Health: Managing the menopause


Dr Marilyn Glenville gives us some more information and help on the menopause.


- In many of the world's cultures, a woman's menopause is a time to be celebrated - a beautiful transition to a new stage in life, a time for joy in which the emphasis shifts from childbearing and chores to becoming 'wise women', looked up to by young couples in that society for advice and guidance.
 - In the West, we tend to view the menopause as an illness or disorder, something to be 'treated' or even ashamed of.
 - However, the menopause is no more of an illness or disorder than puberty or pregnancy.
 - It's a perfectly natural transition that every woman experiences as she ages, and it's to be celebrated.
 - Sadly, many of the women Dr Marilyn sees in her clinic are caught up in the Western view. They see the menopause as a time of loss - of periods, of the ability to have children, of youth and so on.
 - Dr Marilyn wants to encourage women to have a positive attitude towards the menopause.

The facts:

 - In the West, the average age of menopause is 51. Your menopause is classed as premature if it begins before the age of 40
 - In the years leading up to the menopause, your egg supply diminishes, your ovaries produce less oestrogen and you stop ovulating every month.
 - Your pituitary gland in your brain see this as a signal to release more follicle-stimulating hormone (FSH). It's trying to encourage a follicle to mature in your ovaries and release an egg.
 - This process allows your doctor to run a blood test to see if your menopause has begun - if you have high levels of FSH, the chances are it has.

Symptoms of the menopause:

 - In the West we have come to expect that our bodies will provide beacons that the change is happening.
 - However, actually, the transition should be subtle: the only thing you should notice is that your periods have stopped.
 - However, some women experience strong menopausal symptoms that dramatically affect their quality of life.
 - Changes in temperature can be one big problem. Night sweats may prevent sleep and cause tiredness, while hot flushes may appear at inopportune moments, such as during meetings, causing embarrassment.
 - Mood swings, irritability, joint pains, lacklustre skin and hair, and changes in body shape (the 'matronly' shape, as one patient called it), as well as a loss of libido or vaginal dryness that makes sex painful, can all impact on how easy and happy life feels.
 - It's important to bear in mind that an unhealthy diet and lifestyle can cause or aggravate many of the symptoms we automatically attribute to the menopause.
 - If your doctor suggests that you go on to hormone replacement therapy (HRT), Dr Marilyn suggests that instead you try to sort out your diet and lifestyle, to see if you can relieve your symptoms naturally.
 - You may continue to have periods even when you've stopped ovulating, because your body is still producing weaker levels of hormones that cause a build-up in your womb lining.

Taking action:

 - Once you think that your menopause is starting, visit your doctor for the blood test to measure Follicle stimulating hormone levels.
 - Understand though, that your FSH levels are not a foolproof test.
 - If your periods are erratic, during the months when you don't have one your FSH levels will be high and the menopause is likely. Make sure that your doctor considers your cyclical menstrual symptoms as well as the blood-test results before giving a diagnosis.
 - Once you've started the menopause, think positively about the way forward. You still have choices, not least about what approach to take to ease your transition

Dr Marilyn Glenville PhD is the UK's leading nutritionist specialising in women's health.    

- She is President of the Food and Health Forum at the Royal Society of Medicine, a registered nutritionist, psychologist, author and popular broadcaster who obtained her doctorate from Cambridge University.