What happens to your body during menopause?
The physical changes go far beyond night sweats and hot flushes, and knowing exactly what’s going on is key to managing this life stage.
Every woman’s menopause is different, from the level of intensity they experience (one in four women suffer to an extreme degree) to their range of symptoms. Hot flushes and anxiety are the most commonly known, but there are more than 30 and counting.
Other than hot flushes, most of the participants in the 2022 study above were unaware of the wide array of symptoms that occur to women at this life stage and so did not connect them to perimenopause. This despite the fact that women in the group reported symptoms as various as mood swings (68.9 per cent) brain fog, (68.3 per cent) and fatigue (66.8 per cent), with 79.1 per cent also reporting symptoms affecting their desire for sex.
What is the menopause?
Menopause is a term that refers to the transition women experience towards the end of their childbearing years, they stop having periods and the production of the hormones oestrogen and progesterone begins to slow down. On averageoccurs between the ages of 45 and 55.
The three stages of menopause
Perimenopause is defined as the period of time when a woman’s body is moving toward menopause. Periods may become irregular, fertility is reduced and the production of hormones begins to fluctuate and slow down. The average age women experience perimenopause in the UK is 45.
Menopause is the point when a woman has not had a period for a year and is confirmation that the body has stopped producing the hormones that cause menstruation. The average age of menopause in the UK is 51, although this varies from woman to woman.
Post menopause begins after the menopause has happened and lasts for the remainder of a woman’s life. Menopausal symptoms are similar to perimenopausal symptoms and can continue for five to seven years after menopause – some even longer. According to online menopause clinic My Menopause Centre, 40 per cent of women aged between 60 and 65 will experience hot flushes and night sweats.
Symptoms of menopause
Vasomotor symptoms, which include hot flushes and night.
Physical symptoms include muscle and joint aches, as well as headaches, palpitations, poor sleep, a sensation of burning in the mouth, and skin dryness and itching, known as formication.
Finally in the physical category, there are bladder symptoms which include increased frequency, passing urine in the night and discomfort and pain when passing urine,” says Spencer, adding, “Symptoms can mimic a urinary tract infection – and it is important to rule this out.
Psychological symptoms, which can be the most distressing for many women, include anxiety and depressive symptoms. Cognitive symptoms include poor memory, brain fog and trouble finding words.
Lesser-known symptoms
The oestrogen is important for the whole body, which means it can affect everything. Unexpected symptoms may include frozen shoulder, tinnitus, dental symptoms connected to bone density, such as gum inflammation and sensitivity and loose teeth, dry mouth and dry eyes.
How menopause affects your body
Your bones and muscles
With age, our bones become fragile and break more easily, largely the result of a decline in oestrogen. Osteoporosis, the loss of density in bones, has no symptoms – until a bone breaks so it’s important to tackle it early.
That means taking vitamin D and ensuring the level of calcium in your diet is adequate.
In a study of midlife women published in 2020, researchers found that doing exercise to build muscle masswas associated with a lower risk of sarcopenia, the age-related loss of skeletal muscle, in older women.
Muscle is important for hormonal balance, and research shows that strength training can affect hormonal regulation. Building muscles reduces symptoms and protects the metabolism.
Muscle also helps with bone health. As oestrogen continues to decline during perimenopause and menopause, osteoporosis becomes a risk.
Maintaining muscle improves bone density because the stronger the muscles, the more force they will have on your bones.
Effects of menopause on skin
Like so much else in the midlife woman’s body, skin is impacted by menopausal changes in hormone production. With the loss of oestrogen, the body produces less sebum and the skin becomes dry.
There is also an increase in wrinkling as collagen and elastin production slows down. This impairs wound healing, weakening the barrier function.
Some of these changes are due to the natural ageing process or the impact of smoking, sun damage or alcohol.
The best thing you can do is take control of the controllable factors that make this worse: reduce your alcohol intake, reduce stress, do more exercise and wear sunblock.
