October marks Menopause Awareness Month and today the Leigh Day Women's Rights in Healthcare event will focus on the menopause. Here, Michael Roberts and Philippa Wheeler discuss the menopause and why it is important to raise awareness.
What is the menopause?
The menopause is the time when a person stops having menstrual
periods and the ovaries lose their reproductive function.
Menopause is caused by a change in the body's hormone
levels, in particular oestrogen. Over time, the level of oestrogen
produced by the body decreases until it eventually stops.
Symptoms vary from person to person when
going through the menopause. Hot flushes are experienced by every
three in four people going through the menopause and are the most
common symptom. Other common symptoms include night sweats, vaginal
dryness, difficulty sleeping, low mood or anxiety, reduced sex
drive and problems with memory and concentration.
When does the menopause occur?
In the UK, menopause usually occurs between 45 and 55
years of age, with the average age being 51. The timing of
menopause varies from person to person and can be impacted by
lifestyle events such as hormone therapy, removal of the ovaries
and chemotherapy.
If your menopause occurs before 40, or between 40 and 45 years
of age, this is known as premature and early menopause
respectively.
In the years leading up to the menopause, oestrogen levels being to decrease. This leads to a perimenopause, where people experience some symptoms of menopause but continue to menstruate.
After one year without menstrual periods, the person enters the
postmenopausal stage. The postmenopausal stage carries the
particular risk of osteoporosis as, prior to menopause, oestrogen
assists in maintaining skeletal strength.
How is menopause identified and treated?
It is sometimes difficult to diagnose menopause. Symptoms and
irregular periods can be a sign of changes occurring in oestrogen
levels, but not necessarily menopause itself. However, symptoms are
the main focus of diagnosis as other investigations, such as
testing levels of the follicle-stimulating hormone (FSH), are not
always accurate in diagnosing menopause.
Menopause is not a condition that can itself be treated, but the
symptoms can be managed. Often, menopause symptoms are managed by
simply prescribing hormone replacement therapy (HRT), without any
further consideration of the person's symptoms or whether HRT
is a good idea in their case. Hormone replacement therapy is
frequently indicated for those with premature or early menopause, although
research is lacking in this area. It is recommended that people
know the date of their last period to help appropriately respond to
symptoms and be correctly prescribed any relevant
contraception.
It is important to appreciate that diagnoses based on symptoms alone require doctors to consider the subjective nature of symptoms for each person. Dr Louise Newson is a GP and menopause expert. She believes that "every woman is different and that's why every woman's experience of the Menopause is very different. And often, every woman's treatment of the menopause is very different. It's not a ''one size fits all'' and I think that is very important for people to realise."
Why is it important to raise awareness?
It is important for those going through the menopause to realise
they are not alone, and that menopause is not something that you
need to just get on with. Although everyone will experience
symptoms in a different way, there are ways to manage the symptoms
which will help and it is important that you try to seek assistance
if you think you need it.
The British Menopause Society also
suggests the following to help your body through menopause:
- Maintain a healthy diet
- Regular exercise
- Stop smoking
- Drink within reason
- Make use of health screening services
- Stay calm and positive
As healthcare lawyers, we are concerned about the education gap in the training medical
professionals receive regarding the menopause. While some
doctors are able to offer excellent menopause care to their
patients, there is a disparity in the training which may see others
less effective in their care and treatment of menopausal patients.
Specialist NHS menopause clinics are closing due to funding cuts
and there are concerns that this will lead to people not accessing
adequate care to assist them through the menopause and its
associated health implications.
If you have any concerns or questions about menopause, please
visit the British Menopause Society website and/or
consult your GP if you are worried about symptoms.
Register here for Leigh Day's
Women's Rights in Healthcare event on Menopause and perineal
injury.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
