Ladies in your early to mid 40s, this blog is for you – yes you! I’d love some younger eyes on it too, but the title mentions menopause so I suspect many of those on the south side of 40 have scrolled right on past.
“What” I hear them cry…”Menopause? Me? You calling me old???”
But here’s the thing – if you’re in your early forties the chances are that you’re very close to early perimenopause symptoms. Or you may be experiencing some symptoms already but aren’t even aware of it. And even if you aren’t right now –you probably will at some point soon, as 75% of women report experiencing menopausal symptoms with 25% describing them as severe (1).
I’d very much like you to be prepared for what’s to come. Because here’s the thing. For most women, perimenopause symptoms do not suddenly appear in their late forties. They sneak up slowly, and sometimes painfully. And they may not be what you are expecting. Yes ladies, there are some potentially weird and wonderful things ahead of you.
Yet over 90% of women (yes 90%!) report feeling unprepared for menopause with many who have experienced it wishing they’d known more.
Please don’t get me started on how a natural phenomenon, experienced by almost every female on the planet is still so poorly understood. Particularly by the very people who will experience it and those charged with our care.
But I digress. Let’s leave the midlife rage here for a second (that’s a very real thing BTW) and just get on with the job of giving you all a bit more information regarding what may be around the corner.
Here’s a few things you need to know about menopause right now.
1. Menopause symptoms may hit sooner than you think. Officially, the menopausal transition (encompassing perimenopause, menopause and post-menopause) most commonly begins around the mid-forties. Diagnosis is traditionally based on a persistent change of menstrual cycle length of 7 days or more. I do love a good arbitrary medical figure!
Clearly, this level of hormonal disruption does not happen overnight. In reality, many women experience increasingly erratic menstrual cycles and other perimenopause symptoms long before this. Most commonly between 40-44, but for some it can be much earlier. And many of these women are blissfully unaware that their symptoms relate to the big M.
2. Menopause lasts 1 day. Yes – you read that correctly. It begins the day after you haven’t had a period for one full year. Before that day, you are perimenopausal, and after that day you are postmenopausal.
In the UK the average age of menopause is 51 and it’s around that time in most countries. Now see point 1 and do the maths.
That means for many women perimenopause lasts somewhere between 4 and 10 years.
Yes, it’s a marathon ladies, not a sprint. Hence this article. You prepare for a marathon. You prep your body and mind – the same rules should apply here. If you want to minimise your risk of both physical and psychological menopause symptoms then it’s a great idea to put in the groundwork now.
Even if you are in the thick of it – a few key nutrition and lifestyle changes can make a BIG difference. The research is solid – so is my experience in clinic.
3. And, talking of symptoms… there are 34+ recognised perimenopause symptoms:
I’m genuinely not trying to ruin your day but there are many weird and wonderful ways our hormones can torment us in midlife. However, every woman’s experience is different – symptoms, severity, combinations, age of onset and duration. Take home point here?
Do not be told you are not perimenopausal because you are too young, you still have periods and your face hasn’t developed it’s own central heating system.
If you suspect you need support then seek advice from an expert. Not all GPs and healthcare professionals have specialised training. And I have heard some jaw-dropping stories from women being dismissed from consultation rooms, despite a catalogue of debilitating perimenopause symptoms. Why? Because they don’t quite fit the age bracket, they don’t have hot flushes or because they still have a fairly regular period.
Thankfully, there are some great resources available now – I particularly like Balance from Dr Louise Newson and her colleagues (see resources list at bottom of blog) who have collated a wealth of in-depth, current information for women about the menopause and associated health topics.
4. Hormones are unpredictable and strong-willed. They don’t go down without a fight. So rather than a slow, steady and sedate decline, they like to fluctuate erratically and dramatically for years. This can lead to seemingly random peaks and troughs in menopause symptoms and the recurrence of spotting or a full period just when you thought you’d reached the finish line.
For those who like to be in control (erm – that would be me then), now’s the time to lean into meditation, deep breathing and relaxation to help you navigate the chaos.
5. Our hormones own us. Reproductive hormones control more than just our reproductive system- so it’s a big deal when they go haywire and then start to flat line.
Of course, oestrogen and progesterone are best known for their role in female reproduction. However, these hormones also impact many other systems in the body. They are involved in maintaining bone density, blood sugar, cholesterol levels, brain function, blood flow and circulation, skin collagen and moisture, mood regulation and more. Oestrogen is also a potent anti-inflammatory. Find out more about how inflammation increases with age (particularly in women) in my blog ‘Inflammaging: What It Is, Why Care and How to Beat It’.
