flushes, irregular periods and mood swings. But did you know there are actually up to 34 symptoms of menopause? Check out our list for the full rundown of physical and mental symptoms.  Quick facts: Understanding menopause For women and those assigned female at birth, menopause is when your ovaries stop making the hormones oestrogen and progesterone and stop ovulating. Because of this, your periods stop, and you can no longer become pregnant. Menopause usually happens between the ages of 45 and 55, with the average age being 51. A small number of women experience early menopause where you might go through menopause between the ages of 40-45 or premature menopause or premature ovarian insufficiency (POI) where the ovaries stop working before the age of 40, which is seen in 1% of cases. The length of time menopause lasts varies (up to 14 years) but it’s generally around four years. During this time you’ll experience three stages of menopause: Menopause is a natural part of ageing which marks the end of your reproductive years, but the hormonal shift can make you feel misunderstood and isolated. Recognising and understanding the symptoms of menopause can prepare and empower you to tackle menopause with confidence. The 34 menopause symptoms: What are they? Since oestrogen affects so many of your bodily functions, the hormonal change can lead to the onset of various and often frustrating physical, emotional and physiological symptoms, which can disrupt your relationships, confidence and work life. Everyone experiences menopause differently but these common menopause symptoms may be a sign you’re entering the next chapter of your life. 1. Changes to your periods Your periods become irregular during perimenopause (the run up to menopause) and stop altogether. Once you’ve not had a period for 12 months, you’ve experienced menopause. You may notice your cycle length getting shorter and flow getting lighter too. 2. Hot flushes Hot flushes are a sudden rush of heat or ‘burning up’ sensation which can cause redness or sweating usually in the chest, neck, and face. You can try fans, cooling face masks and always carry a cool drink with you to reduce flushes. 3. Night sweats Night sweats are profuse sweating during the night, so much so that you wake up in wet bed sheets or pyjamas. Night sweats can disrupt sleep and it’s important to remember to hydrate in the morning. 4. Anxiety Feeling worried, nervous, on edge, jittery or tense are all signs of anxiety. You might also have sweaty hands, a racing heart, and be overthinking. 5. Low mood Low mood can include things like feeling down, sad or hopeless. Read our blog post on ‘Can Menopause Cause Depression?‘ if you’re experiencing these symptoms. 6. Mood swings This includes your mood shifting in a short space of time. You may experience things like crying for no apparent reason, suddenly feeling very angry or overwhelmed, feeling low, anxious or jittery.  7. Brain fog It’s common to experience brain fog and find it difficult to concentrate on normal tasks or be more forgetful than usual and feel confused. 8. Forgetfulness You may experience memory loss, forget the names of places, people or things, or walk into rooms and can’t remember why. These are all very common. 9. Reduced sex drive This includes a lack of interest in sex or an inability to feel aroused during sex. This can be exacerbated because of pain during sex (another common symptom).  10. Vaginal dryness or pain Vaginal dryness might cause itchiness and soreness, or make sex painful. 11. Breast tenderness Your breasts or nipples may feel sore to the touch, which can make lying on your front, sleeping and possibly exercising uncomfortable. 12. Headaches or migraines These can include painful headaches or more severe migraines that may affect your ability to do daily tasks. 13. Difficulty sleeping or insomnia This may include trouble falling asleep, staying asleep or waking up feeling tired. This can all affect your mood, eating habits and productivity and may exacerbate other symptoms.  14. Muscle and joint aches and pains Sore muscles, tension and joint pain can make everyday tasks and exercise more difficult. It’s also more common for women to develop osteoarthritis and rheumatoid arthritis during menopause. 15. Bloating Stomach aches, gut problems or a bloated stomach can affect your confidence and ability to enjoy food, exercise and do everyday tasks. 16. Electric shock sensations (ESS) This can feel like pins and needles, prickling, pinching or burning. You may experience this on different parts of your body or skin. 17. Restless legs This is an overwhelming urge to move your legs or a crawling sensation. 18. Itchiness The urge to itch or scratch your skin can be frustrating, and cause redness and irritation. 