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Menopause support in Holland and Barrett

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Menopause support in Holland and Barrett

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Menopause Support | Anonymous Menopause Helpline | H&B

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Our friendly menopause advisors can help support you on your menopause journey. Enquire via a confidential video call or voice recording for help today.

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Menopause at work, a guide for professionals

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Menopause at work, a guide for professionals

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The menopause is a natural process which people go through as they get older or, in some cases, is medically induced. As oestrogen levels start to drop, periods become less frequent and eventually stop altogether. For some, their periods stop quickly, but for others it can take a few months or a few years. Everyone is different.

Menopause signs and symptoms are different for everyone and usually begin between the ages of 45 and 55, with the average age for people in the UK being 51.

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The menopause is a natural process which people go through as they get older or, in some cases, is medically induced. As oestrogen levels start to drop, periods become less frequent and eventually stop altogether. For some, their periods stop quickly, but for others it can take a few months or a few years.

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Women in England will be able to access cheaper hormone replacement therapy (HRT) for menopause through a new prescription prepayment certificate (PPC)

To be rolled out from 1 April 2023, the certificate will help around 400,000 women save hundreds of pounds a year, reducing their HRT costs to less than £20 a year

Better access to HRT will improve the lives of millions of women in England who suffer from negative symptoms of the menopause

From 1 April 2023, women prescribed HRT - the main treatment for menopause symptoms - will have access to a new scheme enabling access to a year's worth of menopause prescription items for the cost of 2 single prescription charges (currently £18.70).

As part of commitments to reduce the cost of HRT for menopausal women, the PPC will be valid for 12 months. It can be used against a list of HRT prescription items, and a patient can use this against an unlimited number of HRT items, such as patches, tablets and topical preparations. There will be no limit to how many times the certificate can be used while it is valid.

Reducing the cost of HRT is just one of the steps being taken by the government to improve access to HRT, alongside continuing work with suppliers to encourage and support them to boost supply to meet growing demand.

The introduction of the certificate delivers one of our year 1 priorities for the Women's Health Strategy for England. Published last summer, the strategy sets out an ambitious new agenda for improving the health and wellbeing of women and girls and to improve how the health and care system listens to women. Menopause was announced as a priority area within the strategy.

Health and Social Care Secretary Steve Barclay said:

This new certificate will make HRT more accessible than ever before - helping around 400,000 women save hundreds of pounds a year.

This is another step in our drive to improve support for millions of women experiencing the menopause, delivering on our Women's Health Strategy.

Minister for Women, Maria Caufield, said:

Around three-quarters of women will experience menopause symptoms, with a quarter experiencing severe symptoms - which can seriously impact their quality of life.

Reducing the cost of HRT is a huge moment for improving women's health in this country, and I am proud to be announcing this momentous step forward.

In our Women's Health Strategy, we made menopause a top priority. By making HRT more accessible, we're delivering on our commitment to women.

Women's Health Ambassador, Dame Lesley Regan, said:

The menopause is an inevitable stage in a woman's life course. As a gynaecologist, I've witnessed first-hand the symptoms that women experience, which can have debilitating impacts on their daily lives.

Making HRT more affordable will have a hugely beneficial impact on the lives of so many women. This prepayment certificate is a major step forward in prioritising the health and wellbeing of women.

Around 15% of women aged 45 to 64 in England are currently prescribed HRT, which has increased rapidly in the last 2 years from around 11% and continues to increase.

The government has accepted the recommendations of the HRT Taskforce, including encouraging and supporting manufacturers to boost supply to meet growing demand and continuing to issue serious shortage protocols ( SSPs) when needed to even out distribution. This involved allowing alternative products to be dispensed when necessary, and reducing the need for the patient to return to their GP.

The department engages with suppliers on a weekly basis, closely monitors the supply of HRT, and regularly meets with individual suppliers, including hosting quarterly roundtables with industry to ensure a continuous supply of HRT.

Women will need to apply for the PPC through the NHS Business Services Authority or in person at a pharmacy registered to sell PPCs. Once it has been granted, it will be available for use immediately on or after 1 April 2023. When collecting HRT products, patients will be able to simply show the digital or paper copy HRT PPC to the pharmacist and complete the exemption declaration on the NHS prescription form.

Dr Ranee Thakar, President of the Royal College of Obstetricians and Gynaecologists, said:

We know that cost can be one of the barriers that women face in accessing treatment to manage their symptoms during menopause, and the introduction of HRT PPCs is a positive step to improve access to HRT. This announcement is an important first step, and we hope that more will be done to address the challenges and inequalities faced in accessing menopause care and treatment.

Dr Janet Barter, President of the Faculty of Sexual and Reproductive Healthcare, said:

We welcome the introduction of HRT PPCs by the Department of Health and Social Care. This is a big step towards improving women's access to menopause treatment in England and reducing inequalities in access to this essential healthcare. Improved access to HRT will improve the lives of millions of women, allowing them to easily take control of their own menopause.

Janet Lindsay, CEO of Wellbeing of Women, said:

HRT is a first line treatment for women who may need help with managing menopause symptoms which can be debilitating. Improving access to HRT, by reducing the prescription costs, is absolutely the right thing to do and will help to empower women during this life stage.

The HRT PPC is in addition to the existing help with prescription charges, including the 3 and 12 month PPCs.

For people who need multiple medicines, the existing PPCs may remain a more cost effective method of paying for prescriptions.

HRT items in scope for the HRT-only PPC (as of 21 February 2023)

Bijuve/Bijuva

(Estradiol 1mg; micronised progesterone 100mg)

Climanor

(Medroxyprogesterone 5mg)

Clinorette

(Estradiol 2mg; norethisterone 1mg)

Elleste Duet

(Estradiol 1mg and 2mg; norethisterone 1mg)

Elleste Duet Conti

(Estradiol 2mg; norethisterone 1mg)

Elleste Solo

(Estradiol 1mg and 2 mg)

Estraderm MX

(Estradiol 25mcg, 50mcg, 75mcg and 100mcg)

Estradot

(Estradiol 25mcg, 37.5mcg, 50mcg, 75mcg and 100mcg)

Estring (90-day preparation)

(Estradiol 7.5mcg/24 hours)

Ethinylestradiol 10mcg

(Ethinylestradiol 10mcg)

Evorel

(Estradiol 25mcg, 50mcg, 75mcg and 100mcg)

Evorel Conti

(Estradiol 50mcg; norethisterone 170mcg)

Evorel Sequi

(Estradiol 50mcg; norethisterone 170mcg)

Femoston

Estradiol 1mg and 2mg; dydrogesterone 10mg)

