Dr Anna Reed

In my first blog for the Menopause Handbag I thought it might be best to start at the beginning and think about exactly what menopause is, what causes it, and what the various words around menopause mean. 

The word menopause comes from the ancient Greeks; ‘men’ or ‘meno’ means month, referring to the monthly cycle, and ‘pause’ means literally that – pause or stop. So this gives us our answer, it’s the process of stopping a woman’s monthly cycle. 

The medical definition gets a bit complicated and means the point in time when you have not had a period for over 12 months if you’re over 50 or for over 24 months if you’re under 50 (just to make it even more complicated!). For ease in this blog, I will refer to it being 12 months after a woman’s last period, but if you’re under 50 please swap this for 24 months.

The average age of completion of menopause in the UK is age 51, and by completion, I mean the precise moment when a woman is exactly 12 months after her last period. Technically, everything up to that moment when a woman may be having symptoms but is still have periods (even if they’re not very regular) is referred to as the perimenopause. After this specific moment in time we should refer to a woman as being postmenopausal, but, in reality most people just use the terms menopause or menopausal to cover all of these stages. 

It is actually pretty important to know where in the stages of menopause you are as our options to help with managing symptoms change with the different stages, and it also impacts whether you might need to be using contraception or not. In fact let me just flag that thinking about contraception is a really important area. Even if your periods are few and far between, you may well still need to be using contraception if you don’t want to be pregnant and you are in a relationship which could result in pregnancy. Contraception around menopause will be a whole future blog on it’s own, so watch this space!

So what causes menopause? There are two key female hormones that we need to know about when we’re talking about menopause – oestrogen and progesterone. Oestrogen is produced by the ovaries and is the important one when it comes to thinking about what causes menopause and the symptoms of menopause. 

Perimenopause (to be precise 😉) starts when the ovaries begin to produce less oestrogen. This is a normal process and will happen to almost all women at some point. For most women this will happen around their early 40’s although occasionally it can be earlier. When this happens younger than 40 it is known as early menopause or premature ovarian insufficiency – another future blog topic! Not all women have symptoms related to this reduction in oestrogen levels but a lot do – around 75% of women, and it is often these symptoms which will lead women to realising they are ‘menopausal.’ Perimenopause will last for different lengths of time for each woman, but is usually somewhere between 4 – 7 years. 

If you don’t have any symptoms related to dropping oestrogen levels then as a rule there is no need to seek out any investigation or treatment related to menopause. That is unless you have had an early menopause, as in that case, for most women, it would be recommended to have some form of HRT to help reduce some of the risks associated with early menopause – see comment above about future blog…

How do you know if you are going through the menopause?

Well, for the most part this is where we need to think about the symptoms that can happen during the perimenopause and frustratingly it’s a long and varied list. Our bodies don’t read a rule book and each woman can have a different combination of symptoms coming on at different times. Just to make it even more tricky to know what’s happening to you, there are also other medical conditions that can cause similar symptoms. So, what hope do any of us have of spotting when we are perimenopausal and more importantly getting the right help when it’s needed?

Well a great starting point is to have a look through the list of symptoms below which can (note can meaning not always) be associated with perimenopause. Two of the most common symptoms are flushes and sweats. These are referred to as vasomotor symptoms and are the symptoms that most people tend to associate with menopause. They happen in around 70-80% of women. 

I’m going to leave you with the list for now to have a look through and have a think about how much any symptoms you have are bothering you. If they are causing issues for you and impacting your daily life then do have a look around other areas of the Menopause Handbag where the team will give you a whole host of tips, but also consider requesting an appointment with your local GP practice to discuss your symptoms. Feel free to take this list with you  to your appointment so you can tick off with your healthcare professional the symptoms you have:

  • Poor quality sleep and difficulty sleeping
  • Low energy levels and fatigue
  • Anxiety
  • Low mood
  • Mood swings
  • Poor memory and concentration
  • ‘Brain fog’ – described by a patient of mine as a woolly head
  • Joint aches and pains
  • Headaches
  • Palpitations
  • Low libido
  • Vaginal dryness and soreness
  • Urinary leaking and/or frequency
  • Itchy and/or dry skin
  • Changes in periods
  • Breast tenderness

My next blog will be thinking about what we can do to try and help your menopause symptoms…..catch you then 😊 


Dr Anna Reed

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