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Managing Menopause

Menopause can be a confusing time for women. The changes you're subject to at this time with your hormones can have a significant impact on a woman's body, emotions and mental health. It's no coincidence that the menopause was once known as the “change of life”. This is a time when, typically, the children are grown and people can look forward to the next stage of their lives after raising their family. 

Menopause is normally expected around the age of 50; however, the symptoms that affect women during this period can start in their 40s, or sometimes even earlier. This article will look at what menopause is, how to know if you're being affected by menopause or perimenopause and what action you can take to improve menopause symptoms.

London women's health physiotherapist showing how exercise can help with menopause symptoms.

What is Menopause?

It might be surprising to know that menopause is actually one day, or one moment, in time. Officially it's the point at which a women's periods have been stopped for 12 months. After that, you're in postmenopause, and the time before is perimenopause. The symptoms that are associated with this time, like hot flushes, mood swings or changes in their menstrual cycle, generally start before menopause and continue for months or years into postmenopause.

The changes that mark this time are caused by fluctuation in progesterone and estrogen, hormones produced by the ovaries. That's why when a woman has a total hysterectomy, including removal of her ovaries, she will begin to experience menopausal symptoms immediately, regardless of her age.

A woman uses a fan to relieve hot flushes due to menopause symptoms.

Symptoms of Menopause or Perimenopause

There are more than 30 symptoms that are associated with menopause, but many women will likely be affected by only a fraction of those, and some may not have any unpleasant side effects at all. But there are some classic signs that indicate menopause is approaching and that most women will experience to a greater or lesser degree. 

 Here are the 10 most common signs of menopause:

Irregular periods. Even if your monthlies were always regular during your life, a change in your cycle is often the first sign of perimenopause. This might be differences in timing or changes to flow, such as heavy bleeding or spotting. 

Hot flushes. Everyone has seen images of the middle-aged woman red-faced and fanning herself. The sudden onset of extreme body temperature that typifies the hot flush might be a bit of a cliche, but that's because it's one of the most common symptoms of menopause. It has been described by some women as feeling like they have an inner furnace.

Night sweats. Many people experience overheating at night, but the type of sweating that comes with menopause is distinctive. Like a hot flush, it is generally sudden, extreme and can result in soaked clothing and bedding. 

More frequent urination. A decrease in estrogen can also have an impact on the pelvic floor and the way it supports the pelvic organs, including the bladder. Changes to bladder and bowel habits can follow, and sometimes pelvic organ prolapse. 

Sleep disturbance. With the hot flushes, night sweats and frequent need to wee, it's no wonder that women also suffer from poor sleep in perimenopause and beyond. But alterations to hormone levels can also create anxiety-related sleep disturbance and early-morning wakening. 

Mood swings or irritability. Depression isn't caused by menopause, but research has shown that about 20% of women do have symptoms of depression during this period of their lives. Menopause disrupts the body's production of serotonin, which is the chemical that regulates anxiety happiness and mood. 

Vaginal dryness and/or itching. It's normal for perimenopausal women to experience a decrease in vaginal lubrication. Excessive dryness, burning or itching can indicate a condition called atrophic vaginitis. This is a thinning of the vaginal walls, and it's most common in women who smoke, have never given birth vaginally or who are not sexually active. 

Painful sexual intercourse. As many as half of women will find that having sex is painful in perimenopause and menopause. The dryness and deterioration of the vaginal wall can also mean that tears to the delicate tissues are also more likely. 

Pelvic floor dysfunction. Painful sex can also indicate a problem with your pelvic muscles. Regardless of whether or not you've ever had children, it's very common for women to experience bladder or bowel weakness or incontinence during this time. Pelvic floor tension or weakness can also lead to prolapse. 

Cognitive impairment. Memory problems, brain fog and difficulty in concentrating are some of the most common complaints of women going through menopause or perimenopause. It can affect your work and your confidence, and some women describe it as feeling like they're "going crazy".

A woman suffering from mood swings and irritability because of menopause perimenopause symptoms.

Managing Menopause Symptoms

No two women's menopause experiences will be the same. Most women will be affected by at least some of the common symptoms, but you might not be affected by all or even a lot of them. The severity of their impact will also vary between individuals.  

What decides how intense the symptoms are? 

Genetics play a major part in a woman's menopause, and it's possible that your experience will be the same or similar to your mother's. However, there are some other outside factors which can have an impact on the symptoms, such as body mass, smoking, diet, level of fitness and general health. Because these factors can all impact on your menopause and perimenopause, there are actions you can take to improve your experience.

What can I do to improve menopause symptoms?

When it comes to surviving perimenopause and menopause, the first thing you might think of is hormone replacement therapy (HRT), a treatment provided by your doctor to replace the hormones you are losing. There are both advantages and disadvantages to HRT, and it's not advised at all for some women. If you're looking for more natural help to ride out the menopause, here are some steps you can take.

There are a number of things you can do to help with hot flushes. You will probably find that they are sometimes triggered by certain foods or situations, so avoiding those triggers can help stave off some of them or minimise their intensity. Some common triggers of hot flushes are:

  • spicy foods
  • alcohol
  • caffeine
  • stress
  • sugar

Night sweats due to hot flushes during sleep can be particularly uncomfortable. Opt for lightweight sleepwear and stick with breathable natural fabrics like cotton or silk for your PJs and your sheets. A bag of frozen peas under your pillow can help cool you down once the flush hits.

If you're struggling to sleep even without the night sweats, try some exercise any time up to three hours before bed, as it's proven to help with better sleep. Classic relaxation techniques such as yoga and meditation can also boost your ability to sleep. 

The mood swings caused by menopause can make PMS look like a fun day. Relaxation techniques and planning fun activities might help. But if you're really struggling, your doctor might be able to prescribe low-dose hormones or antidepressants.   

For problems with itching, pain or having sex, try a water-based vaginal lubricant or specialist moisturiser which are readily available without prescription. Your doctor can also prescribe creams or tablets that can also help.

A womens physio helping menopausal women with treatment for perimenopause symptoms.

Menopause MOT

A women's health physiotherapist will give you a comprehensive assessment to identify any weakness in your core, posture or pelvic floor that can also come with menopause and perimenopause. 

You will gain a wealth of exercise and lifestyle tips to help deal with your symptoms and a personalised plan for tackling the specific problems you're having. Pelvic floor dysfunction can cause painful sexual intercourse, incontinence or prolapse. A women's health physiotherapist can give you the tools to improve your pelvic health and move through this part of your life with knowledge, understanding and confidence.


For more information about managing your menopause, perimenopause or other women's health issues, call Magdalena on 07877 017 936 or drop PelviCare an email. Alternatively, you can book an appointment online

PelviCare Women's Health Physiotherapy is located in Greenwich, London, serving women across South London, East London, Essex, Kent and beyond.  

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