Femoston Conti

(Estradiol 500mcg and 1mg; dydrogesterone 2.5mg and 5mg)

Femseven

(Estradiol 50mcg, 75mcg)

Femseven Conti

(Estradiol 50mcg; levonorgestrel 7mcg)

FemSeven Sequi

(Estradiol 50mcg; levonorgestrel 10mcg)

Imvaggis

(Estriol 30mcg)

Indivina

(Estradiol 1mg and 2mg; medroxyprogesterone 2.5mg and 5mg)

Kliofem

(Estradiol 2mg; norethisterone 1mg)

Kliovance

(Estradiol 1mg; norethisterone 500mcg)

Lenzetto

(Estradiol 1.53mg)

Mirena

(Levonorgestrel 20mcg/24 hours)

Novofem

(Estradiol 1mg; norethisterone 1mg)

Oestrogel/dose

(Estradiol 0.06%)

Premarin

(Conjugated oestrogen 300mcg, 625mcg and 1.25mg)

Premique low dose

(Conjugated oestrogen 300mcg; medroxyprogesterone 1.5mg)

Progynova

(Estradiol 1mg and 2mg)

Progynova TS

(Estradiol 50mcg and 100mcg)

Sandrena

(Estradiol 500mcg and 1mg)

Tridestra

(Estradiol 2mg; medroxyprogesterone 20mg)

Trisequens

(Estradiol 2mg/2mg/1mg; norethisterone 1mg)

Utrogestan

(Micronised progesterone 100mg and 200mg)

Vagifem

(Estradiol 10mcg)

Vagirux

(Estradiol 10mcg)

Zumenon

(Estradiol 1mg and 2mg)

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Hundreds of thousands of women experiencing menopause symptoms to get cheaper HRT

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Women in England will be able to access cheaper hormone replacement therapy (HRT) for menopause through a new prescription prepayment certificate (PPC) To be rolled out from 1 April 2023, the certificate will help around 400,000 women save hundreds of pounds a year, reducing their HRT costs to less than

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Women going through menopause to get year’s supply of HRT for under £20

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The government said the new scheme could save about 400,000 women up to £205 a year on hormone replacement therapy that helps relieve symptoms of the menopause.

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Sexual wellbeing and intimacy during and after menopause

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Information about sexual wellbeing during and after the menopause

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Managing Menopause in the Workplace | DavidsonMorris

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There are steps managers and employers can take to improve menopause in the workplace support for workers.

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Domestic abuse and the menopause: what you need to know -

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On average the police in England and Wales receive more than 100 domestic abuse-related calls every hour. And across the UK, police forces often see a spike in domestic abuse-related calls at Christmas. Here, we look at the link between domestic abuse and menopause, and crucially, where to find help and support if you need it.

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World Menopause Day poses an opportunity to discuss a change in life that affects every single woman at some point.

Menopause appears to be one of those taboo subjects where women will just 'put up' with menopausal symptoms. For some women though, menopause can be quite debilitating both physically and mentally.

Bladder weakness is something that affects many women going through menopause. Some women think that urinary incontinence is an inevitable part of the ageing process but it isn't and there are ways to prevent this and treat this if it does happen. Bladder weakness usually starts in the perimenopause stage as levels of oestrogen start to drop. Oestrogen is responsible for causing the urethral and vaginal tissues to thin and as women age, pelvic floor muscles can start to relax. Both of these factors can lead to urinary incontinence.

What Are The Main Types Of Urinary Incontinence In Menopausal Women?

There are two main types experienced...

Stress Urinary Incontinence - where you may leak urine when your bladder is put under pressure such as when you cough, sneeze or exercise

Overactive Bladder - this is usually caused by some kind of irritation to the bladder and cause symptoms of urgency and/or frequency

How Can I Help To Prevent Bladder Weakness?

Having a strong pelvic floor will help to support your bladder and keep your bladder sphincter muscle in control. There is an easy and discreet exercise called 'Kegel Exercises' that you can perform at any time to help strengthen your pelvic floor muscles . Simply, clench your muscles as if you were holding in your urine for around 10 seconds and relax and keep repeating this process several times a day.

How Can I Treat Bladder Weakness?

There are lots of medications that are available on prescription that are used to treated urinary incontinence. You will need to see your GP to discuss your symptoms so they can decide on the best method of treatment for you. Depending on your type of incontinence will depend on your treatment. Below are links to some of the treatment options available
Treatment of stress urinary incontinence Treatment of overactive bladder
Some of these treatments will need time to start working so if you need something more immediate to help you feel more comfortable then there are a wide range of feminine continence products available on the market now. Many of these have now been designed to be more discreet and can help to take away the embarrassment of urinary incontinence. You can find more information on the products available .

HRT And Oestrogen Supplements

Hormone Replacement Therapy has had a lot of bad press in recent years with links to an increased risk of breast cancer. At present, research hasn't been able to definitively prove that HRT does increase your risk of breast cancer, however caution is still taken in some patients in particular with those who have had or have a linked history to a hormone related cancer and those at risk of blood clots.

For others HRT can bring a relief to many menopausal symptoms and help to rebalance hormone levels. HRT comes in many forms including tablets, patches to treat general symptoms and pessaries and creams, which can give localised relief from bladder symptoms and vaginal dryness. You can ask your GP to refer you to a Menopause Specialist, who can advise you on the different types of HRT and what may work for you.

Bladder weakness is experienced by many and we always advise you to seek help from your GP or nearest continence clinic. You can now self refer in many cases. Our search tool on the Bladder and Bowel Community's website allows you to find your nearest self referral clinic .
For more information on managing the menopause, Menopause Matters has some great advice.

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Menopause And The Bladder - Bladder & Bowel Community

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World Menopause Day poses an opportunity to discuss a change in life that affects every single woman at some point. Menopause appears to be one of those taboo subjects where women will just 'put up' with menopausal symptoms. For some women though, menopause can be quite debilitating both physically and mentally.

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The menopause is a natural part of ageing that usually occurs between 45 and 55 years of age as oestrogen levels decline. Research shows that 10 per cent of women leave their jobs, and many more are reducing their hours or passing up promotions, because of their menopausal symptoms.

A survey from Acas has found that a third of employers (33 per cent) do not feel well equipped to support women going through the menopause.

If your organisation has any helpful resources on menopause and the workplace, please email us.

The NHS electronic staff record (ESR) team has worked with NHS England to develop a guide on recording menopause related sickness. The guidance includes step-by-step instructions on how to record menopause related absence to help HR colleagues and ESR users.