Therefore the potential impact of reduced hormone levels after 50 cannot be underestimated when when many of us may live into our 80s and beyond. And it is a key reason we need to engage in healthful nutrition and lifestyle habits, and consider hormone replacement support, to help us thrive into later life.
Which brings me nicely to HRT….
6. Hormone Replacement Therapy. HRT is a potentially safe and effective option for reducing symptoms.
I believe it is a very legitimate choice for most midlife women. Every woman should be presented with the most recent findings regarding HRT so they can make an informed decision.
The collective concern around HRT in the past 20 years predominantly relates to the results of one study released in the early naughties linking HRT to increased risk of both breast cancer and cardiovascular disease. That’s a pretty compelling reason not to use it.
Well yes, except the reported study results have since been found to have been fundamentally flawed and inaccurately reported. Both in the medical and public press.
Newer research suggests the increased risk of breast cancer may be very minimal in most instances. Lower than risks associated with being overweight, smoking, regular alcohol consumption, not exercising and other popular lifestyle habits. It is also generally linked to only specific types of HRT.
Findings also suggest HRT may be protective against multiple other chronic health conditions prevalent in postmenopausal women, including osteoporosis, cognitive decline (including dementia and Alzheimer’s), diabetes and cardiovascular disease.
Given the controversy, conflicting information, and potential benefits I would strongly encourage you to speak to a healthcare professional. Not all GPs have the most up-to-date information so seek out someone specialising in this area to help find the right HRT type, dose and delivery method for you.
Dr Louise Newson has a great podcast (see resource list below) explaining the basics. So you can decide for yourself whether to ignore this section or use it as a jumping-off point for more research.
7. Menopausal symptoms may not end at menopause. I know, I know, I hate to be the bearer of bad news but in the interest of just laying it all out there, symptoms can last up to 15 years post-menopause.
I can hear the collective ‘what the $*&^’ from here.
It’s not common, but it is possible. In my experience, it is not unusual for sporadic hot flushes, night sweats and mood swings to crop up when you least expect them for a few years after your last period. Those hormones are the gift that just keeps on giving.
Putting Menopause in Perspective
Ok – now take a breath. To put all of the above into perspective, and to hopefully justify me ruining your day.
Despite the above, I believe female midlife to be an empowering and opportunity filled life stage. Many women come into their own over 40 and thrive into their later years despite the hormonal challenges.
And some women cruise through menopause with barely a tepid flush in sight. If you’re one of them then high-five, take the win as others are not so lucky.
Many women will experience a bit of a roller coaster of symptoms, have good and bad days, good and bad months, but come out the other end relatively unscathed. They may also have a newfound understanding and appreciation of the need to take care of their bodies.
Then there are the women who suffer. Badly. This is often with limited support (at best), bad advice (common) and active discrimination (at worst). Relationships disintegrate because of menopause, female suicide rates are highest in the 45-49 years old age bracket. This has not been directly linked to menopause but the timing is interesting. Women leave careers they have loved as symptoms, and a lack of support, diminish their confidence in their ability to do their job.
But with improved knowledge, preparation (mental and physical) and support, many of these women could experience the menopausal transition in a far more positive way, with fewer and milder symptoms and greater resilience to rise to the challenges presented. Read my blog ‘Ten Important Nutrients for Menopause’ for information on how to support your body through the menopause.
So please, if you know very little about what lies ahead, speak to your older female relatives. Research suggests genetics play a part in menopausal experience so your mum is a great person to ask if you can). Read books, listen to podcasts, talk to wellness or healthcare professionals – generally seek out the information you need to make your journey as easy as possible.
And if you’re already out the other side, talk to your daughters, sisters, nieces, friends, colleagues and ladies at the back of your Zumba class. Get them to do their research and get prepared too.
The more we normalise discussion around menopause, remove the stigma and get decent support structures in place the more likely we are to improve women’s experience of menopause. This will allow more of us to focus on the immense opportunities for positive growth and development this life stage brings.
Feel free to share this blog with any women you feel may benefit from it.
If you like what you’ve read and would like more practical information and tips on nutrition, lifestyle and mindset for midlife women then I’d love it if you followed me at motherflushingmidlife at the social links below. And if anyone you know might benefit from my content, let them know where to find me xx
- British Menopause Society (2022). The British Menopause Society response to the Department of Health and Social Care’s call for evidence to help inform the development of the government’s Women’s Health Strategy. https://thebms.org.uk/2021/08/the-british-menopause-society-response-to-the-department-of-health-and-social-cares-call-for-evidence-to-help-inform-the-development-of-the-governments-womens-health-strateg/