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Understanding & Managing the Three Stages of Menopause with Confidence

Unlock the secrets to managing your menopausal journey with our comprehensive guidelines. We’ll help you understand the most common symptoms and discover what we believe to be some of the most effective treatment options.

Let’s be honest here: whatever you’re feeling and no matter how much menopause research you’ve done to date, you’re most likely still learning about it, and almost certainly feeling a bit unprepared and overwhelmed by how much, or how little information is out there.

There are approximately 13 million women in the UK either in the first or last stage of menopause. Menopause and the journey before and after will be individual to each of us, and whilst a few will sail through, for many it’s a minefield of physical, mental and emotional hormone lead symptoms. Keeping that in mind, we’re here to offer you plenty of advice and support to help you better understand and manage this important life event.


What exactly does ‘menopausal’ mean?

Glad you asked, because whilst the term ‘menopause’ is often brandished about, for most people it’s the time that precedes menopause, where the biggest changes are noticed – Perimenopause, and sometimes the two can get confused.

Let's be clear here, whilst it may not feel normal and in fact for most of the time it feels totally bizarre, it is in fact a natural part of the ageing process for females. The term 'menopausal' is used to describe a woman whose ovaries are gradually ceasing to produce eggs and when those important reproductive hormones that have been with you since your teenage years start to decline, resulting in the end of fertility and periods.

Typically, menopause is diagnosed when a woman has gone 12 consecutive months without a menstrual period usually around their mid-fifties, and as we’ve said it’s a time of transition associated with a variety of physical and hormonal changes that can bring about symptoms such as hot flushes, mood swings, brain fog and changes in the menstrual flow. In fact, the list of symptoms is so wide-ranging, it’s clear that the menopause becomes a deep-rooted part of how we function during its three stages.  Understanding the meaning of 'menopausal' is the first step in navigating this transformative stage with knowledge and confidence.

The 3 stages of menopause

Menopause isn't a one-size-fits-all experience. It unfolds in 3 distinct stages. Understanding these stages is key to effectively managing menopausal changes.

  • Perimenopause: This is the lead-up to menopause, you’ll still be getting periods, but they may be erratic with an ever-changing flow. It’s when hormonal fluctuations begin, and it can really be a roller-coaster ride of both physical and emotional changes impacting on relationships and your daily life. For most it starts in a woman's 40’s and can last for several years.
  • Menopause: Officially, you’ve entered menopause when you've not had a period for 12 successive months, and this generally happens in your early to mid-fifties.
  • Postmenopause: This phase begins after menopause and continues throughout the rest of a woman's life. It comes with its own set of unique health considerations that are super important to understand for your overall health.

Common menopause symptoms

Oh goodness, where do we start, it might be easier to say what’s not affected by menopause!  It brings with it such a wide range of physical and emotional changes, we’ve listed just a few of the more familiar ones and maybe some of the more unusual ones you may not be aware of, to help you recognise your menopausal symptoms.

Physical Changes

  • Changes in Periods: Irregular pattern and/or a heavier menstrual flow.
  • Hot Flushes (or Hot Flashes): Sudden waves of heat to the face, neck and chest.
  • Palpitations: Sudden episodes when your heartbeat becomes more noticeable.
  • Vaginal Dryness: Thinning and discomfort in the vaginal area.
  • Night Sweats: Intense sweating during sleep.
  • High Blood Pressure: Risk of heart disease.
  • Sleep Disturbances: Difficulty falling or staying asleep.
  • Weight Changes: Fat redistribution to the abdomen – altered metabolism
  • Urinary Incontinence: Increased risk of bladder leaks
  • Decreased sex drive: Less interest in sexual activities.
  • Joint stiffness: Resulting in pain and muscle aches.
  • Urinary infections: Pain and burning when you pass urine.
  • Changes to skin: Dry and itchy skin, adult acne.
  • Oral Health: Sore gums, sensitivity and dry mouth.
  • Bone Health: Risk of reduced bone density or osteoporosis in later life.
  • Facial hair: Coarse hair growth to the chin and upper lip.
  • Changes to hair: Hair thinning and hair loss.

