Why menopause matters

In simple terms, menopause is when a woman stops having periods and is no longer able to get pregnant naturally. The process itself though can be complex, and just like pulmonary hypertension, it can affect people very differently.

A natural part of ageing, the menopause (sometimes referred to as ‘the change’) normally starts when a woman is aged between around 45 and 55 – but this can vary either side. It is caused by a change in the balance of the body’s sex hormones, when your ovaries stop producing as much oestrogen and stop releasing an egg each month.

If you’re reading this whilst going through menopause, you probably don’t need to be told that symptoms can have a significant impact on your life. Women commonly experience hot flushes, night sweats, difficult sleeping, vaginal dryness, low mood or anxiety, reduced libido, heart palpitations, or problems with memory or concentration.

You might already be experiencing some of these symptoms because of your PH, which can make it harder to identify if you are starting to enter menopause – but a simple blood test, available with your GP, can provide the answer.

If you are struggling with menopausal symptoms alongside your pulmonary hypertension, do not be afraid to ask for help.

The average age for a woman to reach menopause is 51, but around 1% of women experience it before the age of 40. If you are experiencing menopausal symptoms under the age of 45, please see your GP, who will be able to run a blood test to confirm your hormone levels.

Source: nhs.uk

Symptoms can begin a long time (even years) before your periods stop, and this is known as ‘perimenopause’.

Symptoms then continue, on average, for around four years – although some women experience them for much longer.

I found the symptoms of perimenopause were much worse than the actual menopause itself

Kim, living with PAH

Symptoms of menopause can be managed in several ways, including:

1 2

Hormone replacement therapy (HRT)

Consultant Pharmacist

Neil Hamilton explains more in section 2

HRT treatments are either a combination of oestrogen and progesterone, oestrogen / progesterone alone, or a medicine called tibolone. Interaction between oestrogen and PH is not fully understood, and it is not suitable for those with certain types of PH.

Oestrogen creams, lubricants or moisturisers

These can all help with vaginal dryness (which can also be a cause of painful sex during menopause).

Cognitive behavioural therapy (CBT)

This is a type of talking therapy that can be helpful in managing low mood and anxiety.

See section 3 for details of a self-help programme specifically to help people with PH manage anxiety.

3 4

Lifestyle modifications

Regular exercise (within your capabilities) and eating a healthy balanced diet can improve some menopausal symptoms.

See section 4 for advice on eating well during menopause.

Wear light clothing

Avoid potential triggers, such as spicy food, caffeine, smoking and alcohol

Keep your bedroom cool at night

Take a cool shower, use a fan or have a cold drink

Try to reduce your stress levels

Source: nhs.uk

With a lot of gynaecological symptoms that women have, whether it’s menopause, incontinence, or heavy periods, they are still seen by many as ‘just part of being a woman’. It’s only recently that women are starting to think ‘hang on a minute, why should l put up with this?’ The help is there; as women we just need to ask for it.

Meera Bhogal, a wellbeing coach who runs guided menopause programmes and is passionate about raising awareness of menopause within South Asian communities.