Menopause can affect you physically and emotionally and may cause a range of symptoms.
In Western cultures, the most common symptoms are hot flushes and night sweats. Some women may also experience insomnia, incontinence and changes to their mood and sex drive.
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Around 80 per cent of women experience hot flushes and night sweats during menopause.
Women's experience of hot flushes vary and they may last one to five or even as long as fifteen minutes. A hot flush may feel like or include:
- a warming sensation that lasts a few seconds
- a sudden feeling of intense heat spreading over the upper body and face
- heavy perspiration and reddening of the skin
- racing or pounding heartbeat
- heavy breathing.
Some women have chills instead of or after a hot flush. Night sweats are hot flushes with heavy perspiration that may wake you from sleep.
There is no strong evidence that menopause has any permanent negative effect on memory or thinking; however, changes in memory and concentration are a common source of complaint for menopausal women. One study noted that 62 per cent of women reported some type of undesirable memory change during menopause.
Memory difficulties typically reported include remembering:
- where you put things
- telephone numbers
- things people have told you
- knowing whether you have already told someone something.
Research on memory impairment during the menopausal transition and perimenopause has provided conflicting results, varying from showing no memory impairment to a temporary mild decline in story recall and information processing speed. Recent cross-sectional studies have shown that along with a reduction in verbal memory, attentional aspects of memory can be impaired during the menopausal transition.
Influence of hormonal changes
The results of studies examining a direct effect of hormonal changes on memory capabilities have been inconsistent. The majority of studies have failed to demonstrate a clear link between oestrogen levels and memory performance.
Role of psychological factors
During menopause and the menopause transition, women not only undergo hormonal fluctuations, but also experience stress related to social changes, signs of the ageing process, other health issues, and changes in personal, family and professional responsibilities.
Women with negative attitudes to ageing or menopause generally report more menopause symptoms, and memory difficulties are associated with menopause. Concern and anxiety about memory can lead to feeling less confident, which can affect your work and social activities. Even if there is no clear indication that memory has been affected, concern about memory can increase anxiety.
The cause of memory difficulties during menopause remains unclear. Sleep problems are among the most prevalent and bothersome of symptoms during the menopausal transition, and poor sleep and stress may have a role in causing memory problems.
Mood changes affect many women during menopause. Such changes might include:
- mood swings
- lack of energy
- anxiety and/or panic attacks
- feeling blue, low, downhearted or depressed.
While women with a past history of depression have an increased likelihood of developing depression again at the time of menopause, the link between depression and menopause is not well understood. It may relate to factors such as:
- the frequency and severity of hot flushes
- sleep disturbance
- feeling out of control of your body
- life changes common at this time, such as:
- ending or starting romantic relationships
- grown children leaving or returning home
- financial or career changes
- concerns about ageing parents
- getting older in a society that values youth.
Some women find that they have changes in sexual desire (libido, or sex drive) during menopause. While some women find a new freedom from worry about unwanted pregnancy, others may find they are not as interested in sexual activity as they once were. Reduced levels of oestrogen and testosterone may affect your sex drive, so too, may other changes common at this time of life.
Symptoms of menopause that may negatively affect your desire and enjoyment of sex may include:
- mood changes
- sleep disruption
- vulvovaginal discomfort.
Sex drive changes become a problem if you or your partner are troubled by them. Some couples are comfortable with a change in their sexual activity as they age.
Urinary incontinence is the accidental leakage of urine.
Up to 50 per cent of women experience stress incontinence (loss of urine caused by weak pelvic floor muscles) that results in leakage after coughing, sneezing, laughing or lifting objects.
Stress incontinence becomes more common during the menopause transition and postmenopause because lack of oestrogen can cause the thinning of the lining of the urethra (the tube that empties urine from the bladder), and ageing can weaken the surrounding pelvic muscles.
Prolapse is when the supporting muscles of the vagina, bladder and bowel become weakened and is also more common with age.
Prolapse is more common in women who:
- have had children (especially those who have had difficult vaginal deliveries)
- are overweight
- have chronic cough.
Exercises and physiotherapy may help, but prolapse sometimes needs surgical treatment.
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