Emotional and Mental Wellness Changes

  • Mood Swings: Anger and irritability.
  • Anxiety: Stress and inability to cope with day-to-day tasks.
  • Brain Fog: Poor concentration, memory and cognitive changes.
  • Loss of confidence: Feeling fearful and lacking in self-esteem.
  • Unexplained sadness: Sometimes leading to depression.

We’re sure we’ve missed quite a few off this list, and during your menopausal journey you may experience all, or just a few of these symptoms.  We hope by understanding what’s happening to your body it will help you feel better about yourself, and you will realise that no matter how frustrating and scary this time is, it’s completely natural and if you learn to accept and embrace the changes to come, you can navigate your way through it.

Will menopause symptoms go away?

Many menopausal symptoms do improve with time, but it's essential to recognise that menopause itself is a permanent biological change. Symptoms such as hot flushes, mood swings, and night sweats can become less severe or frequent as the body adjusts to lower hormone levels, but they may still be experienced from time to time.

However, some symptoms, like vaginal dryness or bone density loss, may persist or become more severe without intervention. The good news is that effective treatments and lifestyle changes can help manage these symptoms effectively, allowing women to lead vibrant lives during and after menopause.

For symptoms like vaginal dryness, hormone therapy or vaginal creams/lubricants can provide relief. To address bone density loss, a combination of dietary calcium, weight training and medications may be recommended. We suggest consulting with your doctor for personalised treatment plans.

Induced, Surgical or Early Menopause

We’ve talked a lot about the natural progression of menopause in a woman’s life, but for some the menopause is medically induced or arrives earlier than expected.

Early menopause is said to effect around 5% of the population and occurs before the age of 45. Premature menopause occurs before the age of 40 and is very rare with less than 1% of women being affected.

Whilst the symptoms of early or premature menopause will be the same as a natural menopause transition, the difference is that the symptoms will often arrive suddenly unlike the gradual process for most women. Here we list some of the reasons for an early, premature or surgical induced menopause.

  • Surgical removal of the ovaries – during a hysterectomy for example.
  • Cancer treatments - such as radiotherapy and chemotherapy can cause either temporary or permanent ovarian failure.
  • Premature Ovarian Failure – can sometimes be genetic, or for those with an auto-immune condition.
  • Chromosome irregularities – Turner Syndrome.
  • Viral infections – such as mumps or malaria, although this is very rare.

Treatment for a surgically induced, or early menopause will be either the contraceptive pill or HRT, to help top up any reduction in hormone levels (although this may vary and be dependent on the reason for reaching an early menopausal state). These medications are often taken into your early to mid-fifties when menopause would have naturally occurred and are aimed to help reduce osteoporosis and other conditions. Your doctor will be able to diagnose early or premature menopause and may also refer you to a specialist, or menopause centre where you will get the support and advice you need at what is often a deeply distressing time.

Does HRT stop menopause?

Hormone Replacement Therapy (HRT) doesn't stop menopause, rather, it helps manage symptoms by replacing the hormones oestrogen and progesterone, that will have already started to diminish in a woman’s 40’s. Once a woman reaches menopause, her ovaries naturally produce fewer hormones, and this change is permanent. HRT provides relief but doesn't halt the natural progression of menopause. It can alleviate many menopausal symptoms like hot flushes and vaginal dryness.

How to manage menopause naturally without HRT

Many women choose to manage menopause without Hormone Replacement Therapy (HRT). Natural and nonhormonal approaches include:

  • Maintaining a balanced diet rich in calcium and vitamin D to support bone health.
  • Staying physically active to alleviate mood swings and weight changes.
  • Practising relaxation techniques to manage stress and hot flushes.
  • Using over-the-counter vaginal moisturizers for vaginal dryness.

Lifestyle modifications like these can effectively address menopausal symptoms without relying on HRT, offering a holistic and natural way to navigate this phase of life.

Managing menopause through diet and weight management

By proactively managing diet and weight, you can empower yourself to navigate menopausal transitions with greater ease and well-being.

