What are menopausal symptoms?

As you go through menopause, you can experience physical and emotional symptoms. These symptoms are caused by changes to hormone levels in your body at this time.

Your symptoms begin when you are perimenopausal — the time leading up to menopause. The symptoms can continue until you are post-menopause.

Physical symptoms of menopause include:

• irregular periods
• hot flushes and night sweats
• dry vagina and loss of sex drive
• fatigue and sleeping problems
• muscle and joint pain
• urinary problems

As you enter perimenopause, your mental health may be affected. You may feel:

• depressed — even if you have not suffered from depression before
• anxious
• irritable, sad and hopeless
• unmotivated
• unable to concentrate or focus

Menopausal symptoms feel different for everyone. Some people have very severe symptoms. Others may only have very mild symptoms, or none. They can last for 5 to 10 years.

How can I manage menopausal symptoms?

You can manage menopausal symptoms in different ways. You may need to try a few options before finding a treatment that works for you. Treatment options include:

• hormone replacement therapy (HRT) — also known as menopausal hormone therapy (MHT)
• non-hormone medicines
• lifestyle and behaviour changes
• complementary therapies

Sometimes you may not be able to take MHT because of other medical conditions, or you may prefer not to.

Always talk to your doctor or pharmacist before starting a new medicine — including complementary medicines — to make sure they are right for you.

Can lifestyle changes help manage menopausal symptoms?

Although there is not a lot of evidence proving that lifestyle and behavioural changes can treat menopausal symptoms, making changes can help you to cope better. For example, maintaining a healthy weight, eating well, exercising and controlling your environment can help improve your wellbeing.

Menopause is an ideal time to assess your overall health. Consider what changes you can make so you can be as healthy as possible.

Maintaining a healthy weight

Menopause does not make you gain weight. But there are other associated reasons why you may gain weight around this time of your life:

• Low oestrogen can cause body fat to move to your waist from other areas of your body.
• As you get older, muscle mass decreases which means your metabolism slows.
• Due to dealing with menopausal symptoms, you may not move or exercise as much and make poor food choices.

Sticking to a balanced diet at this time of life is important. Gaining weight or living with overweight can make menopausal symptoms worse. Fat stored around the belly (also known as visceral fat) is linked to an increased risk of heart disease, type 2 diabetes, breast cancer and dementia.

If you’re trying to lose weight, get advice from your doctor or dietitian. They can guide you and make recommendations based on your needs.

Regular exercise

Exercise may not reduce hot flushes or night sweats, but regular exercise can improve your quality of life as you go through menopause.

The physical and emotional benefits of exercising during menopause are:

• helps with weight loss and to maintain a healthy weight
• reduces your risk of osteoporosis
• improves mood
• improves sleep, which may mean you feel less fatigued during the day
• reduces risk of heart disease
• improves cognitive (mental) functioning

You will best benefit from exercise if you include:

• aerobic activity for your heart health
• flexibility training, such as yoga, to improve your flexibility and balance
• strength training to help strengthen and build bone and muscle

If you have a chronic condition or are with disability and haven’t exercised before, speak with your doctor first. For advice on what activities to take up, talk with a qualified health professional, such as an exercise physiologist, personal trainer or other appropriately trained health professional.

Controlling your environment

For some people, any small increase in your body temperature can trigger hot flushes or night sweats. You can make changes to your environment or lifestyle to help lower your body temperature and prevent it from rising. These changes do not treat actual hot flushes or night sweats, but they can help you to cope.

Examples of environmental and lifestyle tips you can try to help lower your body temperature:

• Adjust your clothing — dress in layers, wear sleeveless tops and wear clothes made of natural fibres that breathe.
• Keep cooler at night — lower your room temperature, put a cold pack under your pillow and turn your pillow over to the cool side when it feels warm.
• Use a hand or electric fan — keep a personal fan in your bag, so you can use it whenever you feel hot.
• Drink cool liquids — keep an insulated water bottle with iced water handy.

Avoid triggers

If you have noticed specific triggers that affect your symptoms, try to avoid them.

Some people find certain things trigger their hot flushes and night sweats, for example:

• spicy foods
• smoking
• alcohol

Can complimentary therapies help manage menopausal symptoms?

Some complimentary therapies can help manage menopausal symptoms:

• Yoga — studies show that yoga can improve menopausal symptoms, for example sleep difficulties.
• Cognitive behaviour therapy (CBT) — group and individual CBT can help reduce the impact of your menopausal symptoms while also improving your emotional wellbeing and sleep. CBT can change unhelpful ways of thinking, feeling and behaving.
• Hypnotherapy — this type of therapy can improve your sleep and the impact of hot flushes. While there’s not a lot of evidence of its effectiveness, some people find it helpful.
• Paced breathing — this technique may help some people manage anxiety that can occur with hot flushes. Take slow, deep abdominal breathing for 15 minutes, twice a day.

Studies have not been able to show that other types of complimentary therapies, such as acupuncture, magnetic therapy, reflexology or chiropractic interventions, directly reduce menopausal symptoms.

Can complimentary medicines help manage menopausal symptoms?

Currently, no, complimentary medicines, such as supplements and herbs, have enough evidence to prove that they stop menopausal symptoms.

Studies are ongoing, but for now, there is not enough evidence to support using herbs, such as black cohosh and red clover, to treat menopausal symptoms.

It’s important to remember that like all medicines, complementary medicines can cause side effects. For some people, they may even be unsafe to take.

St John’s Wort may improve symptoms of depression, but it has not been proven to improve menopausal symptoms.

Speak with your pharmacist or other qualified health practitioner before you take herbal or complementary medicine.

When should I see my doctor?

You should see your doctor if you:

• think you have started to go through menopause and want advice
• have severe symptoms and are struggling to manage them
• have abnormal bleeding or any vaginal bleeding after you have not had your period for a year

Your doctor will examine you and may order blood tests. Together, you can work out a plan that is right for you to manage your symptoms.

Are there complications of menopausal symptoms?

Not everyone who goes through menopause has symptoms or complications. If you do have complications, they may affect your physical and mental health.

Physical complications that happen because of a drop in hormones include an increase in your risk of heart disease and osteoporosis.

Mental-health-related complications are sometimes obvious, but for some people they are subtle. As you go through menopause, you may feel irritable, have a low mood, feel depressed and unmotivated and lose interest in sex. This can affect your day-to-day life and relationships.

Even if you have not had depression in the past, you are at a higher risk of experiencing depression during menopause.

It is important you look after your mental health. If you feel you are struggling, reach out to your healthcare provider or support network. You don’t need to go through this alone. Help is available.

If you need to talk to someone about your mental health, call Beyond Blue on 1300 224 636 or chat online to their counsellor 24/7.

Resources and support

• Jean Hailes for Women’s Health has more information about menopause.
• The Australasian Menopause Society (AMS) has a search tool to help you find a doctor with a special interest in midlife and menopause.
• For more information and support, you can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.
• The AMS has in-depth information about lifestyle and behaviour changes for menopausal symptoms.
• If you think you have symptoms of perimenopause or menopause, the NSW Government has a checklist you can use in Arabic, Filipino and Vietnamese.
• Women NSW has a menopause symptom checklist for Aboriginal and/or Torres Strait Islander people.