FAQ’s:

Here is a list of questions and answers that are commonly asked by users.

What is the Menopause?

The terminology surrounding menopause can be confusing. While "menopause" is commonly used to refer to the entire transition, medically, it is just one day. Using the terms perimenopause, menopause and post-menopause helps differentiate between the distinct stages.

Perimenopause marks the transition leading up to menopause, characterized by decreased egg production and sex hormonal fluctuations, particularly in oestrogen, progesterone, and testosterone. These erratic hormone levels contribute to perimenopausal symptoms. Perimenopause typically spans from 4 to 10 years until hormone production ceases, leading to the cessation of menstrual cycles and menopause. The average age range for menopause onset is between 45 and 55 years.

Menopause means the cessation of periods. 'Meno' relates to menstruation, and 'pause' signifies stopping. In medical terms, menopause is reached when one year has elapsed since your last period regardless of any menopausal symptoms. Your ovaries have stopped producing eggs. If menopause happens before 45 years it is considered early menopause, if it happens before 40 years, it could indicate premature menopause, termed premature ovarian insufficiency (POI). Medical interventions like radiotherapy, chemotherapy, endocrine therapy, or surgical removal of ovaries can induce menopause, potentially intensifying symptoms beyond those of natural menopause.

Post-menopause is when you have not had a period for at least one year. You will remain post-menopausal for the rest of your life.

Why do we experience different symptoms of menopause?

Throughout a woman's life, ovaries release an egg every month along with important sex hormones like oestrogen, progesterone, and testosterone. These hormones, mainly produced in the ovaries, are crucial for sexual development and reproductive health from puberty through childbearing years. At the same time, our brain's pituitary gland releases important hormones called follicle-stimulating hormone (FSH) and luteinizing hormone (LH) to communicate with the ovaries. This communication involves sending messages from the brain to the ovaries and back, making sure everything works smoothly.

As our egg supply decreases, usually late 40’s or 50’s the ovaries produce fewer hormones, especially oestrogen, causing hormone levels to become unpredictable. When oestrogen levels drop, the brain increases FSH production to try to balance things out. We have receptors for sex hormones throughout various tissue in our body. Fluctuating hormone levels can affect the functioning of these receptors for each individual and cause different physical, cognitive, psychological, and genitourinary symptoms of menopause.

Each person's encounter with menopause is unique, influenced by factors such as diet, lifestyle, ethnicity, health history, psychological background, habits, and genetics, which can impact our bodies in diverse ways.

What are the symptoms of menopause?

We have receptors for sex hormones throughout various tissue in our body. Fluctuating hormone levels can affect the functioning of these receptors for each individual and cause various symptoms of menopause:

While this list is not comprehensive, it does emphasize the range of symptoms. These symptoms can fluctuate in intensity from mild to severe, may vary daily and can affect different individuals in diverse ways.

How do I know if I am perimenopausal?

The onset of perimenopause typically occurs in a woman's mid-to-late 40s, but it is important to understand that the timing can vary. While the average age for menopause onset in the UK is around 51, approximately 5% of women experience early menopause between 40-45, and 1% undergo it before age 40, known as Premature Ovarian Insufficiency (POI).

If you are over 45 years and notice changes in your menstrual cycle, and experiencing symptoms associated with perimenopause, it's likely you arre in this phase. Tracking your symptoms and sharing your experiences with a healthcare professional can lead to a diagnosis.

For those aged 40-45, similar signs apply. However, healthcare providers may conduct blood tests to rule out other potential causes for your symptoms, such as anemia or thyroid issues. Elevated Follicle Stimulating Hormone (FSH) levels may indicate perimenopause, but levels can fluctuate during this time, making diagnosis challenging.

If you're under 40, POI could be a concern. This diagnosis is crucial due to its implications for fertility and long-term health, including cardiovascular health and osteoporosis prevention. Blood tests are necessary for further investigation in this scenario.

Maintain a record of your perimenopausal symptoms to facilitate discussions with your doctor or healthcare professional.

If you have concerns or require medical advice, please speak to your doctor or healthcare professional.

What is surgical menopause?

Surgical menopause is brought about by surgical procedures such as the removal of ovaries (bilateral oophorectomy), inevitably leading to permanent menopause. The abrupt cessation of ovarian function triggers an immediate decline in sex hormone levels, resulting in pronounced menopausal symptoms, especially in pre-menopausal women.

How does breast cancer treatment cause medical menopause?

Medical menopause is often trigged by breast cancer treatment such as:

• Chemotherapy: This treatment can inflict temporary or permanent damage to the ovaries by targeting rapidly dividing cells. For some women, periods may cease as soon as chemotherapy begins, while others may maintain them throughout treatment. Typically, menstrual cycles resume within two years after completing treatment, but in about 10% of cases, periods may return three to five years later.

• Endocrine therapy (Tamoxifen and aromatase inhibitors): While not directly causing menopause, these drugs can lead to menopausal symptoms. Aromatase inhibitors offer substantial benefits in preventing cancer recurrence and enhancing survival in post-menopausal women. They cannot, however, be prescribed alone to pre-menopausal women but may be combined with ovarian suppression.

• Ovarian suppression: Interrupts communication between the brain and ovaries, resulting in decreased sex hormone levels. Ovarian suppressors can be administered alongside tamoxifen or chemotherapy.