How do I know I'm going through the menopause?
The most obvious sign of the menopause is the absence of periods - and officially, from a medical perspective, the defining symptom of the menopause is when periods cease completely. However, there are other indicators that show your body is gearing up for the menopause.
Other menopausal symptoms
- Feeling anxious and stressed
- Problem periods which are often very heavy
- Irregular periods
- Vaginal itching
- Stress incontinence
- Breast discomfort
- Increase in allergies
- Worsening PMS
- Issues with concentration
- Body odour caused by hormonal swings
- Nail breakage due to depletion in keratin
- A burning sensation in the tongue caused by hormonal imbalance
- Extreme tiredness
- Problems with IBS and other stomach issues
- Hot flushes
- Bleeding gums caused by oestrogen depletion
- Itchy skin
- Tingling sensations
- Joint pain
- Night sweats
- Weight gain
- Lack of sex drive
Blood Test for menopause
Hormone levels can be measured by a blood test which checks for levels of follicle-stimulating hormone (FSH) and oestrogen. The menopause sees your FSH levels rise and oestrogen levels lower. FSH stimulates maturation of eggs as well as a hormone called oestradiol. When approaching the menopause, periods become irregular, FSH levels increase in an attempt to stimulate the ovaries.
Measuring FSH in the blood can give an indication of ovarian status and whereas levels fluctuate during normal periods , this fluctuation increases 4-5 fold at the time when hormone levels are changing as ovarian function declines.
Osteoporosis test at menopause
Women in their late 40s and 50s should consider booking a DEXA to screen for osteoporosis. Women who have been through the menopause are the most commonly affected group, because of the dip in oestrogen, which is important for bone density. DEXA sends low-energy X-rays from two different sources. The more dense the bone is, the less X-rays get through to the detector. After a DEXA scan, you will be given a T-score. A T-score of -1.0 or above is normal bone density. A T-score between -1.0 and -2.5 means you have low bone density or osteopenia. A T-score of -2.5 or below is a diagnosis of osteoporosis.
The good news is, osteoporosis is treatable with a range of strategies, including lifestyle and medication. When you know your osteoporosis risk, you can make an appointment to see an osteoporosis specialist who can advice on a treatment plan.
Body Composition Scan after menopause
Weight gain is another common problem for women during the menopause. Hormonal fluctuations include an increase in production of the hormone cortisol, the so-called 'stress hormone'. Cortisol quickens insulin release and causes an appetite gain – especially for sweet, high-fat, and salty foods.
Add this to a sluggish metabolism – a common issue as we age – as well as general wear and tear which causes us to exercise less, and you can expect an increase of fat around the middle.
As well as checking for osteoporosis, the latest models of DEXA can also reveal total fat in the trunk region. The menopause is known for causing a thickening effect around the middle,
Check with your DEXA provider whether they offer the CoreScan option. DEXAs with this technology can identify whether this fat has accumulated around the liver, pancreas and intestines – this can be a risk factor associated with diabetes, heart disease and an elevated risk of cancer. Armed with the knowledge of scan results, women can see nutritional advice and lose weight as required.
Thyroid Check at menopause
An underactive thyroid, and menopause symptoms are often mixed up. Thyroid issues usually manifest at the time of the menopause. Symptoms include:
- Low mood
- Memory problems
- Weight gain
- Thinning hair
- Heavy periods
- Dry skin
- Joint and muscle pain
Certainly, an underactive thyroid can exacerbate problems with the menopause. Research from Egypt revealed that treating an underlying thyroid issue resulted in an improvement in menopausal symptoms. If you suspect you may have a thyroid problem, it’s important to get a blood test, so you can get appropriate treatment if required.
If you are in your late 40s or 50s it’s definitely worth booking to see a gynaecologist to see if you require Hormone Replacement Treatment (HRT), or need other tests done. You can also find out more about the latest treatments, including the MonaLisa Touch Laser treatment for vaginal dryness. You can also ask how to manage heavy periods or other menstrual problems. If you are younger but experiencing symptoms of the menopause, discuss your options with your GP. The latest research shows that if you begin HRT treatment before the age of 60, you should be protected against osteoporosis.