Consider the following foods and eating habits:

  • Nutrient-Rich Foods: Opt for a diet high in calcium and vitamin D, found in dairy products, leafy greens, and fortified foods. These nutrients are crucial for bone health conditions during menopause.
  • Whole Grains: Whole grains like oats, quinoa, and brown rice provide steady energy, helping to combat mood changes and fatigue.
  • Lean Proteins: Incorporate lean proteins such as fish, poultry, and legumes to support muscle mass and metabolism.
  • Fruits and Vegetables: Aim for a variety of colourful fruits and vegetables, rich in antioxidants and fibre, to manage weight and overall well-being.
  • Hydration: Drink plenty of water, as dehydration can exacerbate hot flashes. Limit caffeine and alcohol, which can contribute to mood swings and sleep disturbances.
  • Portion Control: Be mindful of portion sizes to prevent weight gain during menopause.
  • Regular Exercise: Combine a healthy diet with regular physical activity. Engaging in both aerobic and strength-training exercises can help control weight, enhance mood, and improve bone density.

Managing menopause in the workplace

We totally appreciate that menopause may not be something you want to share with your employer or work colleagues, but we know it can be overwhelming at times and especially hard to manage when at work, but it isn’t impossible. Many employers now have a menopausal policy in the workplace which will include supporting all three stages of the menopause journey. Consider discussing your menopausal symptoms with your employer or HR department to help them understand your needs and potentially make accommodations, such as adjusting your workspace temperature or providing flexible work hours. You should also prioritise self-care to manage symptoms, wear comfortable clothing and keep healthy snacks at your desk to maintain steady energy levels.

Managing menopause at work can be a collaborative effort between you, your employer, and your colleagues, allowing you to maintain productivity and well-being during this life transition.

Managing menopause mood swings and anxiety

Menopause can bring about mood swings and anxiety, often due to fluctuating hormones levels leaving you feeling out of control. Managing these symptoms involves a combination of self-care and seeking professional help when needed. Regular exercise, like yoga or brisk walks, can help stabilise your emotions. Additionally, maintaining a balanced diet and ensuring adequate sleep can positively impact mood. And sometimes making time to have fun with friends and family can be such a mood booster and help you feel better when things get tough.

We can’t stress enough what an intense time of transition this is and if your mood swings or anxiety become overwhelming, or you have concerns for your own safety and those around you, don't hesitate to consult a healthcare provider who can discuss treatment options, which may include therapy or medication such as antidepressants/SSRIs. The key is to recognise the changes in your emotional well-being and take proactive steps.

Handling menopause with confidence

So, there you have it - a journey through menopause, its stages, and how to tackle its challenges head-on. Menopause is not a period to dread. It's a phase where your strength and wisdom shine. Embrace the changes, celebrate your womanhood, and face every mood swing and hot flush with confidence. You've got this!

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Menopause FAQs

Can you manage menopause without HRT?

Menopause management can occur without Hormone Replacement Therapy (HRT). Many women choose natural approaches and lifestyle changes to ease their symptoms. For example, you could start exercising more often before trying menopausal hormone therapy.

How can I survive menopause without hormones?

Surviving menopause without hormones involves adopting a healthy lifestyle, which includes a balanced diet, regular exercise, mindfulness, stress management and adequate sleep.

Menopause is a natural life stage experienced by all women as they age. It usually occurs between the ages of 45 and 55.

Why do I keep forgetting things?

Menopause can bring about a frustrating phenomenon known as "brain fog." Brain fog is a state of mental haziness or confusion, often characterised by difficulty concentrating, memory lapses, and reduced mental clarity.

To manage menopausal brain fog, staying organised is key. Using tools like calendars, to-do lists and reminders can help you keep track of daily tasks. In some cases, women try out cognitive behavioural therapy (CBT) to maintain mental health and brain functionality. CBT is a talking therapy that can help you manage your problems by changing the way you think and behave.

You should also get enough quality sleep and eat a balanced diet for more energy. Fatigue can exacerbate the cognitive side effects of menopause.


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