19. Concentration issues Struggling to focus can make daily tasks more difficult. 20. Brittle nails You may find your nails become weak or brittle and are easily broken or damaged. 21. Hair thinning Hair can become sparse, fall out and break off easily. 22. Weight gain Hormones affect metabolism and appetite, and the change can lead to weight gain and body composition changes which can affect confidence. Speaking with a nutritionist can help. 23. Urinary issues or UTIs You might need to go to the toilet more often, experience recurrent urinary tract infections, or leak urine when you cough or laugh. 24. Allergies You may find you are more sensitive to allergies with itchy skin, rashes, redness and congestion. Skin conditions like eczema and rosacea can worsen.  25. Feeling dizzy or faint You may experience bouts of lightheadedness, feeling dizzy or faint and in general feel less alert. 26. Heart palpitations This includes your heart feeling as though it’s beating faster than normal, skipping a beat or beating irregularly. This can cause panic and it’s worth getting checked out by a doctor to rule out any cardiovascular issues. 27. Fragile bones and reduced muscle mass If you are breaking bones more easily, it […]

There are several ways to manage the symptoms of menopause through nutrition. The best way for you will depend on your symptoms and preferences. Talk to your Hertility Menopause Nutritionist to get a tailored approach to managing your menopausal experience. Quick facts: Nutrition for menopause symptoms Nutrition and diet can play a big role in managing menopause symptoms. Eating a healthy diet can help to reduce hot flashes, night sweats, mood swings, and weight gain.  Importantly, it can also reduce your risk of associated health conditions, like osteoporosis and cardiovascular disease. These can result from low levels of oestrogen postmenopausal.  As people progress through the stages of menopause, it’s common for body weight to fluctuate. There are several ways to manage the symptoms of menopause, including lifestyle changes and hormone replacement therapy. 3 lifestyle tips to help with menopause symptoms Exercising regularly Exercise can help to reduce hot flashes, night sweats, and improve sleep. Aim for at least 30 minutes of moderate-intensity exercise most days of the week. This includes weight training and light cardio activity. Getting enough sleep Getting enough sleep can help to reduce hot flashes and night sweats. Try to create a comfortable sleep space with a separate sheet and duvet. This is in case you need to remove one at night.  Try to keep your room cool and avoid blue light in the hours before bed. You can get some glasses that have blue light reflectors in them. Also, avoid caffeine after midday. Reducing stress and unhealthy habits Stress can worsen the symptoms of menopause. Find healthy ways to manage stress, such as yoga, meditation, or spending time in nature. Counselling sessions can also help with stress management. Try to cut back on any unhealthy habits like smoking. Smoking can worsen the symptoms of menopause.  7 ways nutrition can reduce menopause symptoms Healthy eating and exercise may seem obvious when it comes to managing menopause and perimenopausal symptoms. However, approaches to this may vary depending on your symptoms and how much they are affecting your daily life.  Here are some tips for using your diet for menopause symptom management. Try the Mediterranean-style diet The Mediterranean-style diet is a great place to start. Well researched in its positive effects on heart health, managing menopausal symptoms and reducing heart disease risk.  This way of eating is rich in heart-healthy nutrients such as healthy fats and fibre. The Mediterranean diet is rich in fish, vegetables, fruits, legumes, nuts, seeds, whole grains, beans and unsaturated fats such as olive oil and oily fish.  It includes smaller amounts of dairy, eggs and lean meat and limits processed and red meats and ultra-processed foods. Eat more oily fish  Oily fish like trout, sardines, herring, anchovies, mackerel and salmon can help to reduce inflammation that is associated with menopause. The risk of heart disease increases after the menopause due to the decrease in oestrogen which is an important hormone as it works to reduce inflammation in the blood vessels.  Omega-3 fatty acids found in oily fish are beneficial to heart health and in maintaining normal cholesterol levels. Therefore, taking HRT containing oestrogen and or optimising your diet and lifestyle can lower your increased risk of heart disease that is associated with the menopause and also reduce cholesterol.  