This post is written by Dr Karen Morton, Consultant Gynaecologist and Obstetrician, medical director to Dr Morton’s – the medical helpline© and MHM’s Medical Adviser.
Am I Menopausal?
If I had a pound for every woman who has said to me about whatever symptom you choose: periods getting heavier, gaining weight, getting hairs on the chin, leaking on the trampoline, or being forgetful
‘I just thought it was the change’, then I would be a very rich woman.
Some women start by saying
‘I think I am premenopausal’, and I reply, well, I suppose we have all been premenopausal since we first started having periods, and of course what they really mean is perimenopausal. So then I get stuck into the definitions.
The menopause is a single date in time. It is the date of the last period ever; when you look back and say
‘I never had another period after June 2016’. That was the date of my menopause.
Then there is the perimenopause which is a length of time during which women get, or don’t get, symptoms of declining ovarian function. Some women don’t get a hot flush in their lives and others will get them to their dying day, with a variable amount of impact of their quality of life. They can be anything from a mild feeling of warmth to a river of sweat drenching the bedclothes and disturbing sleep and wellbeing to the point of exhaustion. Of course a change in menstrual pattern often accompanies the loss of regular egg production, which is the physiological event which tells the uterus what to do. Many women these days have a Mirena in place, so of course for them, as they are not having periods anyway, menstrual disturbance will be a lost clue. To answer the question ‘Am I Menopausal’ at this stage – you are perimenopausal.
Finally there is the post-menopause and the consequences on the body of long-term absence of oestrogen. It is oestrogen which keeps the bones strong, the vagina pink and juicy and the bladder strong and resistant to germs. Collagen (the elastic molecule of the body) is kept nice and coiled up by oestrogen and I see many women whose pelvic floor and vaginal walls deteriorated the moment they stopped HRT. Oestrogen is one of the body’s natural antidepressants too, and I have said many times that I think the most under-estimated feature of menopause (whichever phase) is anxiety. To answer the question ‘Am I Menopausal’ at this stage – you are postmenopausal.
Now just going back to why I wrote this short article, it was because when a woman says that she put whatever it was that she was worried about down to ‘the change’, she usually says it in a way which suggests that it is ‘her just desserts’. I think this is analogous to so many women’s feelings of guilt and lack of self-worth. Many women (probably myself included) spend their adult lives giving themselves a daily dose of guilt. This particularly applies to working mothers. It’s a bit like that fact that women are permanently sorry. Don’t apologise and don’t feel is it your lot. Do something about whatever it is that is bothering you. The menopause has got later and later but it has still not caught up with the fact that we live so long. We should be planning to be 90, and as fit as possible with it!
Good luck! Do ring for advice if you would like to!