Eavesdrop on a group of 40-something women chatting, and if the subject of odd ailments crops up, someone is bound to ask: ‘Do you think it might be because of the menopause?’
If you're not sure whether a bodily change is just ageing, a normal sign of hormones, or something more serious, we've rounded up some of the more surprising symptoms of the menopause ...
Most of us are aware of the obvious signs of the change – no more monthly periods, and of course no more getting pregnant. Many people are familiar with hot flushes, which affect 75% of women. The menopause is a natural part of life. If you haven’t had a period for 12 months in a row and you’re over 45, it’s highly likely you’ve gone through the menopause because your ovaries have run out of functioning eggs. On average, this happens to women at the age of 51. However, it can happen prematurely – if this is the case, it’s important for women to seek medical advice on how to protect their future health. Hormonal changes can begin as early as your late 30s (the perimenopause). It can be a bit of surprise, especially when you believe the menopause is years away. Research has found that frequent menopausal symptoms can last is on average, 7.4 years. With this in mind, we’ve rounded up some of the odder symptoms of menopause that you may experience – but don’t panic. There ARE solutions out there.
1. You get shorter
The phrase ‘little, old lady’ is based in reality. We do get shorter as we age. The discs between the vertebrae naturally shrink, making some height loss normal, but if you've lost more than an inch, it may be because the vertebrae are crumbling due to osteoporosis – a condition that is very much linked to the menopause because of the decrease in bone-protecting oestrogen. Mr Mike Savvas, consultant gynaecologist at The London PMS & Menopause Clinic comments: ‘Many studies have shown an excess risk of bone fractures in postmenopausal women compared to men of a similar age.’ He adds: ‘Perhaps the most important fracture resulting from postmenopausal osteoporosis is fracture of the neck of femur (hip fracture) because this often requires hospitalisation and surgery it is associated with approximately 20% mortality in the first year and many women do not regain their full mobility after this injury.’ So, what can be done to protect yourself against osteoporosis? Mr Savvas says: ‘HRT has been shown to be effective in preventing postmenopausal bone loss and may reverse and any bone loss that has occurred. It has been shown to reduce the incidence of fractures in post-menopausal women.’
2. You can’t sleep …
Insomnia during the menopause is pretty common. From perimenopause to post-menopause, as many as 61% of women report sleeping problems. Mr Savvas says: Quality of sleep declines with age and this is particularly so around the time of the menopause. Women may report difficulty getting off to sleep but more commonly the problem is disturbed sleep with women waking several times a night. ‘
Mr Savvas says vasomotor symptoms - the hot flushes and night sweats – are sometimes to blame, but not always. ‘Poor sleep is also a symptom of anxiety and depression which are common in women around the menopause,’ he explains. ‘It is important for women to follow good sleep hygiene especially around the time of the menopause but HRT has been shown to be effective in improving sleep, indirectly though the alleviation of such symptoms as mood changes or hot flushes and night sweats but it can also have a direct effect on sleep too.’
3. Your tongue feels like it’s on fire
Your mouth feels like you’ve been chewing on chilli, when the hottest thing you’ve eaten has been a slice of bread. What is going on? Burning Mouth Syndrome (BMS) is a condition that affects the tongue and the inside of the mouth and lips. Symptoms include a burning, stinging or tingling, and some people experience numbness, dryness or a metallic taste. It can affect anyone, but medics have noted it is particularly prevalent in older, menopausal women. It’s thought to be caused by an imbalance of hormones. BMS is more common in older women, particularly menopausal women – one study says it affects 18 to 33 percent of postmenopausal women. Hormone imbalance is behind this weird sensation – particularly oestrogen levels. Saliva can dry up because of this, causing a metallic taste and a burning sensation. Restoring optimal hormone levels can treat this, but if this is causing you issues, as a quick fix, try keeping hydrated and chewing gum to restore saliva levels.
4. Your periods become heavier
Many women are surprised when periods start becoming very heavy when they approach the menopause. After all, we are told the main symptom of the change is the cessation of the menstrual cycle. However, for most women, periods don’t simply fade away by getting lighter. In fact, one study from the University of Michigan reported that nearly 78 percent of its 1,300 middle-aged female participants had “three days or more of heavy flow.” When approaching the menopause, follicular stimulating hormone (FSH) levels increase in an attempt to stimulate the ovaries. These can cause irregular bleeding and heavy periods. This can easily be treated by gynaecologists – for example, many women find a Mirena Coil helpful. This small, plastic T-shaped device, fitted by a doctor, gradually releases the hormone progestin, which inhibits bleeding.
5. You feel so itchy!
If you find yourself relentlessly scratching your skin because it’s so incredibly itchy, you’re not alone. Pruritus – to give itchy skin its medical title – is a common complaint for menopausal women. ‘The lack of oestrogen occurring around the menopause has a significant effect on the skin,’ says Mr Savvas. ‘The skin tends to be come drier, itchy thinner with loss of elasticity. We carried out studies more than twenty years ago which showed that skin thickness declines in women after the menopause and this can be prevented and reversed with HRT. We also studied the effect of menopause on skin collagen content and found that skin collagen declines in quantity and quality after the menopause and this too can be prevented and reversed with oestrogen.’ Of course, itching isn’t just restricted to the legs and arms. The vagina and the inner mucosa of the vulva also can become quite irritated and itchy during the menopause. Topical oestrogen or HRT by patch is very effective in combatting this common and confidence-sapping problem.
6. Your heart beats faster …
If it feels like your heart is racing, it can feel extremely alarming. But women should remember the menopause can cause palpitations because of changing hormone levels. Often, but not always, this may be linked to hot flushes. If these palpitations are accompanied by shortness of breath or feeling faint, then it’s important to get it checked out. Palpitations aside, studies show that women do have an increased risk of heart attacks after the menopause, so, it’s important to think about the best way to protect your heart. ‘We know that HRT can offer protection against coronary artery disease – some studies have indicated this can reduce your chances of having a heart attack by up to 50%,’ says Mr Neale Watson, consultant gynaecologist at London PMS & Menopause Clinic. ‘American research has also found that women taking HRT less than six years after the menopause had slower artery wall thickening than those taking a placebo.’ Mr Watson adds that HRT when delivered by patches or gels (as opposed to taken orally) is a safe option that does not raise the risk of deep vein thrombosis (DVT).
7. You can’t remember a thing
Brain fog – that fuzzy feeling when you can’t get yourself organised – is a recognised symptom of menopause. One survey found that around 80% of women had symptoms related to the menopause that interfered with their ability to work, including memory loss. Mr Savvas comments: ‘The inability to concentrate and poor memory or common symptoms of the menopause and respond well to treatment with oestrogen replacement therapy sometimes the symptoms are exacerbated by poor sleep and tiredness which centres which are also held by a HRT. These symptoms may be also be associated with depressed mood and anxiety. Mr Neale Watson adds: ‘There have been good quality studies, with placebo controls, that performance in the mental agility test Suduko can be improved when women are given oestrogen. Many women do experience low mood and highs and lows, which is related to the seesawing levels of ovarian hormones during the transition to menopause.’
These aren't the only odd signs of the menopause. If you're not sure about symptoms and would like to discuss them with a menopause expert, please make an appointment. Call us on 020 7486 0497 or email firstname.lastname@example.org.
To find our more about menopause and HRT, Professor John Studd, the internationally acknowledged expert in the field of gynaecological endocrinology and founder of The London PMS & Menopause Clinic has made a series of podcasts. You can listen here.
To read more about strange symptoms of menopause, please click here