Nearly 60 per cent of people between the ages of 45 and 55 who are experiencing menopause symptoms say it has a negative impact on them at work. By recording accurately, organisations can gain a better understanding of the impact menopause is having on their colleagues and put in place the necessary support.

Mid Yorkshire Hospitals NHS Trust

Sherwood Forest Hospitals NHS Foundation Trust

Menopause awareness eLearning - this 30-minute eLearning session outlines what the menopause is, common symptoms associated with it, and scenarios to help people better understand how they can support themselves and each other.

The Self Care Forum offers a self care aware fact sheet outlining key information on menopause and perimenopause.

Menopause Whilst Black is a podcast aimed at opening the conversation about diversity in the menopause.

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Information on how menopause can affect people at work and practical guidance for employers on how to improve workplace environments for them.

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Menopause and work: why it's so important - Menopause in the Workplace | Henpicked

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Many line managers tell us that they don't feel confident talking about menopause. They don't know enough about it or how they can help. Unlike maternity where it's usually clear: a woman gets pregnant, has antenatal appointments, hands in her MAT B1, goes on maternity, has a baby and returns to work.

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Menopause | Symptoms, Treatment & Help | Balance by Dr Louise Newson

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By making menopause support inclusive and accessible to all, we can change the narrative by educating and empowering people across the world! Discover more.

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Menopause facts: symptoms and signs of menopause | Age UK

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The menopause is a natural part of female ageing and happens when you stop having periods. Find out more about the symptoms and ways to manage them from Age UK.

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Try our Menopause and GSM Symptom Checkers – menopausesupport.co.uk

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Try our menopause symptom checker, learn more about vaginal atrophy and get our help on how to approach your GP about your menopause symptoms

The shocking disparity in menopause training in medical schools is laid bare in our recent survey following a Freedom of Information request

FAQs about HRT and the menopause, Oestrogen and Progesterone

Our video blogs can be seen here

As some of you know I record a podcast with my lovely friend and fellow surgical menopause sister Sophie. The regular podcast - "The Good, The Bad & The Downright Sweaty" - is available on Apple Podcasts or the Podbean app.

Menopause Support has teamed up with Dr Zoe Hodson to see if we can collectively improve access to Testosterone for women via the NHS. Denied local oestrogen by your GP? Here are some template letters that could help you to make your views known.

We would love you to share them on your social media, print them and put them up anywhere that will allow you to; workplaces, community spaces, gyms, hairdressers, shops, waiting rooms, the possibilities are endless !

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Try our menopause symptom checker, learn more about vaginal atrophy and get our help on how to approach your GP about your menopause symptoms The shocking disparity in menopause training in medical schools is laid bare in our recent survey following a Freedom of Information request FAQs about HRT and the menopause, Oestrogen and Progesterone Our video blogs can be seen here As some of you know I record a podcast with my lovely friend and fellow surgical menopause sister Sophie.

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Menopause and me, including advice, support and case study videos

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Menopause and me, including advice, support and case study videos

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Welcome to Menopause and Me!

This website is dedicated to supporting women throughout the menopause journey.

The site offers tailored information about all stages of the menopause, understanding the changes to the body and treatment options. Menopause and Me provides the tools and support you need to help you through your menopause journey.

If you feel you are struggling with any aspect of your menopause journey, ask your healthcare professional for advice and help. You are not alone. Whatever the symptoms, help is available for you.

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Welcome to Menopause and Me! This website is dedicated to supporting women throughout the menopause journey. The site offers tailored information about all stages of the menopause, understanding the changes to the body and treatment options. Menopause and Me provides the tools and support you need to help you through your menopause journey.

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The Menopause Charity/advice and support

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The Menopause Charity/advice and support

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Imagine if over half the UK population was to experience the same life-changing health condition, which if disregarded would contribute to an increase in disease and illness, an increase in mental health issues, and the likelihood of losing jobs and marriages. Wouldn't we want to do something about that?

This is the current situation for the 33 million women in the UK who, at some stage in their life, will experience menopause. But, due to a lack of awareness among the public, a lack of training among some medical professionals and social stigma, their needs during this critical life change are frequently ignored, belittled or overlooked.

No two menopause stories are the same. This contributes to the lack of understanding. Some women transition smoothly, without any major effects. Others will suffer the most extreme symptoms and endure the massive negative impact these have on their lives.

We're working towards a more holistic view of an individual's overall health state. So that multiple symptoms become correctly recognised as perimenopause or menopause. This doesn't just immediately improve current health. Educated decisions protect against long-term medical issues, caused by menopause, that affect quality and longevity of life.

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The Menopause Charity - Menopause Facts, Advice and Support

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The Menopause Charity works to education everyone so that perimenopause and menopause are properly understood. We deliver trusted information and support for those experiencing or treating menopausal symptoms, as well as family, friends, co-workers and employers.

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Read about the main treatments for menopause and perimenopause symptoms, including hormone replacement therapy (HRT).

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Herbal Remedies for Menopause, Menopause Information & Articles | The North American Menopause Society, NAMS

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Attitudes towards menopause: time for change

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In this week’s issue of The Lancet, a Comment by Zoe Schaedel and Janice Ryder highlights
many of the misconceptions around, and barriers to, menopause care. Stigma, embarrassment,
a lack of public awareness, and miscommunication mean that for many women, menopause
is either borne in quiet suffering…

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Confessions of a man whose marriage was ruined by his wifes menopause

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Confessions of a man whose marriage was ruined by his wifes menopause

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Simply Hormones | Making sense of menopause

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Confessions of a man: “How menopause ended my marriage and what I wished I’d known then” | Simply Hormones

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Guest blog from ‘Paul’ – a man whose marriage ended because of his wife’s menopause.
Sadly there is no research about depression and suicide in men at this life stage (there’s little enough about women). More must be done. I invite you to read ‘Paul’s’ story (not his real name). You may recognise a…

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It can break marriages, end careers and even lead to suicide. Anna Moore of the Daily Mail recently interviewed women whose debilitating symptoms went ignored and finds out what it took to get their lives back on track. One of them was our own Diane Danzebrink, founder of Menopause Support.

Read the full article in the Mail Online here.

Aged 45, a hysterectomy had sent her into a surgical menopause, yet no one had warned Diane what she might expect. 'I knew I wouldn't get periods and I might get hot flushes, but I certainly didn't know there were more than 30 other possible symptoms.' These range from insomnia and panic disorder to joint pain, headaches and electric shock sensations.

Within months Diane was paralysed by anxiety that seemed to have come from nowhere. After a terrifying moment where she came within a hair's breadth of driving her car into the path of an oncoming lorry, Diane found herself sitting in front of a doctor who carefully explained the impact of menopause on mental health.

