Leigh Day Women's Rights in Healthcare event looks at the menopause

What is the menopause?

The menopause is the time when a person stops having menstrual periods and the ovaries lose their reproductive function.

Menopause is caused by a change in the body’s hormone levels, in particular oestrogen. Over time, the level of oestrogen produced by the body decreases until it eventually stops. 

Symptoms vary from person to person when going through the menopause. Hot flushes are experienced by every three in four people going through the menopause and are the most common symptom. Other common symptoms include night sweats, vaginal dryness, difficulty sleeping, low mood or anxiety, reduced sex drive and problems with memory and concentration.

When does the menopause occur?

In the UK, menopause usually occurs between 45 and 55 years of age, with the average age being 51. The timing of menopause varies from person to person and can be impacted by lifestyle events such as hormone therapy, removal of the ovaries and chemotherapy. 
If your menopause occurs before 40, or between 40 and 45 years of age, this is known as premature and early menopause respectively.

In the years leading up to the menopause, oestrogen levels being to decrease. This leads to a perimenopause, where people experience some symptoms of menopause but continue to menstruate.

After one year without menstrual periods, the person enters the postmenopausal stage. The postmenopausal stage carries the particular risk of osteoporosis as, prior to menopause, oestrogen assists in maintaining skeletal strength.

How is menopause identified and treated?

It is sometimes difficult to diagnose menopause. Symptoms and irregular periods can be a sign of changes occurring in oestrogen levels, but not necessarily menopause itself. However, symptoms are the main focus of diagnosis as other investigations, such as testing levels of the follicle-stimulating hormone (FSH), are not always accurate in diagnosing menopause. 

Menopause is not a condition that can itself be treated, but the symptoms can be managed. Often, menopause symptoms are managed by simply prescribing hormone replacement therapy (HRT), without any further consideration of the person’s symptoms or whether HRT is a good idea in their case. Hormone replacement therapy is frequently indicated for those with premature or early menopause, although research is lacking in this area. It is recommended that people know the date of their last period to help appropriately respond to symptoms and be correctly prescribed any relevant contraception. 

It is important to appreciate that diagnoses based on symptoms alone require doctors to consider the subjective nature of symptoms for each person. Dr Louise Newson is a GP and menopause expert. She believes that “every woman is different and that’s why every woman’s experience of the Menopause is very different. And often, every woman’s treatment of the menopause is very different. It’s not a ‘’one size fits all’’ and I think that is very important for people to realise.” 

Why is it important to raise awareness?

It is important for those going through the menopause to realise they are not alone, and that menopause is not something that you need to just get on with. Although everyone will experience symptoms in a different way, there are ways to manage the symptoms which will help and it is important that you try to seek assistance if you think you need it. 

The British Menopause Society also suggests the following to help your body through menopause: 

• Maintain a healthy diet

• Regular exercise

• Stop smoking

• Drink within reason

• Make use of health screening services

• Stay calm and positive

As healthcare lawyers, we are concerned about the education gap in the training medical professionals receive regarding the menopause. While some doctors are able to offer excellent menopause care to their patients, there is a disparity in the training which may see others less effective in their care and treatment of menopausal patients. Specialist NHS menopause clinics are closing due to funding cuts and there are concerns that this will lead to people not accessing adequate care to assist them through the menopause and its associated health implications. 

If you have any concerns or questions about menopause, please visit the British Menopause Society website and/or consult your GP if you are worried about symptoms.