While the menopause is a normal and healthy part of ageing, it can also be a time of significant physical and emotional upheaval. Hot flashes, night sweats and mood swings are just some of the symptoms that can occur.

There is no one-size-fits-all solution to managing menopause symptoms, but there is support and treatment available. We spoke to women’s health specialist Dr Rosie Shire about some common questions she gets asked about menopause.

What age do people start to go through menopause? 

This tends to be around 45 years old, but it can start from when you’re 40 years old with some symptoms and it can last until you’re 55 or till 60 years old.

Some women do go through what we call premature menopause, which is before they’re 40. But most women in the forties start to get symptoms. 

If I’m still having periods, is it still menopause? 

Yes, you can still be peri-menopausal starting to go through the menopause, but still having your periods. They can change.

They can either become heavier or they can become lighter. They can become irregular so that you may have one every month and then miss a few months, or you may have a shorter time in between periods. That’s often a sign for women that something is changing. If you’re using contraception, then your periods may not change and you may not notice that particular side.

Contraception and menopause 

One of the myths is that when you’ve started going through the menopause that you then can’t get pregnant. And it’s really important to know that until your period is stopped for 12 months, if you’re over 50 or 24 months, if you’re under 50, you could still get pregnant.

So HRT doesn’t stop you getting pregnant. It’s important to think about other sorts of contraception, whether that might be a marine coil, the hormone coil or progesterone only pill, or using something like condoms. 

Menopause symptoms 

Make sure you do talk to someone about that if you think you might be going through the menopause. There are treatments out there that can help. 

Some women go through menopause and are absolutely fine and don’t really struggle with their symptoms. 

Other women really struggle with perhaps sweats in the day, hot flushes, night sweats, brain fog in particular is a really disabling symptom that can affect women in all areas of life, in particular at work. We do hear of stories of women actually leaving their job because they’re struggling so much with their memory, forgetting what to do, word finding difficulties, struggling in meetings with them memory.

Getting help with the menopause 

If you think you are being affected by menopause, then you can get help from your GP or from other private clinics. If you’re struggling to get help from your GP. 

You don’t necessarily need blood tests to confirm you’re menopausal. We tend to go more on the symptoms that you’re having, how your periods might have been affected. We might talk about when your mum or your sisters went through menopause because it can be inherited at the age that your menopause starts. 

What is HRT?

Hormone replacement therapy. This is made up of two hormones, oestrogen and progesterone. The oestrogen replaces what’s missing as we go through menopause.

And that’s what helps with the symptoms. Like the hot flushes, the brain fog, joint aches and pains, night sweats. However, oestrogen can have the side effect of making the lining of the womb get thicker, which if we just leave it alone and in rare cases, turn cancerous. This is why we get the second hormone progesterone, and that stops the lining of the womb getting thicker.

Progesterone we tend to use is called it suggested Micronised Progesterone . And this is body identical progesterone which means it’s a similar to the progesterone we produce naturally. You take it at night. It has the positive side effect that it can make you feel a bit sleepy and it protects the lining of the womb from anything nasty happening. 

Your clinician can discuss with you whether you need to have progesterone that you take all the time every day, or whether you have it that you just take for 12 to 15 days every month.

Benefits of HRT

We know that HRT can help with the menopause symptoms, and it also has the benefits of helping prevent osteoporosis, which is thinning of the bone. And it can help prevent and protect against heart disease later in life. It’s not completely risk free, but we know that any risks need to be balanced against the benefits of hate, HRT, and also how it makes you feel in your life generally.

Alternatives to HRT

If HRT isn’t for you, there are other medications you can think of trying, such as some antidepressants, which we give at low dose, which can help with the hot flushes. However, they don’t have the benefits, such as coping with the brain fog, the memory loss and the osteoporosis prevention. 

The good news is that if you are struggling with brain fog or memory problems, this tends to go away once you are through the menopause. It doesn’t mean you’re getting dementia. It doesn’t mean you’re going to be like it forever, but it can be really difficult at the time. So do make sure you get some help with it. 

There is information online available just make sure you look at where it’s coming from as we know, there’s a lot of information out there and if you want to know more, please seek further help.

You don’t have to struggle through menopause.

Dr Rosie Shire is an accomplished GP with over 12 years’ experience. She has a particular interest in women’s health and menopause. Dr Shire prides herself on having excellent communication skills and understands the importance of listening to patients. She follows a holistic approach, working in partnership with women to support them with their health.