Menopause & Women’s Lifestyle
Perimenopause
Peri-menopause is the 2-12 years before menopause, and is a time of great transition. It is often referred to as second puberty, due to fluctuating levels of hormones that result in a range of different symptoms.
During peri-menopause, we see an initial increase in oestrogen (followed by fluctuating oestrogen levels) and a decline in progesterone, which can lead to many of the common peri-menopausal symptoms including heavy periods. Progesterone declines by roughly 75% between the ages of 35 and 50 years, therefore supporting progesterone production is an important part of peri-menopausal symptom management.
Common symptoms:
• Hot flushes
• Mood changes
• Insomnia + night sweats
• Changes in menstrual cycle (longer bleed, irregular cycles, shorter cycles)
• Vaginal dryness & atrophy
• Low libido
Menopause
Menopause, on the other hand, is a life phase that occurs 1 year after a woman's last period. Unlike peri-menopause, this phase is generally a time of minimal symptoms as hormones have flatlined.
Continence
Approximately 45-60% of menopausal women experience urogenital symptoms. As the female lower genital tract and its tissues are oestrogen-dependent, menopausal oestrogen decline leads to vulvo-vaginal and urethral atrophy and can result in stress incontinence.
Bone Health
Osteoporosis and joint pain are common challenges experienced during menopause. Approximately 30% of postmenopausal women are estimated to have osteoporosis. Calcium balance deteriorates at menopause when there is a decline in intestinal calcium absorption alongside an increase in urinary calcium excretion. Decreased oestrogen levels impact bone health due to an imbalance in bone formation and resorption, resulting in osteoporosis and joint pain.
Weight Management
Weight and metabolic changes, including weight gain, increased visceral adiposity and increased waist circumference are a common experience during the menopausal transition due to fluctuating hormone levels. Visceral adiposity and menopausal oestrogen decline are associated with the development of metabolic syndrome.
Sleep
Many menopausal women experience significant sleep disturbances, which can be associated with physical and psychiatric disturbances and other comorbid conditions. Declining oestrogen, resulting in decreased levels of serotonin which can impact sleep quality in menopausal women.