Plant-based sources include flax, hemp, chia and pumpkin seeds, walnuts, rapeseed and linseed vegetable oils and soya products such as beans, milk and tofu also contain omega-3’s.  It should be highlighted that plant-based sources are not as rich as a source and should be consumed in addition. Therefore you may consider supplementing if you do not consume oily fish. Eat more pulses and beans Lentils and chickpeas are a great plant-based source of protein, fibre, and iron. They help to maintain energy levels and support healthy weight management. A decrease in oestrogen in menopause impacts where fat is stored and the rate of body fat gain.  Oestrogen increases the storage of fat around our bums and thighs, which is associated with a ‘pear-shaped body’, whereas increased androgens after menopause increase the accumulation of visceral abdominal fat causing weight gain and redistribution of body fat to the middle and around the organs, including our heart.  This is what’s sometimes known as an ‘apple-shaped body’ and in turn can have negative effects on our health.  Resistance and weight-based training are also beneficial for central adiposity – that’s weight found around your tummy.  Try some soya products Soya is a great way of increasing your calcium intake and works well for anyone with diet restrictions. It helps maintain healthy bone density and around 2 to 3 portions of soy per day may reduce the severity and frequency of hot flashes.  There is also some evidence that isoflavones improve symptoms of vaginal dryness. Soya beans are the main dietary source of isoflavones. A large glass of soya milk (250ml) will provide approximately 25 mg of isoflavones, but not all soya foods contain isoflavones due to some processing methods removing them.  Isoflavones do not behave like the human hormone oestrogen, therefore you could consider adding in some isoflavones into your diet such as tofu, tempeh, soya milk or yoghurt and edamame beans. Dairy or calcium-fortified alternatives  These provide a wide range of benefits including protein, calcium, vitamin D and probiotics, which are important for our bone health, mood and gut health. During menopause, oestrogen, a hormone that protects and maintains our bone density rapidly declines, increasing our chances of osteoporosis.  50% of women or people assigned female at birth over the age of 50 will suffer a fracture due to poor bone health. Changes to your bone health are silent and may go unnoticed so it’s really important to keep your bones healthy.  It’s essential to live an active lifestyle, including implementing weight-bearing and strength-building exercises to strengthen bones so that you limit your risk of falling and breaking your bones, but also it’s so important to eat a diet rich in calcium and vitamin D. Up your intake of […]

Perimenopause symptoms can be hard to deal with. Everything from hot flashes to vaginal dryness. But there are several things you can do to manage perimenopause symptoms. Read on to hear our 8 top tips from our specialists. Quick facts: What is perimenopause? Perimenopause is the transition period leading up to menopause. This is when your body starts preparing you for menopause. Menopause is when your periods stop and you can no longer become pregnant.  Perimenopause can last anywhere from a few months to several years, with the average length being four years. However, this will depend on the individual, your lifestyle and hormones.  Most people start perimenopause at some point after their mid-40s, but some as early as their mid-thirties (although this is quite uncommon). During this time, the ovaries begin making less oestrogen and progesterone, which can cause a variety of symptoms, including: While perimenopause can be a challenging time, there are several things you can do to help manage your perimenopause symptoms and improve your overall well-being. Ways you can manage perimenopause symptoms 1. Exercise regularly Exercise is one of the best things you can do for your overall health, and it can be especially beneficial during perimenopause. Exercise helps to reduce hot flashes, improve mood, boost energy levels, and promote healthy weight management. Aim for at least 30 minutes of moderate-intensity exercise most days of the week. 2. Eat a healthy diet Healthy eating and exercise may seem obvious when it comes to managing menopause and perimenopausal symptoms. However, approaches to this may vary depending on your symptoms and how much they are affecting your daily life. Focus on your diet by eating plenty of fruits, vegetables, and whole grains. Limit processed foods, sugary drinks, and saturated and unhealthy fats. 3. Get enough sleep During perimenopause, some sleep problems can happen due to night sweats. If you’re not sleeping well, it could also impact your mood. Try to go to bed and wake up at the same time each day, even on weekends. Create a relaxing bedtime routine and make sure your bedroom is dark, quiet, and cool. 4. Manage stress  Stress can worsen perimenopause symptoms. Find healthy ways to manage stress, such as exercise, yoga, meditation, or spending time in nature. You may also find it helpful to talk to a therapist or counsellor about how to cope with stress. Our Hertility counsellors are trained to support these experiences. 