Most women reach the menopause between the ages of 40 and 55 in the UK. The average age is 51.

The production of sex hormones slows down; the ovaries stop producing eggs; and monthly periods become less frequent and eventually stop altogether, so after the menopause a woman can no longer get pregnant. The menopause is an oestrogen-deficiency state and the symptoms that arise are due to lack of oestrogen. Most of them are cured by taking oestrogen in the form of hormone replacement therapy (HRT). The symptoms most commonly associated with the “change” include hot flushes and night sweats; dryness and soreness of the vagina and consequently some pain on intercourse; anxiety, depression, irritability and tiredness; an inability to sleep at night; a fall in sexual interest; dry skin and thinning hair; and urinary and bladder problems due to the thinning of the bladder lining.

Women going through the menopause have a tendency to put on weight particularly around the waist, “middle-age spread”. This change in shape with loss of the waistline is a sign that carries an increased risk of heart disease, a side effect of the menopause along with stroke, osteoporosis and Alzheimer’s disease. All of these long-term health hazards of the menopause are ameliorated by HRT.

I believe in women managing their menopause and taking steps to have the menopause they want. There are many tools all women can use in taking responsibility for their own menopausal health. The single most effective tool available is HRT.

Measures You Should Take

As well as vitamins and herbal remedies available for menopausal women, there are a number of useful things that you can do to help yourself. To cope with hot flushes, for example, try to keep the room temperature fairly low and wear loose rather than tight clothing (cottons are good). At night it may be useful to have blankets that you can peel off easily if you get very hot. And keep spare night clothing by the bedside in case you have a night sweat. Avoid strong coffee, alcohol and salt. A glass of cold water may help.

If you feel that you are getting hot and red, then you may also be able to help yourself by “thinking cold”. Imagine that you are standing in several inches of snow, or wandering around at a ski resort or taking part in an Arctic expedition. Your skin temperature will fall in response to your imagination and the amount of flushing that takes place will be kept to a minimum.

Finally, even though you feel bright red during a flush, do remember that the flush will probably be hardly noticeable to people around you.
To cope with a dry vagina and make intercourse more comfortable, try using an oil or jelly. You can buy special products from your local pharmacy or you can use an unscented body oil or baby oil. (Avoid anything too thick or greasy or lubricants containing alcohol or medicaments.) Remember that saliva makes a useful and effective lubricant.

Remember that saliva makes a useful and effective lubricant. Annoying or persistent menopausal symptoms merit a visit to the doctor since HRT is considered by many doctors to be safe and effective for most women who have problems. HRT can ease the symptoms women find most troublesome and, despite some controversy in the past, the majority of doctors now agree that replacing missing hormones is sensible, natural and acceptable. Where necessary the treatment can be continued for several years. Indeed I personally see no reason to stop. Finally, remember that although most women do get one or two symptoms, many women go through the menopause with no unpleasant symptoms at all.

Coping With The Menopause The Non-Hormonal Way

Some women sail through the menopause without any problems but most experience symptoms ranging from mild to very severe. Hormone replacement therapy can make all the difference – but what are the options if HRT is unsuitable for you or your personal preference is not to interfere with nature? The good news is there is a lot you can do to help yourself, and homeopathic and herbal treatments can go a long way to relieving symptoms.

Homeopathy

This is a form of natural heading based on the principle that a substance that produces the same symptoms as an illness will, in a very dilute form, help to cure that illness. Homeopathic remedies are derived from mineral, animal or vegetable matter. The homeopathic view of menopausal problems is that they are a manifestation of existing imbalances that can only be treated with regard to the mental and physical make-up of an individual. Women are encouraged to prepare for the menopause by looking at their overall health and developing a positive attitude before its onset.

If you would like to treat your symptoms homeopathically, it is a good idea to consult a homeopathic practitioner If you decide to treat yourself, bear in mind the following things.

  • You should stop taking a remedy as soon as your symptoms start to improve.
  • If your symptoms are not relieved after six doses, seek medical advice.
  • Homeopathic remedies should be kept in a cool, dark place away from smells.
  • Some substances, such as coffee, peppermint, menthol and camphor, counteract the effects of homeopathic remedies and should be avoided.
  • Some homeopathic pills are coated in milk sugar and you should avoid them if you are allergic to milk.
  • If your symptoms are very acute, you can take a remedy hourly. For longer-term problems, remedies can be taken in the morning and at night.

Herbalism

Some of the oldest methods of healing the sick are based on herbalism. Herbal lore was handed down through families who had their own recipe books of tonics and teas.
Like homeopathy, the aims behind herbal treatment are to remove the cause of the symptoms rather than merely the symptoms themselves and to improve the patient’s general standard of health. A disadvantage of herbalism is that agreement over which remedies should be used for particular disorders is still surprisingly limited.

However, herbalism does offer an attractive alternative to other forms of treatment in that it allows for experimentation with a variety of herbs without the complication of serious side effects. It is also recognized that herbal remedies can work as a complement to orthodox medicine. However, it is important to mention that few remedies have been subjected to tightly controlled clinical trials.

