Don’t pause for menopause…

What is Menopause?

Menopause is a natural phenomenon that happens to all women. Menopause is defined as the end of ovulatory cycles, which essentially means that the monthly release of an egg will no longer occur. This in turn means that the woman can no longer bear children. However, many women experience nonovulatory cycles whereby even though they have no eggs left in their ovarian reservoir, they still get regular or irregular bleeds. There is no investigation which can prove whether a woman is still releasing eggs or not and so we give a diagnosis of menopause to the following criteria of women:

• Women below the age of 50 years who have not had a period for over 24 months
• Women above the age of 50 who have not had a period in 12 months.
• Any vaginal bleeding occurring after this timeframe is considered post-menopausal bleeding and needs to be checked out by a doctor.

There are a few cases where some women might reach menopause due to external factors e.g. surgery which removes the ovaries, certain forms of chemotherapy and other medical conditions which suppress ovarian function.

What are the Signs and Symptoms of Menopause?

Menopause affects different women in a variety of ways, some more severe than others. Some women do not even realize they have gone through menopause whereas others have extremely detrimental symptoms which significantly affect their quality of life. Perimenopausal women are women who are likely to be going through anovulatory cycles (periods without any eggs being released) but also experiencing symptoms of menopause. Perimenopausal women often find that their periods are heavier and more painful than usual.

Symptoms of menopause/perimenopause: Hot flushes, mood changes, weight changes, skin changes, vaginal dryness, extreme exhaustion, low libido, hair loss, racing heart (palpitations) and many more. These symptoms occur because the ovaries are producing reduced amounts of the hormone estrogen which some people call the ‘hormone of youth’.

The consequence of this reduction in estrogen however includes the increased risk of osteoporosis (reduced bone density) and the increased risk of cardiovascular disease alongside other consequences like vaginal dryness, depression, anxiety, balding and low sex drive.

How can Exercise help with Menopause?

The focus of this article is to review how we can use exercise as an adjunct in helping not just with the symptoms of menopause, but also with the inevitable long term effects which occur due to the reducing estrogen levels. Exercise in every form is known to release natural endorphins which in turn elevate our mood as well as our energy levels. In addition, exercise helps maintain weight and reduces the risk of cardiovascular and joint disease. There is no exercise which is ‘right’ or ‘wrong’. Any movement which gets your heart rate up, gets you a bit sweaty and most importantly is a form of exercise which you enjoy is the ideal fit for you. Some women find yoga very beneficial for menopause whilst others prefer aerobic classes/dance classes for similar effect. The most popular choice is swimming – the main advantages for swimmers are that there is no weight on your joints at all but equally swimming is a great cardiovascular workout.

Often the exhaustion associated with menopause is severe and it is difficult to motivate oneself to exercise or even be active. If this is relatable to you, then try some baby steps. Start with a 5-minute walk or climb 2 floors – that’s it for one day. Slowly increase your walks to 7 minutes, 10 minutes and gradually keep increasing the time and the pace. Alternatively add more floors as you feel better – climbing stairs is an excellent way to keep fit and to get the heart racing. Lastly if this too seems too much, try simple yoga for 5-10 minutes.

Need more support...?

If you are finding the symptoms of menopause debilitating and feel you need further support, please do not hesitate to reach out. There are many ways to deal with the symptoms of menopause which include conservative methods, medical methods, and hormonal methods. Most importantly, menopause can feel like a lonely place, but it does not have to be – please reach out to us and we would be delighted to help.

Dr Natasha Shah - Consultant Family Medicine