Active Menopause

Perimenopause is the transition leading up to the time before your periods stop, when you may have symptoms. There's a variation how long this can take, but the average is 4 years. Normally, your GP can confirm a diagnosis of perimenopause based on your symptoms, but sometimes a blood test may be used, particularly if you are under 45 years.

Sometimes, women may experience early menopause. This is when your periods stop before the age of 45. If this happens before age 40 then this is known as 'primary ovarian insufficiency' (POI). Often the cause is unknown, but it can be related to genetic or autoimmune conditions, some cancer treatments (chemotherapy or radiotherapy) or surgical removal of the ovaries. It is more common in women who have a strong family history of POI.

Menopause refers to the day after which you haven't had a period for 12 consecutive months. This is due to a reduction in hormone levels (oestrogen and progesterone) as your ovaries stop producing eggs. The average age is 51 in the UK, but it can start much earlier, or much later than this.

Postmenopause is the time after your periods have stopped for 12 months.

Reduced levels of oestrogen in the body can cause most menopausal symptoms.

Every woman's experience of perimenopause and menopause is different, but some common symptoms include:

• Change in the normal pattern of your periods, for example they become irregular, during perimenopause
• Mood swings - such as low mood or irritability
• Odd taste in the mouth or the feeling of zaps under their skin.
• Mood swings - such as low mood or irritability
• Weight gain and changes in body shape
• Difficulty sleeping - which may be a result of night sweats and make you feel tired and irritable during the day
• Anxiety
• Brain fog - problems with memory or concentration
• Hot flushes - when you have sudden feelings of hot or cold in your face, neck and chest which can make you dizzy
• Exhaustion
• Joint pain, including stiffness and aches
• Perimenopause present as irregular menstruation while the menopause features a total absence of menstruation
• Low sex drive
• Vaginal dryness
• Headaches and migraines that are worse than usual
• Palpitations, when your heartbeats suddenly become more noticeable
• Increased risk of heart attack and high blood pressure during menopause due yo the decline in oestrogen.

Oestrogen offers some protection against coronary heart disease therefore reducing the risk of a heart attack. It helps to control your cholesterol levels and so reduces the risk of fatty plaques building up inside the artery walls.

During and after the menopause, a woman's body gradually produces less oestrogen than it used to. This increases your risk of developing heart disease or stroke due to increased cholesterol levels and blood pressure.

Regular physical activity of any type can offset some of these changes (1).

The decline in oestrogen production can affect the amount of calcium in your bones. This can decrease your bone density, leading to a condition known as osteoporosis. It can also make you more susceptible to hip, spine, and other bone fractures. Many women experience accelerated bone loss the first few years after their last menstrual period.

Regular physical activity, particularly weight bearing, resistance exercise and low impact physical activity e.g. jogging can maintain bone density, preventing osteoporosis and the risk of fractures (2).

Changes in your hormone levels may cause you to gain weight. However, aging can also contribute to weight gain.

Physical activity, particularly weight bearing, and resistance exercise maintains muscle mass (3), which is important for strength and metabolism. As well as preserving muscle mass, regular physical activity can limit weight gain during the menopause (6).