I am often asked, ‘How do I know that what I am experiencing is menopause? Is there a menopause diagnosis? The doctor just says it’s my age but could it be something else?’
Can you get a menopause diagnosis?
Menopause isn’t an illness. It is like the twin of puberty. The reproductive hormones, oestrogen and progesterone, start to decline after our mid 20s but that decline accelerates from our mid 30s. Women can start to experience symptoms from their early 40s and into their 50s. the term ‘menopause’ actually relates to your last menstrual period and the average age of that is 51 in the USA and 52 in the UK.
Typical symptoms associated with the decline in reproductive hormones during perimenopause include:
- Mood changes – mood swings, low mood, tension
- Changes in regularity or heaviness of menstrual periods
- Hot flashes and night sweats
- Poor or interrupted sleep
- Weight change – weight loss or gain, change of body shape
- Migraine
- Tiredness
- Dizziness or faintness
- Forgetfulness
- Changes to breast size and texture
It is important to note that not all women will experience all or any of these symptoms. Just as with puberty, some women sail through it without even noticing that it happens.
Some of these symptoms may be the result of other underlying health issues that may be present at this time of life. Let’s look at some common examples.
- Underactive or overactive thyroid. Underactive thyroid (hypothyroidism) affects about 15 in every 1000 women. The symptoms develop slowly and include tiredness, weight gain, low mood and muscle aches. It can be diagnosed through a blood test which measures levels of Thyroid Stimulating Hormone (TSH) in the blood. It is treated by taking a daily hormone replacement called levothyroxine.
Overactive thyroid (hyperthyroidism) affects 1 in 50 women and symptoms can start at any age. It occurs most frequently in white and Asian women and less in Afro-Caribbean women. Symptoms include nervousness and anxiety, unexplained weight loss and swelling of the thyroid gland in the throat. It is diagnosed through a blood test. It can be treated with: medication such as thionamides; beta-blockers to relieve tremor, rapid heartbeat and hyperactivity; radiotherapy to shrink the thyroid gland; or surgery to remove all or part of the thyroid gland.
- Fibroids are non-cancerous growths that develop in or around the. They vary in size and many women who have them don’t experience any symptoms. Symptoms that may be experienced include heavy or painful periods, a frequent need to urinate and pain or discomfort during sex. Sometimes fibroids are detected during a routine vaginal examination. Otherwise they can be diagnosed through an ultrasound scan, hysteroscopy (where a small telescope is inserted into the womb through the vagina), laparoscopy (a small telescope and camera are inserted into the womb via an incision), and biopsy where a small tissue sample is removed for analysis. Treatment may not be required. Fibroids often shrink after menopause. If treatment is required, particularly for heavy bleeding, it can be by medication, insertion of an intrauterine device, anti-inflammatory medicines, contraceptive pill, progesterone or surgery (hysterectomy, myomectomy, hysteroscopic resection) and other non-surgical procedures.
- High or Low Blood Pressure
High blood pressure or hypertension can be the result of other medical conditions such as sleep apnoea or constriction of the blood vessels. However in 90% of cases of there is no known medical cause. It is mainly symptomless even though most people think it is connected with headaches, nervousness, facial flushing and sweating. Dangerously high blood pressure or hypertensive crisis may lead to severe headaches, anxiety, shortness of breath and nosebleeds. It is normally treated with medication such as ACE inhibitors, calcium channel blockers, diuretics, and beta blockers. You can also make lifestyle changes such as losing weight, exercising, stopping smoking, losing weight and cutting down on caffeine.
Low blood pressure or hypotension can lead to unsteadiness, dizziness or fainting. It may not give rise to symptoms and will only need to be treated unless if it is giving rise to problems such as recurrent falls. There are some practical things you can do to alleviate symptoms such as avoiding caffeine at night, limiting alcohol intake, staying hydrated, eating smaller more frequent meals and wearing support stockings or tights. Medication is available but rarely prescribed.
- Breast cancer. There are several types of breast cancer and it can have a number of symptoms such as a change in size or shape of one or both breasts, discharge from the nipples, a lump or swelling in either of the armpits, and dimpling on the skin of the breasts. Breast pain isn’t usually a symptom of breast cancer. It is important to examine your breasts regularly and visit your medical practitioner if you find anything that concerns you.
So how do you know if what you are experiencing is menopause or a medical condition? You can ask your medical practitioner to carry out a blood test to measure your follicle-stimulating hormone (FSH) levels. When the FSH blood level is consistently elevated, and you have not had a menstrual period for a year, it is generally accepted that you have reached menopause. Saliva and urine tests to measure oestrogen levels are expensive and not generally believed to be reliable.
Be aware that the reproductive hormones do not decline at a steady rate and can vary from day to day, particularly while you are still having menstrual periods. Therefore a single test can be misleading. Also, if you are using birth control pills an FSH test is not suitable.
The best advice is that if you are over 40, think you are in perimenopause and you are experiencing frequent and/or intense symptoms, it is a good idea to have a complete medical examination. Keep a symptom journal for a few weeks so that you can provide your medical practitioner with evidence of what you are experiencing. This will help him/her to reach a diagnosis, possibly a menopause diagnosis. (A Symptom Journal is available as a free gift from the home page of this website)
For more information see
UK www.nhs.uk/
You can download free menopause resources by signing up at www.hotwomencoolsolutions.com
If you would like more help with your menopause symptoms contact Pat for more information.
