The Menopause - the start of symptoms 

Every woman experiences the menopause differently

Many hardly notice 'the change', except perhaps their periods become irregular. Others suffer every symptom and find their lives are severely affected.

The transition into the menopause is usually gradual and is accompanied by a range of symptoms.

• Hot flushes and sweating

The most common symptoms by far are ‘hot flushes’ and sweating attacks. These episodes can happen at any time, as often as several times an hour.

Each hot flush usually lasts for three to six minutes.

Exactly why flushes and sweats occur is not fully understood, but mostly it is because the automatic controls of the nervous system become erratic.

This triggers the skin blood vessels to open and signals the sweat glands to become active at any time. Usually, this would only happen if you were too hot and needed to lose heat.

• Sleep disturbance

Sleeping difficulty can be due to problems falling asleep, restlessness or night-time sweats. Some women sweat heavily and have to get up to change the sheets several times a night.

• Psychological changes

Depression, mood swings, tiredness or headaches are all possible symptoms. Forgetfulness or irritability can be distressing for both you and the rest of the family.

• Physical changes

• During the menopause your skin becomes thinner.

• A lack of oestrogen often means the glands in the vagina don't produce as much lubrication as before and this may cause stinging around the vagina during sex.

• Some women don't feel like having sex, whereas others find their orgasms become less intense.

• The lack of oestrogen also affects the bladder and you may find you need to pass water more often.

• There is a gradual rise in the risk of heart disease and stroke after the menopause.

• Falling oestrogen levels result in unfavourable changes in cholesterol and fat levels in the blood, causing a predisposition to these problems.

• Osteoporosis

In recent years there has been a lot of interest in osteoporosis (thinning of the bones) in connection with the menopause.

Oestrogen normally stimulates the bone-building cells.

As a result of the drop in oestrogen, women tend to lose bone mass and strength for several years following the menopause. Ultimately, this can make the bones more likely to collapse or fracture.