Video above: Kayte explains her views on hormone replacement therapy. Full ep. available on SBS On Demand.
Even though half the population will experience it, menopause and perimenopause, the hormonal rollercoaster years leading up to a woman’s final period, are often still taboo subjects to discuss and neglected areas of women’s health.
But the The World Health Organisation (WHO) and the International Menopause Society have designated October as world menopause month, and October 18 as world menopause day. This was done to raise awareness of the stage in a woman’s life when she stops menstruating.
In Australia, some women are turning to Google to find the answers to their menopause questions.
Below are the top 10 questions related to menopause in the past six months in Australia and the answers to those questions from Dr Nicola Gates, a clinical neuropsychologist and author of
How long does menopause last?
Menopause is determined retrospectively after a woman has had no periods for 12 months. The symptoms of menopause begin earlier and last longer so the term 'menopause transition' is often used to cover the whole time of symptoms. On average menopause symptoms last four to five years however some women experience symptoms of much longer and I personally know of one woman who had hot flashes into her 70s.
What is perimenopause?
Perimenopause is the time before menopause is determined. It usually starts in the mid to late 40s, and the first symptom is usually a change to menses – shorter or longer period duration, heavier or lighter periods, and less regular periods. However for some women it is the hot flashes, poor sleep, and mood changes they first notice. Research suggests that the symptoms of perimenopause can be more difficult than menopause because the cyclical ratio or oestrogen and progesterone becomes haywire.
When does menopause start?
The average age in Australia for menopause – a woman's final period – is 51 years however this varies as women from Asia for example enter menopause earlier.
How to deal with menopause.
There are many things women can do to help themselves through the menopause transition. We can try multiple things simultaneously, from practical things like wearing looser clothing, to lifestyle changes such as drinking less alcohol and improving stress management as these both increase hot flashes and sleep disturbance. You can also try more psychological strategies like acceptance or cognitive behaviour therapy and medical interventions such as hormone therapy. Talk to your doctor to discuss other strategies, or you can read about some other options in my book, The Feel Good Guide to Menopause.
What happens during menopause?
In menopause women are essentially switching over from the hormones that supported sexual reproduction and potential pregnancy (oestrogen and progesterone) back to a simpler less potent form of oestrogen that we had prior to puberty. In puberty we go through massive hormone changes that take several years as our bodies change into our female reproductive high point and then in menopause we go back. Imagine going up a hill in puberty and then back down in menopause. Women are switching back to the same oestrogen levels as men as oestrogen is required by multiple body systems.
How to lose weight during menopause.
It is easy to put on weight during the menopause transition for many, often inter connected reasons. However, as women’s risks for cardiovascular disease increase it is important that we attain or maintain optimum weight and cardiovasacular health. This may mean changes to what we eat, how much we eat as well as how much we move and exercise. Post menopause we will convert androgens into oestrogen in adipose tissue (fatty tissue) so it is also important not to be too thin, too stressed, or do too much aerobic exercise as these things impact the synthesis of androgens. It is about getting a healthy balance for ourselves as individuals.
Does not having a child affect menopause?
Your life time exposure to oestrogen may make a difference to your health but not to your menopause experience. There are so many factors that can influence the menopause experience but the important thing, I believe, is to remember that you only get to go through menopause if you are; still alive; have been healthy; and were fertile in the first place. It is easy to forget those blessings when we feel lousy with menopause but there are so many women world wide who do not have those three things.
How do you know if you are in perimenopause?
I suggest any changes that you are experiencing in your menstrual cycle need to be examined at any age. The most common symptoms are changes to periods, hot flashes, night sweats, headaches and mood changes. It is good to pay attention to your body to learn its rhythms so you can detect changes and check them out.
Are your prolactin levels high during menopause?
Prolactin is a hormone to support breast feeding (breast growth and the production of milk) and surges after a child is born. Both women and men have very small amounts of prolactin circulating in their blood. The more common things that change with menopause, in terms of sexual reproduction, are oestrogen (to release eggs), progesterone (to support pregnancy), and testosterone (to give you a sex drive so you can procreate.)
Does menopause make you cry for no reason?
Oestrogen and progesterone are often described as psychologically protective as they keep stress levels down (mother nature doesn’t want potential mothers to be stressed, anxious, or depressed). During the menopause transition women can experience higher stress levels, and mood changes. The reduction in oestrogen and progesterone is also associated with other hormone changes which can impact mood. The transition can be very hard for women with mental health issues and for some, it can significantly compromise their psychological health. However, there is help available and things that can be done to assist.