'Within days of taking HRT, life didn't seem quite so hopeless,' says Diane. 'As I started getting better, I couldn't believe that I was the only person this had happened to. I set up a website to find others.'
For many women, the menopause has brought total rupture, dividing lives into 'before' and 'after'.
'Some have lost careers or marriages,' says Diane. 'Many have been told by their doctors that their symptoms can't be hormone related as they are still having periods or they aren't experiencing hot flushes.' In truth, the years before menopause, the perimenopause - where hormones can be in freefall, or on a rollercoaster of peaks and troughs - can be equally challenging. Perhaps it's not surprising that in the UK women in their early 50s have the highest risk of suicide compared to women in other age groups.

The Mail article also looks at the cases of three women, Joan, whose symptoms were so bad after coming off the contraceptive pill that she almost took her own life, Sarah, whose menopause cost her a career she loved, and Lesley, who says she ended her marriage 'needlessly' following stress and anxiety.

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It can break marriages, end careers and even lead to suicide. Anna Moore of the Daily Mail recently interviewed women whose debilitating symptoms went ignored and finds out what it took to get their lives back on track. One of them was our own Diane Danzebrink, founder of Menopause Support.

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Summary

What is the menopause?

What are the symptoms of the menopause?

How can the menopause affect my emotional and mental health?

The menopause and mental health conditions

Getting help with menopause symptoms

Your experience of the menopause will be affected by many different things, not just what's happening in your body. Menopause may be one of many significant events happening in your life, such as your children leaving home or your parents needing more care. You may still be working full-time and having to juggle these new responsibilities.

Cultural differences can shape how you're affected by the menopause too. Research shows that in societies where older people are respected, menopause symptoms are often less troublesome; but where younger women are admired more highly, going through menopause can feel like a time of loss and be less valued by society. Menopause symptoms for these women can feel much worse. (' Culture may influence how women experience menopause').

However you feel about the menopause, you may find physical symptoms such as mood changes and hot flushes hard to manage. Don't be afraid to talk about it and ask for help if needed.

What is the menopause?

The menopause is a natural biological process. Put simply, the menopause is when you stop having periods and are no longer able to get pregnant naturally. It happens when your ovaries age and naturally produce lower levels of reproductive hormones. If you've had a hysterectomy and had your ovaries removed, you will immediately reach menopause. This is known as surgical menopause and can happen to women of any age.

We often use the word menopause to describe when we notice our periods changing, and we start to experience menopausal symptoms, which is called perimenopause. The menopause itself is defined as the day when you haven't had a period for 12 months.

The average age of menopause is 51 but it may happen sooner or later than this. Around one in 100 women experience the menopause before they reach 40.

What is the perimenopause?

The perimenopause is the time when your body starts transitioning towards the menopause, and your ovaries slow down. It can start months or years before the menopause. You might experience irregular periods that are lighter or heavier than normal, hot flushes, mood swings, sleep problems and fatigue.

What are the symptoms of the menopause?

Eight out of ten women have symptoms in addition to their periods stopping. The type and severity of symptoms can vary, and some are the same as the symptoms that can occur during the perimenopause. Common menopausal symptoms include:

hot flushes - short, sudden bursts of heat that can leave your skin sweaty and red

night sweats - hot flushes that occur at night

sleep problems

mood swings

brain fog, forgetfulness and difficulty concentrating

loss of interest in sex

vaginal dryness or pain

headaches

aches and pains

urinary tract infections (UTIs)

The Menopause Charity has a symptom checker you can use to monitor how you're feeling
How are trans people affected by the menopause?

If you're trans, how the menopause affects you will depend on which medical interventions you've undergone and whether or not you're taking hormones. Speak to your doctor if you have any questions or concerns. Rock My Menopause has some information about the menopause and trans people.

How can the menopause affect my emotional and mental health?

Changing hormone levels can cause mood swings, low mood and anxiety around menopause. For some women, these are the first signs that they are approaching menopause.

Self-help measures such as getting enough sleep, eating well, taking regular exercise and practising yoga or meditation may help. You might also want to speak to your doctor about getting help. They may suggest talking therapy, medication or both.

Can antidepressants help?

The low mood you may experience with menopause is different from depression. NICE (the organisation that produces guidelines for healthcare professionals) is clear that you shouldn't be offered antidepressants as the first line of treatment. Your changing hormones cause mood changes, so hormone replacement therapy (HRT) can help.

However, you may be prescribed a low dose of antidepressants to help with hot flushes and night sweats.
The Menopause Charity has more information about antidepressants and menopause
The menopause and mental health conditions

While the menopause isn't a mental health condition, it can affect your mental health. Hormone changes during the menopause can sometimes make mental health conditions worse.

If you have a history of depression, you're more likely to be depressed during menopause.

If you have bipolar disorder, you may experience more depressive episodes. This is likely to be linked to a decrease in oestrogen.

If you have schizophrenia, you may find your symptoms get worse, and you need a higher dose of medication.

Not all women are affected but speak to your doctor if you find your mental health condition harder to manage. Changes to your treatment may help you feel better.

Getting help with menopause symptoms

Speak to your doctor if your menopause symptoms are affecting your life. You don't just have to put up with them - there is help available.

The main therapy is hormone replacement therapy (HRT). This replaces the hormones that are reducing your body and is very effective at relieving menopause symptoms. It can also help with thinning of the bones, which is more common after the menopause. There's no limit on how long you can take HRT, but most women stop taking it after their symptoms stop - usually after a few years. You may find your menopause symptoms come back for a while after stopping HRT. If they're severe, speak to your doctor about managing them.

As with all medication, you must weigh the benefits and risks of taking HRT. Some women and doctors have been reluctant to use HRT because of studies that have focused on the potential risks. However, recent evidence shows the risks are very small and usually outweighed by the benefits. Talk to your doctor about any concerns.

It's always your choice whether to take medication or not. Some women prefer not to take HRT and to manage their symptoms in other ways until this stage in their lives has passed.

Talking therapy, such as cognitive behavioural therapy (CBT), can help with low mood, anxiety, stress and even hot flushes and night sweats.

The NHS website has more information on treatment and self-help for menopause symptoms.

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What is the menopause, symptoms of the menopause, how menopause can affect emotional and mental health, the menopause and mental health conditions, and getting help with menopause symptoms.