5. Avoid caffeine and alcohol Caffeine and alcohol can trigger hot flashes and other perimenopause symptoms. If you’re experiencing hot flashes, it’s best to avoid caffeine and alcohol altogether or try to limit your intake to one or two servings per day. 6. Dress in layers It may sound simple, but this will help stay comfortable during hot flashes. By picking lightweight, breathable fabrics, and wearing layers, you can pivot between outfits as necessary. 7. Use a fan or cool compress If you’re experiencing a hot flash, try using a fan or cool compress to help you cool down. You can also try placing a cool washcloth on your neck or wrists. 8. Talk to a Hertility menopause specialist Our Menopause Specialists can offer tailored perimenopause advice and guidance. Our calls are always personalised to you, offering you a safe space to discuss treatment options for perimenopause symptoms, including HRT prescriptions. Managing the main symptoms of perimenopause Perimenopause can be a challenging time, but it doesn’t have to be hormonal hell. By following the above tips, you can manage your symptoms and improve your overall well-being. Here are some additional tips for managing specific perimenopause symptoms: Managing hot flashes: Managing night sweats: Managing vaginal dryness: Managing mood swings: Manage stress: References: 

Hormone replacement therapy (HRT) is a common treatment for easing menopause symptoms, like hot flashes, brain fog, joint pain, low mood and low libido. But how does it work and what are the signs you need hormone replacement therapy? Read on to find out. Quick facts: HRT explained Hormone Replacement Therapy for menopause is a treatment that uses hormones to relieve the symptoms of menopause and to prevent health problems that can occur after menopause.  The hormones commonly used in HRT are oestrogen, progesterone and sometimes testosterone. It does what it says on the tin—replaces the hormones that are declining in your body during this natural part of ageing, with synthetic or bioidentical hormones. These hormones mimic your natural hormones, relieving symptoms.  HRT can be taken in a variety of ways, including pills, patches, gels, sprays, vaginal cream and pessaries. The best method to take HRT will depend on your individual needs, preferences and medical history. Do you need HRT? You can take HRT to relieve menopause symptoms if you’re in perimenopause (the years leading up to menopause before your periods stop) or postmenopause.  Challenging symptoms like brain fog, night sweats, vaginal dryness, reduced sex drive, insomnia and concentration issues can interrupt your daily life. Hormone replacement therapy helps to restore hormonal balance to provide relief. Whether or not you’ll need HRT will depend on your symptoms and physiology and is always a personal choice. For personalised advice, you can book an appointment with one of our Menopause Specialists.  They can prescribe HRT based on your individual needs and preferences and can offer expert guidance on navigating symptoms and treatment options. Different types of HRT There are different types of HRT to choose from. Which type is right for you will depend on: HRT options can contain different hormones, including oestrogen, progestogen, a combination of both, and sometimes testosterone. HRT can be taken in different ways tablets, including patches, gels, sprays, implants, coils, or creams. It can also be taken using different regimens, including cyclical or sequential treatments, or continuous treatments.  Tablets Tablets are one of the most common ways of taking HRT. You usually take them once a day. Tablets are available in both oestrogen-only and as combined HRT.  