Menopause – what to expect
Going through menopause can be stressful. But it’s much easier to navigate if you know what to expect and what you can do to make it easier.
When am I likely to go through menopause?
Menopause starts at the time when a woman has her last period and finishes a year later. The average age at which women go through menopause is 51 but it can happen anytime between 45 and 60.
What will I experience?
Some of the common symptoms of menopause are hot flushes and night sweats, weight changes, sleep problems, dry skin and lack of libido.
But it’s important to remember that every woman’s experience of the few years leading up to menopause, menopause itself and the time after will be different. Some women sail through while others will struggle with daily symptoms.
Weight gain
When I hit my late 40’s I started to put on some weight even thought I was still exercising the same amount and my eating and drinking habits hadn’t changed. Not too much, just a kilo in the first year, another the next and another the year after that. Not a big deal except that with the exception of my first year at university where I discovered the joys of food as a study aid, I’d pretty much been the same weight since my late teens. And at 50 kg even an extra kg or two means I’m struggling to get into my clothes.
Hot flushes and night sweats
During menopause I didn’t experience hot flushes or night sweats. But a good friend of mine spent a year or so feeling like she was constantly drowning in sweat. This made it really hard for her to get a decent night’s sleep especially as some nights she’d have to get up in the middle of the night and change the sheets. Apparently, her experience is more the norm than mine with about 80% of women experiencing flushes and night sweats.
Sleeping
I didn’t really notice much of a change during menopause, but I started to have more trouble sleeping after menopause. I’d always been a bad sleeper and prone to waking up in the night, but suddenly if I woke up I’d still be wide awake an hour or two later. And it wasn’t that I was worried about work or anything else, I just felt really awake and nothing seemed to help. Apparently I’m not alone here, with the Sleep Foundation in the US indicating that the risk of insomnia increases into menopause, with as many as 61 percent of postmenopausal women reporting insomnia symptoms.
Sex
I didn’t find that my libido dropped (being in a new relationship with a hot younger guy probably helped in that regard) but a year or two after menopause I started to find that I had a lot of trouble reaching an orgasm. My partner was still doing all the right things and it still felt really good but I just wasn’t as sensitive. Of course I did the thing that woman do, which is stress about how I wasn’t going to have an orgasm which means that of course you definitely aren’t going to have one. It was pretty frustrating for both my partner and I. A panicked call to my best friend led to me finding out that she experienced exactly the same thing. Luckily that problem naturally resolved itself for both my friend and I after around 6 months.
But just about the time I got my sensation back, I found that no matter how turned on I was, I just wasn’t as lubricated and so sex become slightly uncomfortable. The bad news on that one is that it will eventually happen to pretty much every woman no matter how hard or easy getting through menopause was.
What can I do about it?
Hormone replacement therapy
Pretty much all of the symptoms of menopause are caused by reducing hormone levels. So replacing those hormones will help alleviate those symptoms. Hormone replacement therapy, now known as menopausal hormone therapy (MHT) involves taking taking oestrogen and progesterone.
The Victorian Hospital for Women indicates that MHT reduces hot flushes and night sweats by around 80 per cent, making it the most effective treatment currently available. MHT also protects bone by reducing osteoporosis and fracture.
My family has a pretty strong history of breast cancer and I’d been told by well meaning relatives that this meant I couldn’t go on HRT / MHT as it would increase my risk. When I finally decided (post menopause) to investigate it I found this wasn’t the case. Apparently the study which showed an increase in the rates of breast cancer amongst women using HRT was done quite a long time ago in the US and involved a synthetic combined progesterone / oestrogen pill which hasn’t been prescribed in Australia for many years. The global consensus among expert medical societies now is that HRT / MHT is low risk in healthy women aged 50-60.
I started taking MHT about 4 years post menopause. I haven’t had any adverse side effects. While it’s oestrogen that is alleviates most of the symptoms of menopause, and doctors only really prescribe progesterone as oestrogen taking on it’s own can increase the risk of uterine cancer for me it’s progesterone that’s had the bigger impact. It’s made a dramatic difference to the amount of sleep I get. Since taking it I find it easier to get to sleep and if I do wake up in the night I’m no longer lying awake hours later. I thought maybe it was a placebo effect until recently I went away for a month and accidently only took enough for 2 weeks with me. I found sleeping a lot harder in those last two weeks.
Testosterone
It’s important to realise that’s menopause results in a reduction in not just the female hormones (oestrogen and progesterone) but also testosterone. This is something a lot of doctors seem to ignore. When I started putting on weight in the lead up to menopause every GP I saw for advice (all of who were women) said to me “it’s just menopause, you have to accept that as a woman you’re going to start putting on weight once you reach a certain age, there’s nothing you can do.”
One day I was complaining to my cosmetic doctor about the weight gain and he said have you had your hormones checked? When I said yes he asked whether it had included checking my testosterone levels and I said no, the GP never mentioned getting those checked. So he sent me off for some tests, which showed that my testosterone levels were pretty much zero. He prescribed testosterone for me which I’ve been taking ever since. My only regret is that someone didn’t prescribe it sooner. As soon as I started taking it I found I had more energy, could do more in the gym, dropped straight back to my normal weight and had a libido I hadn’t experienced since I was in my 20’s. And no I haven’t developed a beard or a deep voice because the amount you need to make a difference as a women is only very small.
When I first started taking testosterone, I was taking troches which you suck which had to be made up at a compounding chemist, but found that the amount you actually ingest can vary a bit. For the past few years, I’ve been taking Andro Femme testosterone cream for women which I’ve found works much better.
Mona Lisa Laser Treatment
While MHT helped a little with vaginal dryness, the treatment that made an incredible difference to my sex life was the Mona Lisa Laser Treatment. If you’ve ever had IPL or something similar to rejuvenate the skin on your face, it’s pretty much the same kind of treatment. A specially designed laser is inserted into your vagina and the heat stimulates the tissue to regenerate. They recommend around 3 treatments to start spaced about a month apart and then a top up treatment once a year or so. I didn’t experience any discomfort either during or after the treatment. The whole treatment takes about 20 minutes (15 of which is spent waiting for the numbing cream to work). There’s no real downtime, other than you need to wait 5 days before having sex. It’s not cheap, prices can range anywhere from $500-$1,000 a treatment depending on where you go but both my partner and I would say it’s money very well spent.
Other alternatives
If you don’t want to take hormone replacement therapy, there are other alternatives that can help, depending on what your symptoms are.
If you are getting hot flushes or night sweats, reduce common triggers such as caffeine, alcohol, stress, anxiety and spicy foods. Carry a hand-held fan to cool your face, or a small water spray to spritz your face. If you are having difficulty sleeping, try some of the tips in this article on how important is sleep.
If the problem is lack of libido, you might want to still consider a testosterone cream. If that doesn’t appeal, do something that makes you feel sexy, whether that’s wearing lingerie or watching porn and make sure to engage in plenty of foreplay.
If it’s painful sex, your GP can also prescribe an oestrogen cream which you can insert into your vagina. Use plenty of lubricant both on yourself and your partner. Make putting it on each other part of the fun. Use a water based commercial lubricant, or if like me you find that you are sensitive to them, olive oil makes a great natural alternative. A word of caution from someone who’s made this rookie error – don’t put your best sheets on the bed just before using it.
If your skin is dry, avoid long, hot showers, which can dehydrate skin. Use a moisturising body wash instead of soap and swap to a heavier mousturiser.
Having a conversation with your doctor
It’s really important that you are able to have an open and informed conversation with your doctor about what you are experiencing and what treatment options are available. Prevention Magazine has great tips on how to have a productive conversation with your doctor about menopause.