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Changes in your hormones during menopause can impact your mental health as well as your physical health. You may experience feelings of anxiety, stress or even depression. Menopausal symptoms may include:

anger and irritability

anxiety

forgetfulness

loss of self-esteem

loss of confidence

low mood and feelings of sadness or depression

poor concentration - often described as 'brain fog' and/or lost words

Many women experiencing menopause or perimenopause will experience problems with sleeping. Lack of sleep and tiredness can also make symptoms including irritability, ability to concentrate or anxiety worse.
Further support and information about your mental wellbeing
Addressing problems with sleep may help you manage some of the mental health symptoms you can experience due to menopause.

There are lots of different options that can help you with these experiences and improve your mental health and wellbeing during the menopause.

Some women have been prescribed anti-depressants to help with the mental health-related symptoms during the menopause, but unless you have been diagnosed with depression there are other treatment options that are more appropriate.

It's important to realise that the mental symptoms of menopause are as real as the physical ones, and you should not wait to seek help if you are struggling. Speak to your local GP practice and they can provide you with the right support and help.

Treatment options

There are various treatments that you might want to consider to help relieve some of the psychological impacts of menopause. Everyone is different so it's about choosing what's right for you. Treatments can include:

Eating a healthy, balanced dietand exercising regularly can help to improve some menopausal symptoms. There are lots of helpful and free resources that can help you get active and feel good, including yoga, mindfulness and walking.
Further information about the treatment options available
Depression

You might experience mood changes as a result of menopause, but this should not be confused with depression. Depression is a more serious condition, where very low mood is more constant for longer periods of time.

Menopause can cause an increased risk of depression. If you think you or someone close to you might be suffering from depression, you should speak to your GP.
Further information about depression
Physical changes and impacts

Some of the physical changes that women can experience as they go through menopause can affect the way they feel about themselves, their confidence and self-esteem.

The menopause can feel like a big change physically and mentally for many women, so it's important to give yourself the time and space you need to work through these changes.

It can be difficult to find time for yourself when you are juggling a busy life, working and supporting family members, friends or children. If you can, try to remember to take time for yourself too. Finding time for a cup of tea, to read a book, go outside for walk, gardening or go online can give you a break from the pressures of life. Mindful breathing exercises and yoga can also really help.

Speaking to other women online or in real life about the physical changes you're experiencing can also help. There might be Menopause Cafes or social media groups that allow you to listen to other women's stories, and to share your own.

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Changes in your hormones during menopause can impact your mental health as well as your physical health. You may experience feelings of anxiety, stress or even depression. Menopausal symptoms may include: anger and irritability anxiety forgetfulness loss of self-esteem loss of confidence low mood and feelings of sadness or depression poor concentration - often described as 'brain fog' and/or lost words Many women experiencing menopause or perimenopause will experience problems with sleeping.

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It's important to remember that the menopause is normal and that support should be available to help you at work.

Menopausal women are the fastest-growing demographic in the workforce, so it's important now more than ever to be able to speak openly about menopause at work.

Menopause can affect a woman's working life. Sometimes menopausal symptoms or working conditions can impact your ability to concentrate or carry out your role to the best of your ability.

In a survey of 1,000 adults in the UK, the British Menopause Society found that 45% of women felt that menopausal symptoms had a negative impact on their work and 47% who needed to take a day off work due to menopause symptoms say they wouldn't tell their employer the real reason.

Many women have said that they often find managing their menopause symptoms in the workplace very challenging. Coping with symptoms in the workplace can be hard, especially as many women find it difficult to talk about menopause at work.

Things you can do

You can request reasonable adjustments be made within your workplace to help you manage your menopausal symptoms, such as:

flexible working

requesting a different uniform if you are experiencing hot flushes

moving to a cooler part of the office or asking for a fan

using technology where it can help you, for example setting up reminders on your phone or taking more notes to help with 'brain fog'

It's useful to think about the practical changes that will help you. If you have access to an occupational health service, you can speak to them about support and possible work adjustments.

If you have supportive work colleagues talk about your experiences with them, you may find that you're not alone.

Outside of the workplace, you should consider lifestyle changes such as taking part in more exercise or walking more as well as eating a healthy balanced diet. You should also look for local Menopause Cafes or social media groups online to speak to people going through a similar experience.

How your employer can support you

If you are experiencing menopausal symptoms that are impacting your ability to work, you can speak to your manager and let them know what you're going through.

Opening up to someone in a professional environment may feel awkward, especially if your manager is someone you don't feel comfortable talking to about personal matters. If you feel like this is the case, you could try speaking to a different member of your management team or human resources (HR).

Before speaking to someone you could try:

taking notes of your menopausal symptoms and how or when they are affecting you

preparing what you plan to discuss with a friend

thinking of solutions that you think could help you

If you are a manager

There are lots of resources available that can help you understand more about the menopause and the support women experiencing menopausal symptoms in your workplace may need.

There are solutions available to help women continue to work comfortably during menopause.

Things you might want to consider offering employees:

flexible working such as changing working patterns or working from home

counselling through workplace

option to take more regular breaks

more time to prepare before meetings, appointments or engagements

Further information about supporting someone through the menopause
Guidance from the Faculty of Occupational Health

Guidance from the Faculty of Occupational Health suggests that regular, informal conversations between manager and employee may help conversations about changes in health, including menopause. It's important to keep in mind that unless an employee mentions it directly, it's not appropriate to suggest someone is experiencing menopause.

It may be helpful for line managers to simply check-in regularly about employees wellbeing. If the topic of menopause is raised, it's important to acknowledge this is a normal stage of life and that changes and adjustments can easily be made. Having these conversations can identify support at work that can help women. You can also encourage them to discuss any relevant health concerns with their GP practice.
Further information about menopause and the workplace

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Information about menopause and work, including things you can do, and support managers and employers can give women

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Some men develop depression, loss of sex drive, erectile dysfunction, and other physical and emotional symptoms when they reach their late 40s to early 50s.
Other symptoms common in men this age are:

mood swings and irritability

loss of muscle mass and reduced ability to exercise

fat redistribution, such as developing a large belly or "man boobs" (gynaecomastia)

a general lack of enthusiasm or energy

difficulty sleeping (insomnia) or increased tiredness

poor concentration and short-term memory

These symptoms can interfere with everyday life and happiness, so it's important to find the underlying cause and work out what can be done to resolve it.

Is there such a thing as a 'male menopause'?

The "male menopause" (sometimes called the andropause) is an unhelpful term sometimes used in the media.

This label is misleading because it suggests the symptoms are the result of a sudden drop in testosterone in middle age, similar to what occurs in the female menopause. This is not true.

Although testosterone levels fall as men age, the decline is steady at less than 2% a year from around the age of 30 to 40, and this is unlikely to cause any problems in itself.

