Coping with the menopause

The menopause is an inescapable part of a woman's life and the effects of the "change of life" can be very distressing. However, there are treatments and support services that can help even the worst-affected through this testing time.

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A woman is said to have reached the menopause when she has not had a period for one year and the average age at which this occurs is 52, though some women under the age of 45 experience premature menopause. In the lead-up to the menopause, periods will become less and less frequent until they stop altogether. The change in hormones causes a range of physical and emotional symptoms.

Signs and symptoms
According to the NHS, an estimated eight out of 10 women experience some symptoms prior to the menopause.

Hot flushes, often starting in the face, neck or chest, are commonly associated with the menopause and those that occur at night are called night sweats. Because of this, many women have trouble sleeping throughout the night and this can lead to irritability, short-term memory problems and a lack of concentration.

Others experience vaginal dryness, itching or general discomfort which can make sex difficult or uncomfortable. Some women find they experience a sudden need to urinate and urinary tract infections such as cystitis often occur more frequently.

Many women do not need treatment as they go through the change, but if you are struggling to cope with the symptoms, seeking medical advice may help.

Hormone replacement therapy (HRT)
By replacing oestrogen, levels of which naturally fall prior to the menopause, HRT is effective in treating a number of the most common symptoms, including hot flushes, cystitis and vaginal discomfort.

Taken as a cream, gel, tablet, skin patch of implant, it is not without some side effects. There is a slightly increased risk of developing breast, endometrial and ovarian cancer but most experts agree the benefits outweigh the risks as long as HRT is used only in the short term (ie no more than five years).

Similar to HRT is Tibolone, a synthetic hormone that acts in much the same way. This is also effective in the treatment of hot flushes and night sweats and can improve sex drive, though it is not suitable for the over-60s.

Clonidine, on the other hand, was designed to treat high blood pressure but can help with hot flushes. It does, however, come with side effects and may cause drowsiness, depression and constipation so a trial period is advisable.

If depression takes hold as you go through the change, there is no need to suffer in silence - it happens to many women. Your GP will be able to prescribe antidepressants such as venlafaxine, fluoxetine and citalopram to help you get through the rough patches.

Self help
If you are keen to avoid medication and HRT, there are some simple changes that may help you to cope with the symptoms. Regular exercise can help to reduce hot flushes and the NHS recommends avoiding potential triggers such as spicy food, caffeine, smoking and alcohol. However, to improve the quality of your sleep, exercising late in the day should be avoided.

It is also important to take care of your emotional health during this period. Though exercise will help to reduce stress and release feel-good endorphins, plenty of rest is also essential. Many find taking up yoga or meditation helps to relieve some of the stress associated with the menopause.

A healthy diet, as always, is important at this time of life - ensure that you getting the correct amount of vitamins A to E and plenty of calcium (no more than 2,000mg per day) to maintain bone density, as the menopause can sometimes trigger osteoporosis.