Am I going through the menopause? Dr Mary Ryan shares the symptoms to look out for – RSVP Live

Education around hormonal health is sadly lacking, with many women thinking they are suffering from depression or dementia when actually they are entering the menopause.

Here, Dr Mary Ryan explores the difference between perimenopause and menopause, the various symptoms involved, treatments available and a new surgery which could actually delay the menopause by up to 20 years.

For some women, the first clue they have been experiencing symptoms of the menopause is after they arrive at the doctors surgery, fearful that something is gravely amiss.

Women often think they are suffering from depression. And I have patients coming to me saying, Doctor, my memory is gone, am I getting dementia? But in fact it is all down to hormonal imbalance as they enter the menopause.

Women of my mothers generation never discussed menopause, they suffered dreadfully and were supposed to put up and shut up. But menopause is something all women should discuss and the stigma needs to go. Too many women struggled in the past, which was wrong and unnecessary.

Perimenopause Vs Menopause

Perimenopause begins several years before menopause, as the ovaries gradually begin to make less oestrogen. Perimenopause usually starts in a womans 40s, but can start as early as your 30s. The transition phase to menopause may last four to eight years and it is very important that during this time of hormone imbalance that women pace themselves and listen to their bodies requirements as this helps with hormone regulation. Menopause officially kicks in when the ovaries produce so little oestrogen that eggs are no longer released, also causing your periods to stop.

Symptoms

The symptoms for perimenopause and menopause are extremely similar. The key difference is in their severity. Typically symptoms include: mood swings, depression, brain fog, hot flushes, sleeplessness, vaginal dryness, reduced energy, bloating, aches and pains and reduced sex drive.

Hormone Health Is Key

The decrease in oestrogen and progesterone that occurs in menopause can result in a reduction in your immune function.

Oestrogen and progesterone are also thought to play a role in autoimmune diseases where the immune system attacks the body, meaning menopausal women may be more susceptible to autoimmune disease. In addition, menopause results in a decrease in T cells, which are a key part of the immune system, and help destroy cancer cells, fight bacteria and orchestrate the immune response throughout the body.

Not only do womens immune systems become compromised during the menopause, but their mental health may suffer too. Oestrogen acts to increase your happy hormone, serotonin, as well as your memory neurotransmitter.

As these levels begin to fluctuate, your hormone levels also fluctuate affecting your mood, memory and your bodys energy levels.

This is wrongly labelled depression when it is actually a hormone imbalance that can often settle with no medication and a good support structure.

Has My Period Gone For Good?

Periods become irregular during the perimenopause. However, not having a period for six months doesnt mean it wont return. I always tell women to carry pads with them even when their periods are irregular because they could suddenly have a deluge. Perimenopause can start when youre about 47, and your cycle could remain irregular until you are 53 or 55, so it may be a long time before youre through it.

Am I Going Through The Menopause?

The only way to accurately confirm you are perimenopausal is to visit your GP. Women can have their hormones tested by their doctor and get the full basic tests of bloods including the hormones that control periods FSH and LH and the thyroid hormone to rule out any underlying conditions and confirm the menopause.

Treatment

Early intervention is key. Perimenopause is just the start and women who look after themselves at this stage will have a much easier menopause. Depending on the severity of your symptoms, a combination of diet, supplements and medication may be helpful. In my experience, 50 per cent of women do well after making some lifestyle changes, through healthy eating and natural supplements. In addition to the above, 30 per cent need medication for peripheral nerve pain and autonomic symptoms, and the remainder may need HRT. Everyone is different.

Diet And Supplements

Soya products are great sources of oestrogen. Both Omega 3 and B vitamins are also of benefit at this time. Vitamin B6 contributes to the regulation of hormonal activity and along with vitamins B1 and B12, it also contributes to normal psychological function. Vitamin D3 is important for bone health as we age, as osteoporosis can become an issue for women as their oestrogen decreases. I like supplements like Cleanmarine which contain everything you need.

Hormone Replacement Therapy (HRT)

For patients with chronic symptoms, HRT can be a life changer. I reserve HRT for the women who come in profusely sweating which, thankfully, is only about 20 per cent. My preference is to prescribe the patch: you are getting the minimal amount and it is not as highly concentrated, which works very well for almost all of the women who try it. When prescribing HRT, I will always do a mammogram even if there is no history of breast cancer to ensure there is nothing there. I always inform women on the slight risk of breast cancer new research indicates it increases your risk by four per cent. However, this doesnt give any indication of whether there are other factors such as obesity. Some eight per cent of breast cancer is caused by excessive weight, and eight per cent is caused by excessive alcohol. Both of these figures pose a far more significant threat than HRT.

At the end of the day it has to be about the womans quality of life and she has to be trusted to make an informed decision.

A lot of women are now asking about bioidenticals a natural form of oestrogen but for me there isnt enough research yet.

Postponing The Menopause

A first-of-its-kind surgery is now being piloted which could delay the menopause by up to 20 years. The procedure involves removing a portion of a womans ovaries and then cryogenically freezing it. If this is safe then it will be wonderful and will offer working women a choice while taking some of the pressure off their shoulders. It would also allow women to hold onto their collagen production for much longer, however we dont have enough evidence to assure us of its safety just yet.

Stress And Self Love

Women need to listen to their bodies and rest more to allow the hormone control centre to cope better. Those who go into menopause pacing themselves and eating healthily fare much, much better. Your body is wonderful at adapting to change once we allow it to rest and be healthy.

Women need to realise that once they lose the protective effect of oestrogen in menopause they are at risk of heart disease so it is important that they keep their weight and blood pressure normal during this time and also look after their bone health.

I advise all my patients to listen to their bodies: when they are tired, they must rest. We plug in our mobile phones when they are in the red, but we must also do the same with ourselves.

We need to empower women to put themselves first and look after their wellbeing. After all, menopause is only the next chapter in their lives. It is part of a normal evolution and women can look forward to the next 40 years with vigour provided they take care of their health.

Dr Mary Ryan, consultant endocrinologist, will be a guest speaker at The M Word, Irelands first major conference on the menopause, on October 11 in Dublin.

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Am I going through the menopause? Dr Mary Ryan shares the symptoms to look out for - RSVP Live