A testosterone deficiency that develops later in life, also known as late-onset hypogonadism, can sometimes be responsible for these symptoms, but in many cases the symptoms are nothing to do with hormones.

Personal or lifestyle issues

Lifestyle factors or psychological problems are often responsible for many of these symptoms.

For example, erectile dysfunction, loss of libido and mood swings may be the result of either:

There are also physical causes of erectile dysfunction, such as changes in the blood vessels, which may happen alongside any psychological cause.
Find out more about the causes of erectile dysfunction
Psychological problems are typically brought on by work or relationship issues, divorce, money problems or worrying about ageing parents.

A "midlife crisis" can also be responsible. This can happen when men think they have reached life's halfway stage.

Anxieties over what they have accomplished so far, either in their job or personal life, can lead to a period of depression.
Find out more about the male midlife crisis
Other possible causes of the "male menopause" include:

lack of sleep

a poor diet

lack of exercise

drinking too much alcohol

smoking

low self-esteem

Late-onset hypogonadism

In some cases, where lifestyle or psychological problems do not seem to be responsible, the symptoms of the "male menopause" may be the result of hypogonadism, where the testes produce few or no hormones.

Hypogonadism is sometimes present from birth, which can cause symptoms like delayed puberty and small testes.

Hypogonadism can also occasionally develop later in life, particularly in men who are obese or have type 2 diabetes.

This is known as late-onset hypogonadism and can cause the "male menopause" symptoms.

But this is an uncommon and specific medical condition that's not a normal part of ageing.

A diagnosis of late-onset hypogonadism can usually be made based on your symptoms and the results of blood tests used to measure your testosterone levels.

What to do

If you're experiencing any of these symptoms, see your GP. They'll ask about your work and personal life to see if your symptoms may be caused by a mental health issue, such as stress or anxiety.

If stress or anxiety are affecting you, you may benefit from medication or a talking therapy, such as cognitive behavioural therapy (CBT).

Exercise and relaxation can also help.

Read about:

Do I need hormone replacement therapy (HRT)?

Your GP may also order a blood test to measure your testosterone levels.

If the results suggest you have a testosterone deficiency, you may be referred to an endocrinologist, a specialist in hormone problems.

If the specialist confirms this diagnosis, you may be offered testosterone replacement to correct the hormone deficiency, which should relieve your symptoms.

This treatment may be either:

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Some men develop depression, loss of sex drive, erectile dysfunction, and other physical and emotional symptoms when they reach their late 40s to early 50s.

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Davina McCall: Sex, Mind and the Menopause

Davina McCall's Pill Revolution

Davina McCall Sex, Myths & Menopause (Signed)

Davina McCall Sex, Mind & Menopause (Signed)

Celebrity Save Our Sperm

My Big Boobs: UNTOLD

Obsessed with My Muscles: UNTOLD

Are Women the Fitter Sex?

Davina McCall: Sex, Mind and the Menopause

Davina McCall's Pill Revolution

Davina McCall Sex, Myths & Menopause (Signed)

Davina McCall Sex, Mind & Menopause (Signed)

Celebrity Save Our Sperm

My Big Boobs: UNTOLD

Obsessed with My Muscles: UNTOLD

Are Women the Fitter Sex?

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Davina McCall: Sex, Myths and the Menopause

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Davina was 44 and felt like she was losing it - hot flushes, depression, mental fog. Now she tells her menopause story, busting midlife taboos from sex to hormone treatment.

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In the years around menopause, you may experience changes in your sex life. Some women say they enjoy sex more. Other women find that they think about sex less often or don't enjoy it as much. Low hormone levels after menopause cause vaginal tissues to be thinner or drier. There are treatments to help your symptoms.

What effects will menopause have on my sex life?

Menopause may cause changes in your sex life, or you may not notice any changes at all. Here are some possible changes:

Lower hormone levels can make your vaginal tissue drier and thinner. This condition, called vaginal atrophy, can make sex uncomfortable or painful.

Lower hormones may lower your sex drive. It may take you longer to get aroused.

Night sweats can disturb your sleep and make you tired.

Emotional changes can make you feel stressed or irritable.

Being less interested in sex as you get older is not a medical condition that requires treatment. But if changes in your sexual health bother you, talk to your doctor or nurse about ways to help, such as treatments to relieve vaginal dryness.

What can I do to improve my sexual health before and after menopause?

You can steps to improve your sexual health during perimenopause and after menopause:

Be active. Physical activity can boost your energy levels, lift your mood, and improve your body image. All of these can help increase your interest in sex.

Don't smoke. Cigarette smoking can reduce blood flow to the vagina and lower the effects of estrogen. This can make it more difficult to get aroused.

Avoid drugs and alcohol. They can slow down how your body responds.

Have sex more often. If you choose to have sex, it can increase blood flow to your vagina and help keep tissues healthy.

Allow time to become aroused during sex. Moisture from being aroused protects tissues and makes sex more comfortable.

Practice pelvic floor exercises. These can increase blood flow to the vagina and strengthen the muscles involved in orgasm. Learn more about pelvic floor exercises.

Avoid products that irritate your vagina. Bubble bath and strong soaps might cause irritation. See your doctor or nurse if you have vaginal itching or irritation as it may be a sign of infection.

Talk to your doctor or nurse about products to increase your sex drive if you are bothered by a low level of interest in sex. Some women try products like pills or creams with the male hormone testosterone or similar products. The Food and Drug Administration (FDA) has not approved these products for treating low female sex drive. But, the FDA has approved flibanserin, a medicine to treat low sexual desire.If you take flibanserin, you cannot drink alcohol because of its risks for serious low blood pressure problems and loss of consciousness. Flibanserin can increase the number of times you have a satisfying sexual experience by once a month or once every two months. Talk to your doctor about the benefits and other risks of taking any medicine.

How can I treat vaginal dryness after menopause?

For vaginal dryness that causes mild discomfort during sex:

Use an over-the-counter, water-based vaginal lubricant when you have sex.

Try an over-the-counter vaginal moisturizer to help increase moisture. You may need to use it every few days.

For more severe vaginal dryness, your doctor might prescribe medicines that you put into your vagina to increase moisture and sensation. These may include:²

Discuss your symptoms and personal health issues with your doctor or nurse to decide whether one or more treatment options are right for you.

How can I talk with my partner about menopause and sex?

