Am I going through the Menopause?
This is a very common question I get asked. Menopause is only strictly diagnosed when periods have stopped for one year. In the run up to this, women can experience a variety of symptoms and we call this the perimenopause.
Symptoms of Perimenopause:
Discomfort with sex
No confidence and a sense of feeling invisible
This perimenopause is diagnosed by considering a whole host of factors. Over the age of 45 years, when a woman has a change in periods combined with hot flushes or sweats, it is usually enough to be able to diagnose. NHS GPs will often have strict guidelines on which tests they can offer. Outside of the NHS, there are other interesting tests such as those which measure hormonal and nutritional metabolites in the urine. These can carry a cost, but can sometimes give additional information that some women may be interested in but you must always consider whether they can add real value to your decisions.
Below the age of 45 years, it is more common to assess perimenopause by use of a blood test called FSH. This is Follicle Stimulating Hormone, which is secreted by the pituitary gland. Raised FSH can be suggestive of menopause. It is often useful to get more than one reading to be sure.
A blood test for Anti-Mullerian Hormone, (AMH), is increasingly being used to assess fertility treatment. The level of AMH can reflect the amount of ovarian reserve. This refers to the amount of eggs a woman has left in her ovary. The higher the level, the better the chances of fertility. It is not routinely used to diagnose the menopause, but often women are keen to investigate this if fertility is an issue or concern. In the USA it is used more routinely than the NHS, where it is not generally indicated.
Measurement of hormones is particularly important when premature menopause is suspected. The commonest age for menopause in the UK is 51-52 years but perimenopause can start much earlier, sometimes 5 or 10 years before periods stop completely as the official menopause. This time can be a nightmare. If your periods stop before the age of 45 years it is important to see your GP to check as this is early menopause and often needs to be medically treated to protect long term risks to bones and help prevent cardiovascular disease.
Risk Factors for Early Menopause:
DIET and LIFESTYLE IS IMPORTANT
Interestingly a recent UK study suggested a diet high in refined carbohydrates such as white pasta and rice can bring on an early menopause whereas a diet with more oily fish and legumes (peas, chickpeas, lentils and beans), may delay menopause.
FOOD IN PERIMENOPAUSE?
Ditch the processed food, caffeine and junk and limit alcohol.
Oily fish such as salmon, herring, anchovy, mackerel and sardine
Magnesium rich food-leafy green vegetables
Fibre- pulses, vegetables and wholegrains
Fermented foods for a healthy gut
Soy- tempeh and tofu
Calcium rich food
Check vitamin D levels
Menopause matters and many women can suffer for a long time in the ‘peri’. My advice, don’t suffer in silence. See a GP who knows about the perimenopause and who can give you advice on testing, diet, lifestyle, hormone replacement therapy and natural alternatives. Know your options.