The menopause is also known as the 'change of life' or the 'climacteric'. It is part of the natural ageing process of a woman and is the time in a woman's life when menstrual periods stop. The menopause usually occurs between the age of 45 and 55 but it can occur earlier or later than this. A woman will usually experience the menopause at a similar age to her mother.Sometimes periods stop abruptly but in many cases the menopause occurs gradually. Periods can become irregular until they eventually stop altogether. This is known as the 'perimenopause'. During this time periods may also become lighter or heavier than normal.Reduced levels of oestrogen can give rise to other symptoms during the perimenopause. These can include hot flushes, night sweats, sleeplessness, headaches, lack of concentration, poor memory, tiredness, mood swings, tearfulness, irritability, dry skin and hair, brittle nails, a pounding heartbeat (palpitations), vaginal dryness and a loss of interest in sex. Eventually these symptoms should subside.

Oestrogen protects the body from heart disease and osteoporosis. Levels of oestrogen fall during and after the menopause therefore women become at greater risk from these diseases in later life.

Causes

Before the menopause occurs, the balance of hormones in a woman's body starts to change. Oestrogen and progesterone levels drop, and levels of gonadotrophin and androgen hormones increase. Eventually the ovaries stop producing eggs.The menopause can occur naturally or as a result of having a hysterectomy involving the removal of both ovaries.

Certain factors can bring about a premature menopause such as smoking and excessive dieting and exercise.

Treatment

Hormone replacement therapy (HRT) is widely used to treat the symptoms of the menopause. It is available in many forms including tablets, implants, patches, cream, gel and pessaries. As well as treating the short-term symptoms of the menopause, HRT can also help to reduce the long-term risk of heart disease, stroke and osteoporosis. There is, however, evidence to suggest that HRT can increase the risk of breast cancer and endometrial cancer.HRT is not a contraceptive therefore a separate method of contraception should be used. It is possible that women can still conceive for up to two years after their last period.If sex is becoming painful due to vaginal dryness, lubricants may help. Ask your pharmacist for advice.

Plant oestrogens are similar in structure to human oestrogens and can help to relieve symptoms of the menopause. They can be found in the following foods: soya beans, soya beansprouts, soya flour, tofu, soya milk, soya drinks, soya yoghurt, chickpeas, kidney beans, mung beans, haricot beans, green split peas, green beans, broad beans, citrus fruits, rhubarb, berries and currants, plums, cherries, papaya, pomegranate, cranberries, apples, pumpkin, broccoli, cabbage, carrots, fennel, sweet potato, potatoes, squash, peas, cucumber, celery, peppers, alfalfa, beetroot, garlic, sage, parsley, sesame seeds, linseed, aniseed, sunflower seeds, oatmeal, oat bran, barley, wheat, rye, rice, hops, corn, corn oil, brewer's yeast, olives, olive oil, red clover, red wine, red grape juice and liquorice. Plant oestrogen supplements can also be bought in tablet or capsule form from most good health food shops and pharmacies.

When To See A Doctor

Make an appointment to see your doctor if any of the symptoms mentioned in this leaflet are causing you distress.

Women under 45 years of age who think they are experiencing the menopause should also see a doctor.

Additional Information

Additional information about the menopause can be obtained from the 'Well Woman Clinic' at your local health centre.

Alternatively, The Amarant Trust provides information and support about the menopause. They can be contacted at 80 Lambeth Road, London SE1 7PW. Tel: 0171 401 3855. Fax: 0171 928 9134.