Talking with your partner about your concerns can strengthen your relationship. Getting older and chronic health problems like heart disease or diabetes can affect your sexual health and how you feel about sex. Some possible topics to discuss include:

What feels good and what doesn't

Times that you may feel more relaxed

Which positions are more comfortable

Whether you need more time to get aroused than before

Concerns you have about the way your appearance may be changing

Ways to enjoy physical connection other than vaginal intercourse, such as oral sex or massage

You may want to also consider meeting with a therapist or sex counselor for individual or couples therapy if changes in your sex life bother you.

Do I still need to practice safe sex after menopause?

Yes, you still need to use condoms after menopause if you are not in a monogamous relationship. In a monogamous relationship, you and your partner have sex only with each other and no one else. Also, you have both been tested for sexually transmitted infections (STIs, or STDs) before having sex without a condom.

Condoms are the best way to prevent STIs when you have sex. Because a man does not need to ejaculate (come) to give or get some STIs, make sure to put the condom on before the penis touches the vagina, mouth, or anus. After menopause you may be more likely to get an STI from sex without a condom. Vaginal dryness or irritation is more common after menopause. This can cause small cuts or tears during sex, making you more likely to get an STI.

Learn more ways to prevent STIs.

Did we answer your question about menopause and your sexuality?

For more information about menopause and your sexuality, call the OWH Helpline at 1-800-994-9662 or check out the following resources from other organizations:

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In the years around menopause, you may experience changes in your sex life. Some women say they enjoy sex more. Other women find that they think about sex less often or don't enjoy it as much. Low hormone levels after menopause cause vaginal tissues to be thinner or drier.

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Advice for employers on how to manage the effects of the menopause on staff and why it's important.

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Menopause support in the workplace - download

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3 simple steps to implement effective menopause support for your employees

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This guideline covers the diagnosis and management of menopause, including in women who have premature ovarian insufficiency. The guideline aims to improve the consistency of support and information provided to women in menopause.

For information on related topics see our women's and reproductive health summary page.

In December 2019, in response to an MHRA safety alert on hormone replacement therapy (HRT) and the risk of breast cancer, we replaced the table in the recommendation on breast cancer risk with a link to the MHRA's advice on HRT risks and benefits. We will also update this recommendation as part of the planned update to the guideline.

Recommendations

The guideline includes recommendations on:

Who is it for?

Healthcare professionals who care for women in menopause.

Women in menopause, and their families and carers

Is this guideline up to date?

We checked this guideline in December 2019 and September 2021, and are updating it. The update will focus on managing urogenital atrophy, the long-term benefits and risks of hormone replacement therapy, and cognitive behavioural therapy for managing menopausal symptoms. See the guideline in development page for progress on the update.

Guideline development process
How we develop NICE guidelines
Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

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This guideline covers the diagnosis and management of menopause, including in women who have premature ovarian insufficiency. The guideline aims to improve the consistency of support and information provided to women in menopause

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Menopause is when your periods stop due to lower hormone levels. It usually affects women between the ages of 45 and 55, but it can happen earlier.

It affects anyone who has periods.

Menopause can happen naturally, or for reasons such as surgery to remove the ovaries (oophorectomy) or the uterus (hysterectomy), cancer treatments like chemotherapy, or a genetic reason. Sometimes the reason is unknown.

Perimenopause is when you have symptoms of menopause but your periods have not stopped. Perimenopause ends and you reach menopause when you have not had a period for 12 months.

Menopause and perimenopause can cause symptoms like anxiety, mood swings, brain fog, hot flushes and irregular periods. These symptoms can start years before your periods stop and carry on afterwards.

Menopause and perimenopause symptoms can have a big impact on your life, including relationships and work.

There are things you can do to help with symptoms. There are also medicines that can replace the missing hormones and help relieve your symptoms.

Page last reviewed: 17 May 2022
Next review due: 17 May 2025

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Find out about menopause symptoms, causes and treatments, and things you can do to help.

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Menopause | Symptoms, Treatment & Help | Balance by Dr Louise Newson

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By making menopause support inclusive and accessible to all, we can change the narrative by educating and empowering people across the world! Discover more.

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Decision Tree Flow Chart : Menopause Matters

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Menopause and treatment options. An independent, clinician-led site aiming to provide accurate information about the menopause.

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Could lifestyle changes and a brighter outlook make your midlife brain less fuzzy asks Kerry Dolan?

Scrolling through my social media this morning, I spat out my coffee as I read a post from a menopausal lady who, on her first day in a new job at a phone company, offered a customer 'unlimited data, calls and sex' with their mobile contract. Not bad for £20 a month!

Brain fog has always been good fodder for humour but the reality of playing word roulette, dealing with the menopausal name-thief and trying to marshal scattered attention, can be distressing. Fear of what may or may not come out of her mouth when she speaks can undermine a woman's confidence and even raise concerns about dementia.

A recent survey of women in the West Midlands police force found that around 80% felt that menopausal symptoms interfered with their ability to work. The three most common symptoms were memory problems, fatigue and anxiety.

Hormones play an important role in shaping the structure of the brain and, at times of hormonal change - puberty, pregnancy, menopause and even our monthly cycles - our brains undergo something of an overhaul. Reassuringly, women's health expert Christine Northrup, M.D. claims, 'The reality is, our brains continue to create new cells for life. After menopause we just move more into the right hemisphere of our brains.' But, as with any restructure, perimenopausal thinking can be disrupted.

A study directed by Dr G A Greendale, published in the National Library of Medicine, followed 2,362 perimenopausal women for four years. While they did observe declines in memory and learning ability, they found that these rebounded post-menopause, "suggesting that menopause transition-related cognitive difficulties may be time-limited." In an interview, she said, "During the menopause transition, a woman's brain may feel a little off, a little muddy, but when the transition passes, the clouds clear and the fog lifts. Sometimes all a woman needs to know is that this too shall pass." In the meantime, there is plenty you can do to enhance your mental clarity, recall and focus.
Be a pleasure seeker
In her book, The Secret Pleasures of Menopause, Christine Northrup, M.D. champions the gas, nitric oxide, which the body produces when we experience pleasure. Laughter, restorative exercise like yoga, massage, positive thinking and orgasms have all been shown to boost the production of nitric oxide, which can decline as we age. She says: "With enough nitric oxide in your body, your blood vessel walls relax allowing more life-supporting oxygen and other nutrients to flood your heart, brain and internal organs."
Drink plenty of water
The brain is 80% water so it makes sense to stay hydrated. Drinking at least 8 glasses of water a day, not only assists with brain functioning but also helps to flush out toxins.
Eat good fats
The other 20% of your brain is made up of good fats. So, including foods rich in Omega-3 fatty acids promotes good brain health as well as supporting the production of those much-needed hormones. Don't fall into the trap of following a low-fat diet, oily fish like salmon and mackerel, as well as coconut oil, avocados, nuts and seeds contain healthy fats that are essential to a midlife diet.

