Menopause
Menopause is when your periods stop and your ovaries do not produce an egg each month. Your body produces smaller amounts of the hormones oestrogen and progesterone. As these hormone levels change, you can experience a range of different symptoms.
Menopause affects anyone who has periods. It can happen naturally but can also be caused by surgery or some cancer treatments.
There are 3 stages of menopause:
perimenopause - the time leading up to menopause when you have some symptoms but still have periods.
menopause - if you’ve not had a period for 12 months in a row, you have reached the menopause
postmenopause - after menopause your periods have stopped and you can no longer get pregnant. You may still have some symptoms.
This usually happens between the ages of 45 and 55. It’s a normal, natural part of life but the symptoms can be difficult to manage and it can have a big impact on your life.
Symptoms of menopause
Menopause is different for everyone. You might experience a mix of symptoms or you might not have any. They might last several years or just a few months. There are treatment options available to help manage different symptoms.
Symptoms can include:
changes to your period, for example becoming less regular or experiencing more spotting
anxiety, low mood and mood swings.
forgetfulness and trouble with concentration, known as brain fog.
vaginal dryness, loss of sex drive (libido)
hot flushes and night sweats
insomnia and trouble sleeping
If you have these symptoms, speak to your GP or a nurse.
There are lots of things you can try to help with menopause symptoms. Exercise, changes to your diet and good mental wellbeing can all make the symptoms easier to deal with. The NHS has some good tips for tackling different menopause symptoms yourself.
Menopause and contraception
If you’re using hormonal contraception like the pill, hormonal coil, contraceptive ring, patch, implant or injection, it will not affect the start of menopause symptoms or how long they last. But it can mask some of the signs and make it hard to know when you’re reaching menopause.
For example, it can be hard to notice changes to your natural period if your hormonal contraception has caused your period to get lighter or stop.
If you use a combined hormone method, you will have period-like withdrawal bleeds when you take a break even once perimenopause has started. Or if you use contraception to stop your period, it will stay stopped. This can disguise any changes that might be signs of menopause.
Stopping contraception
When you reach menopause, you can stop using contraception. Or you can stop using contraception when you’re 55. Even if you’re still having periods, it’s very unlikely you’ll get accidentally pregnant at this stage.
Current national guidelines recommend that at 50 years old, you stop using combined hormonal contraception like the pill, the patch and the ring. And the progestogen only injection is not recommended at this age either.
This is because some of the health risks, like the increased chance of developing blood clots or having a stroke, start to outweigh the benefits. You do not want to put your health at risk for birth control. So we suggest switching your contraception to a progestogen only method, like the progestogen only pill or the implant, or a method without hormones, like the non-hormonal coil.
Treatment for menopause and perimenopause
The main medical treatment for menopause and perimenopause is hormone therapy also known as hormone replacement therapy (HRT) or menopause hormone therapy.
This involves taking synthetic hormones to manage the symptoms caused by changing levels of hormones in the body. The treatment can be oestrogen-only or oestrogen combined with progestogen. These come in different forms, like pills, patches or creams. This hormone therapy is a very safe and effective treatment.
You can start treatment once you start experiencing perimenopause symptoms, or you can wait until it feels right for you. It’s safe to use for as long as you need to, though what you use may change over time. You will be invited to review your treatment with a clinician every year.
The type of treatment you need will depend on your symptoms and your medical history. Talk to your GP or a menopause specialist to understand the risks and benefits of the different options.
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