18/10/2023
Studies show that less than 10% of women under 40 feel they fully understand menopause and what it means for them. Any woman who has already been through menopause will tell you it isn’t easy. Even more would say that’s an understatement.
However over 50% of the women in the same study never looked for information about it. At Randox Health, we believe knowledge is power. So, this year, during Menopause Awareness Month, we are looking at what menopause is, how and why it happens, the risks associated with this transitional period of life & how a menopause blood test provides a measure that prepares women for it in the best way possible.
What is Menopause?
Menopause is the decline and cessation of reproductive potential as the follicles in the ovaries become depleted1. In other words, menopause is when your periods stop because of changes in your hormone levels, usually between 45 and 55 years old. It is generally divided into perimenopause, menopause and postmenopause. Perimenopause, meaning around menopause, is the stage when you are having symptoms of menopause but are still menstruating and ends when you’ve gone a year without a period1.
What should you expect?
Menopause is different for every woman. Often the first sign that you’re entering perimenopause is a change in your menstrual cycle where your periods become less regular. This can be accompanied by changes to your mood like anxiety, mood swings, low self-esteem and problems with memory or concentration. Some studies have shown an up to 5x increase in the risk of depressive episodes during perimenopause when compared with women about to enter perimenopause2.
The physical symptoms of perimenopause and menopause also vary throughout the population, however, around 80% of women experience hot flashes and/or night sweats2. Sleep disturbances are common and may get worse as you progress through menopause. Other symptoms include palpitations, headaches or migraines, muscle aches or joint pain, reduced sex drive, vaginal dryness or pain, and recurring urinary tract infections.
These symptoms are the result of changes in the expression of various sex hormones. The expression of these hormones varies at the different stages of menopause. Hormones, including oestrogens, like oestradiol and Anti-Müllerian hormone (AMH) decrease in concentration. Concentrations of follicle-stimulating hormone (FSH) are increased and highly variable throughout menopause, stabilising post menopause1. Changes in FSH levels are detectable up to 6 years before your final period2. Many other changes occur during menopause, which can affect various bodily processes, but we’ll look at those later.
When should it happen?
Menopause normally occurs between 45-55 years old – it’s considered early between 40-45 but not premature.
Premature menopause is that which occurs before the age of 40. Approximately 1.9% of women enter premature menopause2. These age ranges are estimates and can change depending on ethnic background. When compared with non-Hispanic white women, Japanese American women experience menopause later, and women of Hispanic, Hawaiian, and Black ethnicity may enter this period of life a little earlier2. There is a distinction between natural early menopause and other causes of ovarian failure which are pathological. For this reason, cases should be investigated to distinguish menopause from a condition which causes infertility.
Premature menopause
Premature menopause can result from various factors, including genetic abnormalities such as irregularities in sex chromosomes like Turner syndrome and Fragile X syndrome3. Autoimmune disorders leading to the production of abnormal antibodies targeting ovarian tissues, metabolic irregularities, viral infections like mumps, aggressive cancer treatments such as chemotherapy or radiation therapy, as well as surgical interventions like bilateral oophorectomy or hysterectomy, are also known culprits3. Furthermore, exposure to toxins like tobacco can contribute to the onset of premature menopause3.
Menopausal Complications
Post-menopausal women display increased concentrations of total and LDL cholesterol, apolipoproteins, and triglycerides1,2. These molecules have long been associated with cardiovascular health, therefore, a relationship between menopause and cardiovascular disease is intuitive. Oestrogen plays a role in the regulation of cholesterol levels and therefore helps to control the formation of plaques in the arterial wall which can cause heart disease. Furthermore, as age increases, blood pressure increases – a common risk factor for heart attacks and strokes4.
New studies show that menopausal women receiving hormone replacement therapy (HRT) are not at a significantly increased risk of fatal cardiac events4. Previous studies had shown a link here which caused controversy in the use of HRT to treat premature menopause. However, new research suggests the risk of premature heart disease is more significant for women who enter menopause before 40 than for those who receive HRT to treat premature menopause4.
Menopause may also increase your risk of other conditions, including type 2 diabetes as a change in hormones can affect your insulin processing capabilities and cause a serious hinderance to our bodies ability to process sugar5 .
Similarly to Osteoporosis, a change in hormone levels can have significant impact on our bodies bone remodeling processes6. Deteriorating our body’s ability to maintain healthy bones, the first 5 years of menopause results in a swift decrease in bone density before returning to a normal rate and within this timeframe, bones are more susceptible to fractures7. For more information on Osteoporosis, take a look at our blog, ‘Build Better Bones – World Osteoporosis Day.’ Quitting smoking, reducing your alcohol intake, and getting regular exercise are your best bets in combating this risk5,6.
What Measures can you take?
The symptoms of menopause will differ for every woman. However, there are some measures you can take to help alleviate the symptoms. Developing good sleep and exercise habits is key. This can help with the immediate sleep disturbances related with menopause, as well as helping to reduce your risk of developing osteoporosis8.
For women with more severe symptoms, hormone replacement therapy (HRT) may be recommended by your healthcare professional. HRT may come in the form of oestrogen replacement, a progestogen or both depending on the circumstances and symptoms. Progestogens act as a replacement for progesterone, a female hormone made by the body7. However, there are some risks associated with HRT7, so it’s essential you discuss your options with your doctor or healthcare professional.
What’s Involved In A Menopause Blood Test?
At Randox Health, we aim to equip you with the information and knowledge to make the best decisions about your health through services such as our private menopause test. Menopause brings with it much uncertainty but don’t fear. Our Menopause blood test measures over 30 data points to help you understand your hormone levels better and to help evaluate other key aspects of health, including nutrition, risk of heart disease, thyroid function and bone health.
References:
- Honour JW. Biochemistry of the menopause. Ann Clin Biochem. 2018;55(1):18-33. doi:10.1177/0004563217739930
- El Khoudary SR, Aggarwal B, Beckie TM, et al. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020;142(25). doi:10.1161/CIR.0000000000000912
- Pinkerton J V. Premature Menopause. MSD Manuals . Published February 2023. Accessed October 17, 2023. https://www.msdmanuals.com/en-gb/home/women-s-health-issues/menstrual-disorders-and-abnormal-vaginal-bleeding/premature-menopause
- British Heart Foundation. Menopause and heart disease. Information & support. Published 2023. Accessed September 27, 2023. https://www.bhf.org.uk/informationsupport/support/women-with-a-heart-condition/menopause-and-heart-disease
- Diabetes UK. Menopause and Diabetes. Life with Diabetes . Published 2023. Accessed October 6, 2023. https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/menopause
- Föger-Samwald U, Dovjak P, Azizi-Semrad U, Kerschan-Schindl K, Pietschmann P. Osteoporosis: Pathophysiology and therapeutic options. EXCLI J. 2020;19:1017-1037. doi:10.17179/excli2020-2591
- Pinkerton J V. Menopause. MSD Manual. Published July 2023. Accessed October 17, 2023. https://www.msdmanuals.com/en-gb/home/women-s-health-issues/menopause/menopause
- Tu KN, Lie JD, Wan CKV, et al. Osteoporosis: A Review of Treatment Options. P T. 2018;43(2):92-104.