Most women going through the menopause experience typical symptoms caused by a natural dip in oestrogen levels. “The most common are hot flushes, night sweats, vaginal dryness, difficulty sleeping, low mood or anxiety, reduced sex drive (libido) and problems with memory and concentration,” says Dr David Edwards, a GP and specialist in female sexual dysfunction. “For some women, these symptoms may continue for up to 15 years.”
As women approach their late 30s, their ovaries start making less oestrogen and progesterone — the hormones that regulate menstruation — and fertility declines. In their 40s, during the peri-menopausal period, women’s’ menstrual periods may become longer or shorter, heavier or lighter, and more or less frequent, until eventually, on average, by age 51, the ovaries stop producing eggs and the woman has no more periods.
“Oestrogen plays a role in body temperature regulation, which helps to explain why hot flushes and night sweats occur. Declining oestrogen can explain changes in skin and hair. Loss of oestrogen causes the vaginal epithelium to become redder and thinner, causing dryness,” says Dr Edwards.
Changing hormone levels may also cause mood swings and other emotional changes. The impact oestrogen and progesterone have on the body is widespread, and research continues to be done to better understand the roles these hormones play.
“These hormonal changes occur naturally but can be exacerbated by poor lifestyle choices, smoking, excessive alcohol, poor diet, lack of exercise and so on,” explains Dr Edwards. “Hysterectomy, chemotherapy and radiation can also bring on the menopause and its symptoms. This can be very distressing for the patient as in these situations the menopause occurs suddenly and often at a younger age.”