Although it’s small, the risk of developing blood clots is higher with tablets compared to other HRT methods like patches, gels and sprays. Skin patches HRT patches are available in both oestrogen-only and combined. They are stuck to the skin, usually on the lower half of your body, and gradually release small amounts of hormones through the skin. You’ll usually change your skin patch every few days. Patches could be a preferred option if you have difficulty swallowing tablets, get indigestion or are likely to forget to take tablets. Some patches can leave marks and cause redness or irritation. Oestrogen skin gels and sprays You apply oestrogen-only skin gels by smoothing them onto your skin. Apply sprays by spraying them on the inside of your arm or thigh once a day. Your body absorbs the oestrogen gradually. Vaginal oestrogen Low-dose vaginal oestrogen is also available in tablets, pessaries, creams or vaginal rings that you insert into your vagina. This can help to provide relief for particular menopause symptoms like vaginal dryness and pain during sex (dyspareunia). Testosterone Like oestrogen and progesterone, menopause also causes your testosterone to decline. This can make you feel tired, unmotivated and low in libido. While testosterone isn’t currently licensed to treat menopause symptoms in the UK, specialists may prescribe it. It’s given in the form of a gel that you can rub over the skin where it’s gradually absorbed. Although uncommon, possible side effects of taking testosterone include acne, unwanted hair growth and weight gain. Intrauterine system (IUS) or Mirena coil If you have a womb and are using oestrogen-only HRT, you’ll need to also take a form of progesterone HRT to protect against endometrial cancer. You can do this with the Mirena coil, an intrauterine system (IUS). Inserted into your womb, the Mirena coil gradually releases progestogen (levonorgestrel) into your body. Once inserted, the Mirena coil can stay in place for up to five years and double up as contraception to prevent pregnancy. Benefits and risks of HRT Like other medications, there are benefits and risks associated with HRT. Benefits of HRT Most of the symptoms of menopause are associated with declining oestrogen levels. People have found that HRT is useful to manage symptoms including:  There are several long-term effects associated with low oestrogen. Taking HRT can help to reduce the risk of: Risks of HRT The risks of any serious side effects are usually very low, and depend on: HRT can slightly increase the risk of breast cancer. If you’ve had breast cancer or have a family history of it you’ll usually be advised not to take HRT.  Currently, the risk of breast cancer when using HRT has been found to be an extra 5 in every 1000 women who take combined HRT for 5 years. The risk increases the longer you take it, and the older you are. It falls again after you stop taking it.  Oral HRT can increase the risk of blood clots and in rare cases, stroke. If your medical history would indicate that you are at an increased risk of blood clots or strokes you should be recommended HRT patches, spray or gel rather than tablets, which have been found to not carry this risk. Weighing up the risks and benefits of taking HRT needs to be considered on an individual basis. It has been found in more recent studies that usually the benefits outweigh the risks and why HRT is now so commonly used. If you haven’t had a hysterectomy, you’ll need to take oestrogen and progesterone combined to protect against cancer. Oestrogen thickens the womb lining which can increase the risk of developing endometrial cancer. Progesterone helps to protect against it by ensuring the lining is shed regularly. The HRT timeline: How long before results? Once […]

Menopause can be a challenging time, with many women experiencing a sleuth of uncomfortable symptoms. Here we get into everything you need to know about menopausal symptoms, the stages and the treatment options available.  Quick facts: What is menopause? Menopause is when your periods stop due to low hormone levels. It will happen to anyone who has periods, usually at around 45-50 years of age and is a natural part of ageing.  Menopause marks the end of your reproductive years. After you’ve experienced menopause, it’s no longer possible to become pregnant naturally without assistance. In the UK, the average age for experiencing menopause is 51. Approximately 25 million people go through menopause every year. Despite it directly affecting half of the population, knowledge and understanding of menopause remains incredibly low. For many people, menopause can be an incredibly difficult time as it is often accompanied by a series of both physical and psychological symptoms—in addition to a lack of public understanding as to what experiencing menopause can entail.  How is menopause diagnosed? Menopause is usually diagnosed when: If you are experiencing symptoms associated with menopause but don’t meet all of this criteria, it is possible you could be experiencing a different health condition, or premature menopause if you are under the age of 40. What is early menopause? Around 5% of people may experience menopause before 45 years of age, known as early menopause. This can happen naturally or due to side effects of some treatments, like cancer treatments or surgeries to remove the ovaries. What is premature menopause? If you experience menopause before 40 years of age, it is known as premature menopause, which may also be described as Premature Ovarian Insufficiency (POI), depending on your circumstances.  