Effects of menopause on hair
Hair loss is experienced by 40 per cent of postmenopausal women. Problems can range from smaller hair diameter, changes in texture and a more delicate hair shaft. While hormonal changes are responsible for much of this, stress can also be a factor. Getting regular exercise is vital for stress relief and mood improvement.
Menopause and your weight
As oestrogen levels decline, women tend to put weight on around the abdomen. About 50 per cent of women gain weight during perimenopause at an average 1.5kg a year, according to the British Menopause Society but experts are clear that weight gain is also connected to the genes we inherit from our parents and lifestyle issues.
“Trying to lose weight by focusing on food is like trying to quit drinking by focusing on alcohol,” says expert. “In the clinic, the best results occur when women look at their eating habits and behaviours, rather than purely focusing on calories. Your genetics play a part and so does your environment, your job, your family and your socio-economic background”.
“Nutrition doesn’t have to be expensive or complicated. Eat according to your daily energy needs, make sure you’re getting plenty of plants for fibre, protein for muscle and calcium for bone health,” Bardwell continues. “You don’t need masses of supplements but it is worth taking vitamin D3, which helps regulate calcium and phosphate levels and is important for bone health, immunity and mood. Omega-3 is important primarily for brain health and inflammation, which can rise at menopause, while magnesium is good for anxiety, restless legs and sleep. Some recent studies have linked the potential benefits of creatine to cognition and brain fog, as well as muscle strength and stamina.”
Fitness also has an important role to play here, and Kate Rowe-Ham urges women to focus on exercise that builds muscle, such as strength training.
“If women are so focused on losing weight and exercising, they may miss the point that training for muscle strength will burn more fat. Even resting muscle burns more calories than fat.”
Menopause and mental health
Mental health for women at midlife is an intricate combination of physical symptoms, emotional issues and the reality of ageing. Women’s stories of leaving the keys in the fridge, being so anxious they forget how to drive, and anger so strong they throw something in rage are much more frequent than we might think.
When women experience perimenopause and their oestrogen levels go down, it affects the amygdala (a part of the brain associated with emotional processes).
“Exercise is a fantastic mood boosterand can empower women to feel more confident at a time when self-doubt can escalate,“ says Rowe-Ham. “Most women have the ability to move regardless of their HRT status and it is without doubt one of the most effective tools they can use.”
Long-term risks associated with menopause
“Women’s health risks for chronic disease increase quite significantly over menopause due to the decline of oestrogen and testosterone,” says Dr Shahzadi Harper. This can include osteoporosis, an increased risk of heart disease, diabetes, urinary tract infections, depression, obesity and dementia, where more research is currently being done.
While the British Menopause Society recommends a lower dosage of HRT for women over 60 who wish to continue on it long-term, Spencer explains: “HRT should be taken primarily to manage symptoms of the menopause. It can also help prevent osteoporosis and osteoporotic fracture and, if started early in the menopause transition, may help prevent heart disease. It is likely that the dose of oestrogen needed to manage symptoms decreases with age.”
Balanced Nutrition and Exercise are fundamental tools that can help every woman protect herself from serious health outcomes. “Your body simply isn’t the same as it was when you were 20 or 30”, points out nutritionist Emma Bardwell. “You need to be really focusing on your heart, brain and bones at this time. Nutrition plays a pivotal role in futureproofing peri- and postmenopausal women’s health.”
“Exercise helps to manage a myriad of symptoms,”points out fitness expert Kate Rowe-Ham. “It’s great to have in your toolkit, and research shows that it does reduce menopause symptoms. It helps with hormone regulation and has an impact on anxiety and depression because it builds up endorphins and serotonin.
Strength training and weight-bearing exercise is especially important in maintaining muscle mass and overall strength as we age,” she continues.
“Muscle mass is associated with longevity and may reduce your risk of cardiovascular disease, diabetes, osteoporosis, and early death.”