Get more sleep

Many women report feeling constantly exhausted around perimenopause. As menopause is really just puberty in reverse, that's hardly surprising. Think of your own teenage years or any teenager you know, often their coping strategy is to sleep all day!

Sadly, that's not an option for many of us but consider adapting your routine to ensure you get extra time in bed during this transition. Make sure you create a sleep routine, which gives you plenty of time to wind down, to make sleeping easier.

If night sweats or insomnia keep you awake, allow yourself to simply rest at this time. Our brains do a lot of clearing and processing while we rest.

Meditate

The benefits of meditation are widely extolled and, at midlife, can provide your brain with valuable respite and reduce the impact of stress as well as improving mood, concentration and clarity. Take time to explore different types of meditation to find one that works for you and remember, even a couple of minutes of regular meditation will make a difference
Take regular breaks
Like any system, the brain can't make updates and changes while in use - and, let's face it, the mind of a woman at midlife is pretty much constantly in use. As a result, our thinking can become sluggish and clogged.

Finding regular opportunities to pause throughout your day can provide valuable processing time to clear the random, unimportant and temporary data which may be bogging you down and exacerbating brain fog.
Reduce stress
Stress activates the fight or flight response. The Relaxation Response is the lesser-known counterpart to the Fight or Flight Response. The Fight or Flight response rallies the body to fuel a rapid retreat or a physical attack - rarely the most appropriate response in a world where your stressor is more likely to be a long to do list than a raging tiger. It's lesser-known counterpart, the Relaxation Response, utilises those valuable resources for general repairs and 'house-keeping' in the body.

At a time when your body and brain are in need of a little TLC, it is essential that we learn to manage stress and facilitate healing and restoration as frequently as possible.
Exercise regularly
With the distinct lack of energy that many of us feel around menopause, it can be easy to fall into an even more sedentary lifestyle. However, exercise can increase oxygen flow, boost energy and improve circulation, all of which are known to enhance cognitive ability.

Y.K. Chang's study, published in the Journal of Sport and Exercise Psychology, suggests that moderate to intense exercise may increase cognitive flexibility and working memory, and high-intensity exercise could increase information processing speed.
Avoid insulin spikes and dips
If you find yourself with flagging energy and focus, perhaps mid-morning or afternoon, you might be experiencing fluctuating blood sugar levels. Instead of grabbing a coffee or sugary snack, try a healthier option. Nutritionists recommend that snacks and meals should contain both protein and fibre to avoid the insulin spikes and dips that can derail the brain and bring on the fog.
Be a single tasker
Have you ever experienced the spinning vortex of the loading icon on your computer? The interminable wait for your page to open? With too many tabs open, your computer starts to slow down and become clogged. You too are coping with more input than ever before. Like open windows in your browser, your attention might well be split among many different things at the same time. Working on one thing at a time can help to restore the clarity and calm you need.
Hypnotherapy
The hypnotic state can provide relaxation, clarity and enhanced capacity for learning. As a result, hypnotherapy and self-hypnosis can be valuable resources for tackling brain fog.

By reprogramming your brain, adjusting your mind-set, managing stress, improving sleep and facilitating changes to old habits and behaviours, hypnotherapy can be a fantastic tool to support brain function at this time.

Kerry is a hypnotherapist, NLP Master practitioner and speaker with a specialism in women's health. If you're interested in finding out more about tackling brain fog or any other symptom of menopause with hypnotherapy, email her on [email protected] ,
visit www.wombservice.co.uk or follow her on Instagram at kerry.wombservice

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Could lifestyle changes and a brighter outlook make your midlife brain less fuzzy asks Kerry Dolan? Scrolling through my social media this morning, I spat out my coffee as I read a post from a menopausal lady who, on her first day in a new job at a phone company, offered a customer 'unlimited data, calls and sex' with their mobile contract.

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Menopause: What and when is Menopause?
Menopause- what happens?
All women will experience the menopause. Natural menopause takes place when the ovaries become unable to produce the hormones estrogen and progesterone. Menopause can also occur when the ovaries are damaged by specific treatment such as chemotherapy or radiotherapy, or when the ovaries are removed, often at the time of a hysterectomy. Ovaries naturally fail to produce estrogen and progesterone when they have few remaining egg cells; the maximum number of egg cells in the ovaries is present before birth, with a reduced number already at birth, gradual reduction from puberty, and a rapid decline from 40 onwards. With less egg cells, the ovaries become less able to respond to hormones from the pituitary gland in the brain: follicle stimulating hormone (FSH) and luteinising hormone (LH) and less estrogen is produced. Levels of FSH and LH subsequently rise and a measurement of FSH is sometimes used to diagnose menopause. The resulting low, and changing levels of ovarian hormones, particularly estrogen, are thought to be the cause of menopausal symptoms and later consequences in many women.

The term climacteric refers to the time in which the hormone levels are changing, up to the periods stopping; reducing and changing hormone levels can cause early menopausal symptoms. At this stage, there may still be enough hormones produced to stimulate the lining of the womb (endometrium) to produce monthly periods (menstruation).

Menopause means the last menstrual period. Periods stop because the low levels of estrogen and progesterone do not stimulate the lining of the womb (endometrium) in the normal cycle. Hormone levels can fluctuate for several years before eventually becoming so low that the endometrium stays thin and does not bleed.

Perimenopause is the stage from the beginning of menopausal symptoms to the postmenopause.
See our magazine article: Perils of the Perimenopause. PDF (115Kb)

Postmenopause is the time following the last period, and is usually defined as more than 12 months with no periods in someone with intact ovaries, or immediately following surgery if the ovaries have been removed.

Menopause - when?

The average age of the natural menopause is 51 years, but can occur much earlier or later. Menopause occurring before the age of 45 is called early menopause and before the age of 40 is premature menopause.

Generally, women having an early or premature menopause are advised to take HRT until approximately the average age of the menopause, for both symptom control and bone protective effect.

Late menopause may also occur but by the age of 54, 80% of women will have stopped having periods.

Links

" The one thing they wish they'd known about menopause

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Menopause Symptoms - what happens and when : Menopause Matters

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Menopause- what happens? All women will experience the menopause. Natural menopause takes place when the ovaries become unable to produce the hormones estrogen and progesterone. Menopause can also occur when the ovaries are damaged by specific treatment such as chemotherapy or radiotherapy, or when the ovaries are removed, often at the time of a hysterectomy.