Menopause

What is menopause?

Often referred to as ‘the change’, menopause marks the end of the monthly cycle of menstruation for women and your reproductive years. It means that you have run out of eggs (as females are born with all the eggs they will ever have during their lifetime), and as you’ll no longer have periods you won’t be able to conceive a child.

Menopause – safe treatments are available

There is now no need to put up with any symptoms that are adversely affecting your life. It’s a good idea to discuss what you are feeling with your GP or one of our specialists. We use the latest evidence and our years of expertise to guide you through effective management of your symptoms.

Watch John Eden speaking about Menopause and Breast Cancer on our You Tube channel.

Contrary to popular belief, both the contraceptive pill and menopause hormone therapy have a very small effect on breast cancer risk. The oestrogen arm of the Womens’ Health Initiative study (2014) showed that women taking long-term oestrogen had a lower risk of breast cancer than the control group. Prof Eden looks at the risk factors for breast cancer as well as the mechanisms involved in his 2024 peer-reviewed medical paper here Why does hormonal contraception and menopausal hormonal treatment have such a small effect on breast cancer risk?.

When does menopause happen?

Most women reach menopause between the ages of 45 and 55, with an average age around 51. The table below summarises the different stages of the menopause transition.

What changes can I expect?

During menopause, most women experience both emotional and physical symptoms, and some can greatly affect your quality of life. Around a third to a quarter of affected women will seek medical attention.

Some common symptoms include:

• Hot flushes
• Night sweats
• Insomnia
• Mood swings
• Aches and pains
• A sensation of ‘ants’ crawling under the skin
• Vaginal dryness
• Light-headed
• Headache

The postmenopausal phase of life is associated with adverse long-term health problems such as increased bone loss (osteoporosis) and an increased risk of cardiovascular disease (heart disease and strokes). 

How are menopause symptoms treated?

Until recently, standard treatment involved combining natural oestrogen with a synthetic progestin to protect the uterus from cancer. Unfortunately, the progestin slightly increased breast cancer risk. Body identical HRT involves combining natural oestrogen (oestradiol) with micronised natural progesterone. This approach protects the uterus from cancer and is linked to a significantly lower risk of breast cancer than HRTs containing progestin. Please see our News section for more details on this newly-available treatment. 

The initial consultation will take around 30 minutes, and will uncover details about your medical history to help us better understand your circumstances. This will include gathering information on your menstrual cycle, sleep patterns, contraception, and the menopause symptoms you are currently experiencing. To determine how much discomfort your menopause symptoms are causing you, we’ll typically use the form below, using a scale of 0-6 where 0 is “not bothered at all” and 6 is “extremely bothered”.

We can then recommend the best course of action for managing your symptoms. In many cases, some simple lifestyle changes may be all that’s needed to reduce the severity of your symptoms. These include a healthier, varied diet, more exercise, quitting smoking and thinking positively.

In others, we may recommend herbal remedies, hormonal treatments or non-hormonal therapies, and arrange a follow up appointment in around six to eight weeks to see how you are progressing.

Helpful resources

If you’d like more information you can view the health information fact sheets below or browse our Health Information page.

• Managing Hot Flushes
• Heavy Bleeding
• Depression, Anxiety, Sleep and Menopause
• Bioidentical hormones
• The Menopause Consultation
• Premature Menopause
• Menopause after Breast Cancer
• Incontinence
• Painful sex
• Managing PMS and PMDD
• Prolapse
• Herbal medicines

You can also complete this questionnaire at home to help you decide if you need to come in and see us.

References

1. Sherman S. Defining the menopause transition. American Journal of Medicine 2005; 118(12B): 35-75