Again, premature menopause may occur naturally, due to genetics or lifestyle factors, or as a result of medical or surgical treatment. Some things that might increase the chances of premature menopause are: POI affects 1 in 100 people under the age of 40, one in 1,000 people under 30 and one in 10,000 people under 20. It occurs because the ovaries do not function properly and are unable to make sufficient levels of hormones like oestrogen and progesterone, which have important roles in overall health and well-being.  POI can occur because of many reasons. Unfortunately, in the majority of cases, no underlying cause can be found. What are the 3 stages of menopause? The stages of menopause include premenopause, perimenopause and post menopause. The menopause actually only references the time when it has been 12 months since your last period. Let’s take a look at these stages one by one… What is premenopause? Premenopause refers to the period of your life before the transition into menopause has started, also sometimes referred to as your reproductive years. This is when you shouldn’t be experiencing any (peri)menopausal symptoms and have a healthy and regular menstrual cycle. What is perimenopause? The transition to menopause is known as perimenopause. This is when your body starts preparing you for menopause. During the perimenopausal phase, your ovaries will begin producing less oestrogen and progesterone and your periods can become irregular or erratic. Perimenopause can be challenging because it is often accompanied by lots of physical and emotional symptoms, which can be distressing and impact your quality of life.  Perimenopause can last anywhere from a few months to several years, with the average length being four years. However, this will depend on the individual, your lifestyle and hormonal make-up. Most people start perimenopause at some point after their mid-40s, but some as early as their mid-thirties (although this is quite uncommon). Sometimes people even skip perimenopause all together and enter menopause suddenly. Although chances of pregnancy are low during perimenopause, it is still possible as ovulation may still be occurring and an increased risk of sexually transmitted infections if you aren’t using barrier contraception methods. If you are sexually active and in the perimenopausal stage, it is important to speak to your doctor about appropriate contraception for you. The menopause The menopause actually refers to the time when it has been 12 months since your last period. This is technically when you have experienced menopause.  What is post menopause? Post menopause refers to the time after you have experienced menopause—the rest of your life after menopause. During this time your sex and cycling hormones will be at different levels to where they were before menopause and you will no longer have periods.  At what stage of menopause are symptoms worse? Symptoms and their severity will depend on the individual, but for most, perimenopause is the time when you will experience the most symptoms. This is because of the huge hormonal fluctuations happening during this stage and your body adjusting to lowering hormonal levels. What are the symptoms of menopause? Most of the symptoms of menopause are associated with declining oestrogen levels. The duration and severity of these symptoms can vary depending on the individual.  Symptoms usually start a few months or years before your periods stop (in the perimenopausal stage) and can persist for some time post menopause.  On average, most symptoms will last for around four years after your last period, although some people may experience them for much longer.  Let’s take a look at some of the most common symptoms… Changes in menstrual cycle characteristics Often the first sign is a change in the normal pattern of your periods—cycles may be shorter or last longer, become erratic or increase in frequency.  You may find that you begin to experience fewer periods and go for months at a time between periods until they eventually stop altogether. Your menstrual flow may also become lighter or heavier than normal and last longer than normal. Hot flushes and night sweats Hot flushes are sudden feelings of heat, usually in the face, neck and chest, which can make your skin red and flushed. These can happen at any time and often erratically with seemingly no external trigger.  Flushes can be followed by […]