For me, there are five main things that all women need to know about menopause. But it can be such a minefield trying to navigate through.
1 What is perimenopause?
Women really need to know what the difference is between perimenopause and menopause because there is massive confusion around these terms.
The way I have learnt about it, that I think is the easiest to relate to, is to think about puberty. Puberty does not happen overnight. It takes years. Puberty starts and the hormone line starts going up and down, quite dramatically when you start your periods until the massive hormone fluctuations stop after a while.
Now those puberty peaks and troughs are much more like the perimenopause phase. Of course in pregnancy you get massive mood swings but it only lasts about nine months.
Perimenopause can start in your mid 40s when your progesterone declines and oestrogen levels become erratic. So think of it as exactly the same as you did for puberty. You still get periods but they may start altering – fewer, more, heavier, lighter – and start getting mood swings and anxiety.
The perimenopause phase can be the time when women are actually really vulnerable. Most women have no information at all about what to expect.
By the time you get to the menopause phase, you are likely to have talked to someone, seen a doctor and got some info. The symptoms in perimenopause are very sneaky and can catch women off guard. That is when you need to be informed. There is no reason to have awful symptoms so you need to be prepared. You can get mood swings, forgetfulness, brain fog, you wonder how you ever got a job, let alone were able to do it because you suddenly feel that you are unable to do anything even the most basic tasks. Real issues which are all hormone driven.
So basically in your 40s you really need to know about this and take really good care of yourself. Imagine not knowing how you got pregnant?
2 How do you know when you are in menopause?
Those big hormone swings do calm down and when your periods do finally stop the hormone fluctuation curve is likely to be much gentler.
Then in your 50s, your hormones are generally not fluctuating so much. You are getting older so you need to make a plan to age well. You don’t want to slip down a hormonal rollercoaster. We have 35 years, 35 years – it is ages…
I like to use Dr Tara Allmen’s definition of menopause. She says that menopause technically starts one year after you have finished your periods. Now that is the common definition but what I like about what she says is the bit she adds on the end – which is that menopause is one year from when your periods end till the day you die.
I have to say that when I heard her say that, I thought blimey! Now generally the average life expectancy of a healthy woman is 83 years, and the average of menopause is 51. So we have a long time in menopause, so we need to prepare for the two proactively.
3 Make the lifestyle changes
A big thing is that lots of women don’t have a plan for this phase of their life. I didn’t either before I realised how important it was to have a sense of purpose and that gives you back your va va voom. Along with you having to ditch the sugar, you have got to learn to manage your stress, you have got to exercise more if you don’t already. In other words – do all the things you have been putting off.
4 Maintain the changes
I can tell you now that your body stops being so forgiving, if you keep abusing it. So you have to woman up and make those changes. Really make those changes and maintain them. Don’t just pretend for one day. That is why we have to discuss health for women over 40, so that you can plan these parts of your life confidently.
5 Friend power, not just doctor power
The other thing you need to stop expecting is that doctors can somehow fix us. This is a tendency when you go down the doctor route for HRT. Now of course there is a place for these, but certainly from what I have learnt and heard from dozens of other women, is that medication without the lifestyle changes just isn’t enough. Many doctors don’t know what to do with women over 40 anyway, as the guidelines were only introduced in the UK in late 2016 (NICE guidelines November 2016). Great to have guidelines BUT it usually takes about 5-10 years for them to be implemented.