25/05/2016 07:54 BST | Updated 24/05/2017 06:12 BST

The Menopause: All Your Questions Answered

Menopause is a natural phenomenon that occurs when the ovaries stop functioning (i.e. no longer produce eggs and thus estrogen and progesterone hormones). A main symptom is that the woman's menstrual cycle will stop; hence the name: 'menopause' [menstruation pause]. It's a perfectly natural process so nothing to worry about. However, it can dramatically alter her hormonal composition, impacting on her fertility, body, mood and much more. If managed properly, she will happily continue with her life as before; if not, she can become depressed, irrationally argumentative, her body can change making her feel less attractive and alienated from her loved ones.

This is easily avoidably with the correct gynaecological guidance and medication. Here are some tips to help:

1) Am I menopausal?

Menopause can begin at any age. If your period has stopped (or become irregular with long intervals) for longer than 6 months, this is a sign of early menopause (if aged <45) or actual menopause (if aged >48).

There are many other reasons why your period may stop. (E.g. due to hormonal imbalances, contraception or surgical damage to the uterus lining.) If you are concerned, please arrange an appointment with your gynaecologist.

2) I think I'm menopausal but I'm still menstruating. What does this mean?

Many people assume that if a woman is menstruating she is ovulating and fertile. This is incorrect. Most women menstruating experience healthy ovulation; however, sometimes, your period continues BUT you may have stopped ovulating and be menopausal. Similarly, you may experience intermittent menstrual bleeding, variable in amount, with some symptoms of the menopause. There's no right or wrong.

These tests can determine if you are menopausal and/or ovulating:

  • Menopause: Testing will determine the level of pituitary gland hormones in your body. If you're menopausal, the results will show elevated levels of FSH and LH hormones, and a reduction of the plasma estradiol.
  • Ovulation: Testing will determine the timing of your menstruation and a pelvic ultrasound will examine your ovaries and endometrium.

3) If I have early menopause (e.g. in my 20's), can I conceive?

Once you are menopausal (as confirmed by blood tests, examinations and ultrasounds), unfortunately, you won't be able to conceive using your ovaries. However, in the future, new science may permit women to use other cells within their body to replace their eggs and achieve pregnancy.

4) What are the main symptoms of menopause?

  • Menstruation changes. (E.g. irregularity (e.g. every 2-3 months); bleeding varies in heaviness or ceases completely.)
  • Hot flushes
  • Mood swings
  • Loss of confidence
  • Vaginal dryness, often causing painful intercourse (Dyspareunia)
  • Loss of libido
  • Weak hair and nails
  • Dry skin and dull complexion
  • Loss of memory and concentration
  • Premature aging caused by reduced collagen supply
  • (Note: Symptoms are variable between women.)

It is important to receive treatment as soon as you start experiencing symptoms. The sooner you do, the more manageable your symptoms will be and the less they will impact your body, mentality and overall quality of life. Procrastinating may result in serious long-term complications (e.g. osteoporosis, increased risk of heart attack and clotting of the vital organs) that could have been avoided.

5) What is the best medication for managing my menopause?

The most effective treatment is HRT (Hormone Replacement Therapy). This restores your body's hormonal balance of estrogen, progesterone and testosterone, which changed when your ovaries became inactive and stopped producing eggs.

Taking HRT early into your menopause substantially reduces the side effects incurred by depleted estrogen supply. For example:

  • It prevents loss of collagen in your skin.
  • It prevents you from experiencing extreme mood swings, depression and loss of confidence.
  • Your vagina will become moist, making sex pain free again and increasing your sex drive.
  • Your hair, skin and nails will appear healthier, nourished and revitalized.
  • Increased happiness, alertness and confidence.

Important: A huge myth was created by ill-informed 'experts' that HRT causes breast cancer. This is untrue. HRT provides your body with estrogen - a hormone that's naturally produced by all women's bodies. Therefore, if they're correct, why haven't all women had it?! HRT won't cause breast cancer so please don't avoid taking it on this basis. HRT has the potential to change your life so, if you're menopausal, I highly recommend taking it.

Before taking HRT, your medical history and examination will rule out any signs of cancer that could be accelerated by giving estrogen. If any exist, your gynaecologist will identify them and advise you further.

6) What should I do if I can't take HRT?

From experience, very few women are unable to take HRT if they're offered experienced gynaecological care and guidance. If you cannot take HRT for medical reasons (e.g. deep vein thrombosis), soya capsules with natural estrogen-like effects are a good alternative. They aren't available on the NHS but are sold in supplement stores (e.g. Holland & Barrett's or Boot's.)

For more information, visit