If you plan to treat your symptoms with herbs you would be wise to follow these guidelines.

■ Always use herbs in moderation.
■ Discontinue use if you start to experience side effects.
■ Give each herb a week or two to assess its effect.
■ Start by taking a herb in tea form. Increase the amount from half a cup a day to several cups a day, over a period of a week.
■ Don’t take herbs for longer than a few months without a break.
■ If you are taking medication, you should check with your doctor before you take a herbal remedy.
■ Don’t defer seeking medical advice because you are taking a herbal remedy.

Chinese Herbs

Chinese medicine views illness as a result of an imbalance or disturbance in the body’s two energy forces, yin and yang. Chinese medicine tailors its remedies and dosages to the individual woman and her symptoms. You should consult a Chinese doctor for an individual diagnosis.

Vitamins and Minerals

We all know how important it is to eat a balanced diet to stay healthy but it is especially important during the menopausal years to have a sufficient daily intake of vitamins and minerals.

Symptoms of Menopause

Night Sweats

The night-time equivalent of the hot flush is the night sweat, in which you wake up hot and drenched in perspiration. Most women who experience night sweats also have hot flushes during the daytime, but the reverse isn’t always so. Night sweats can very occasionally be a symptom of stress, or of a disease that is unrelated to the menopause – if you consult your doctor he will be able to make a diagnosis.
Sleeplessness in menopausal women is nearly always linked to night sweats.

Self-help

  1. Keep your bedroom temperature fairly cool. Leave a window open; try to create
    a draft.
  2. Avoid night clothes and bed linen that are made of nylon or polyester as they can act like sheets of plastic, holding the sweat next to your body. Cotton fabrics will be more comfortable.
  3. Keep a battery-operated fan, a bowl of tepid water, and a sponge on your bedside table so that you can cool yourself down quickly and easily. Never use cold water as it can cause you to overheat after you have applied it. Allow the tepid water to evaporate from your skin – as it evaporates it will take the heat from your skin, which will make you feel cooler and bring the feeling of fever to a more rapid end.
  4. Relaxation is particularly therapeutic – it calms the mind and body, which in turn normalizes body chemistry and makes the skin sweat less.

Muscle and Joint Symptoms

Collagen is a protein that provides the scaffolding for every tissue in the body and when it begins to disintegrate at the menopause, muscles lose their bulk, strength and co-ordination and joints become stiff.

Self-help

  1. If you keep your muscles strong with exercise you will stave off osteoporosis and bone fractures, you’ll be more agile and, if you do trip up, muscle strength and co-ordination will help you to fall with less impact.
  2. If you are suffering from rheumatoid arthritis or osteoarthritis, your doctor will advise you about self-help aids for use in the home.
  3. If you are suffering from stiff and swollen joints, a poultice made with cayenne pepper may be helpful.

Premenstrual Symptoms

If you have suffered from premenstrual syndrome all your life, you are more likely to experience intensified symptoms as you become menopausal. The symptoms of PMS usually include fatigue, anxiety, irritability, tearfulness, breast soreness, water retention, skin problems, sugar cravings and insomnia.
If you suspect your mood swings are PMS- related, you can confirm this by charting your menstrual cycle for three months and recording your symptoms on a day-to-day basis.

Self-help

  1. Avoid sugar cravings by eating several small meals a day – you will find that your cravings lessen if your blood sugar level is stable.
  2. Eat less salt as it increases water retention and bloating.
  3. Avoid alcohol and caffeine; they aggravate many of the emotional symptoms of PMS.
  4. Make sure you are getting enough calcium, magnesium, vitamin B6, and vitamin E, as these may reduce emotional symptoms.
  5. Get plenty of exercise.
  6. Aromatherapists recommend the oils of ylang-ylang, lavender and lemon grass, which you can use in a warm bath.

Skin, Hair, Eye, Mouth And Nail Symptoms

The lowered oestrogen levels that occur at the menopause cause changes in the skin, hair, nails, eyes, mouth and gums.

Self-help

  1. Moisturizing is important as you grow older. Avoid soap, which strips skin of its natural oils, and use special cleansing creams and lotions.
  2. Toenails and fingernails need special care, so give yourself a manicure and a pedicure at least every six to eight weeks.
  3. Ulcers in the mouth and on the tongue should be treated immediately. Rinse your mouth with salty water or use a proprietary ointment. If rough edges on your teeth are causing ulcers, have them filed down.
  4. Guard your skin from the sun. As the years pass, you will be less protected from exposure to sunlight. Avoid direct sun at all times and when you go out in sunny weather, wear a sun block. If possible, limit your exposure to the sun to the early and late parts of the day.
  5. The health of the skin, nails and hair and eyes is largely dependent on a diet rich in vitamins, minerals and trace elements. It is essential you have a sufficient intake of the vitamins A, B, C and E as well as potassium, zinc, magnesium, bioflavonoids, iron, calcium and essential fatty acids. Particular attention should be paid to the B vitamins, especially Bj, B2, B3, B6, B12 and folic acid.

Insomnia

If you are feeling depressed or anxious or you are suffering from night sweats it can become difficult to get to sleep and common to wake early in the morning.

Self-help

  1. If you take a long walk or some other form of aerobic exercise an hour before bedtime the quality of your sleep should noticeably improve.
  2. Warm milk at bedtime works for many insomniacs. This may be due to the action of calcium on the nerves.

Stomach and Bowel Symptoms

Bloating with abdominal distension may be a problem during the menopausal years. It is usually due to gas in the large intestine produced by fermentation in the bowel. Constipation is another frequent symptom at the menopause because intestinal’ motility (movement) is affected by the sex hormones.

Self-help

  1. A high-fibre diet, plenty of fluids and frequent exercise will keep the bowels normal. Cutting down on sugar, dairy products and alcohol will also help.
  2. Eat foods that cause fermentation, such as foods containing yeast and sugar, only in the early part of the day.
  3. A fast, effective remedy for constipation is to eat lots of prunes and figs, fruits that are both high in fibre.

Emotional Symptoms

Feelings such as tension, anxiety, depression, listlessness, irritability, tearfulness and mood swings can occur at any age, but they rarely occur together or as frequently as they do during the menopause.

Self-help

  1. Severe mood swings and irritability can distance you from your partner and, occasionally, can jeopardize a relationship. However, if you share your feelings you may find your partner is very supportive. Several studies have shown that partners are keen to understand menopausal symptoms and would prefer to have insight into potential problems before the onset of the menopause.
  2. Women who go to self-help groups may be better able to deal with depression. Think about joining such a group, or starting one up yourself.
  3. 20-30 minutes of strenuous exercise results in the release of endorphins, producing an “exercise high” that lasts for up to eight hours.
  4. Yoga, relaxation techniques and meditation all promote tranquillity and combat anxiety.

Intellectual Symptoms

Forgetfulness is one of the most common symptoms that menopausal women complain about and they may experience it long before they actually stop menstruating. The ability to concentrate can also become impaired.

Self-help

Any sort of work or studying will go a long way to preserve your intellectual ability. It’s never too late to get a job, although many women in their menopausal years express fear about how to go about finding one. Many universities, colleges and evening classes offer courses in a range of subjects, including employment retraining.

Breast Symptoms

It is estimated that 70 percent of women in Britain suffer from breast pain at some time in their lives but particularly in the premenopausal and premenopausal years.

Self-help

  1. Ask your doctor to examine you to exclude a lump.
  2. Wear a good supportive bra and if necessary go to a special bra fitter. Wearing
    a bra in bed may relieve pain during the night.
  3. Cut down on the amount of saturated fat you eat.
  4. One of the essential fatty acids, gamolenic acid, which is found in evening primrose oil, significantly reduces breast pain in up to
    70 percent of women and has not been found to have any side effects.
  5. If the breast pain is very severe it may be treated by drugs such as danazol and bromocriptine, which alter hormone balance. However, these drugs can have side effects, including nausea, weight gain and sometimes hirsutism (excess body hair) and lowering of the voice.

Weight Gain

The weight we may gain at the menopause is due to a slower metabolism – something that affects both men and women as they grow older – and a decline in oestrogen levels, which affects the way that fat is distributed. It is important to have a realistic outlook and be aware that changes in body shape happen to all postmenopausal women. Excessive or faddy dieting is unhealthy.

Self-help

If your weight is over the recommended weight for your height and age, the following tips may help you to lose weight.

  1. Drink half a pint of water before you start to eat. This will make you feel more satiated at the end of the meal.
  2. Put your food on a small plate. This controls the amount you can reasonably eat at one sitting.
  3. The more time you take eating food, the more satisfied you’re likely to feel. People who over-eat usually eat quickly; they don’t taste the food and have to eat more in order to feel satisfied.
  4. Taking exercise an hour or so before a meal is a potent appetite suppressant. Eat your largest meal early in the day when you have most time to burn up the calories you’ve eaten. Avoid eating large meals late in the evening – sleeping during the night does not burn off many calories.

Sexual Symptoms

A common myth about the menopause is that it marks the beginning of a woman’s sexual decline. Nothing could be further from the truth. The majority of women can continue to experience sexual pleasure well
into old age.

Self-help

  1. Before sex put some sterile, water- soluble jelly on your vaginal entrance.
    Water-based jellies are better than oil-based ones because they are less likely to promote bacterial growth and infections and they will not cause the rubber of a condom to perish.
  2. Avoid douches, talcum powder, perfumed toilet papers and any fragranced bath oils and foams, which can irritate the vagina.
  3. Avoid washing the inside of your labia with soap as it will dry the skin.
  4. Avoid remedies for genital itchiness containing an antihistamine or perfume.
  5. Spend longer on foreplay to give your body more time to produce its own lubrication.
  6. Women who have low histamine levels may find it difficult to reach orgasm. Women who take antihistamines regularly need to be aware of the possibility of decreased sexual desire and delayed orgasm.
  7. Zinc is a mineral associated with histamine production and deficiency can be common in women who suffer from heavy bleeding or women who diet a lot. You can increase your zinc intake by including more zinc-rich foods, such as sardines and wheatgerm, in your diet.

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