Why menopause matters

MPs in October called for all women aged over 45 to be offered a free menopause health check on the NHS to help them better prepare for the natural changes that affect all women.

The call, by the All-Party Parliamentary Group on Menopause, came just before this year's World Menopause Day on 18 October. The MPs said far more needs to be done to help women understand the transition to menopause, especially the onset of 'perimenopausal' symptoms.

Menopause - or the period of a woman's life when menstrual periods stop - affects all women as they age, with most beginning to experience menopausal symptoms between the ages of 45 and 55, and the average age being 51.

Initially, a women will enter perimenopause or, as the name suggests, the onset of hormonal changes in a female body that are normally the precursor of menopause. This may happen typically two to ten years before a woman's periods actually stop.

Both perimenopause and menopause can bring with them a wide range of symptoms, from the well-recognised 'hot flushes' through to period changes and changes in period frequency, sleeping issues, night sweats, anxiety, 'brain fog', weight gain, headaches and mood swings, among others.

While the severity of symptoms will vary from woman to woman, they can be debilitating. Indeed, the call by the MPs followed warnings earlier this year by another committee of MPs, the Women and Equalities Committee, that as many as one in three women end up taking time off work because of menopause symptoms.

In fact, a study by the Fawcett Society found that menopause symptoms can be so severe as to cause one in ten women to leave the workplace, with a further 14% reducing their hours and 8% not going for a promotion as a result.

When talking about menopause, there is often an assumption that medical intervention, in particular hormone replacement therapy (HRT), is the answer. As Anjanette emphasises, while this may well be an option, it is important, again, to be led by a doctor.

However, there are also diet and lifestyle changes that can help. For example, stimulants such as caffeine and alcohol can make hot flushes worse or mood swings more severe. "Think about those excessive stimulants; can these be reduced a little bit?" Anjanette advises.

Moving to a more plant-based diet can also be beneficial. "Things like nuts and seeds and herbs and spices and lentils and beans," she points out.

Glucose highs and lows can worsen the effects of brain fog. Avoiding or cutting down on sugar-laden, ultra-processed foods can therefore help to maintain more even levels of energy throughout the day.

Oats, nuts and seeds can be further important sources of fibre, and therefore also good for sustaining energy, as can be soy, tofu, raw carrots, peppers or celery. Similarly, Omega-3 - often found in oily fish - can be beneficial, with algal oil a vegetarian or vegan alternative.

Revisiting how, when and how often exercise is taken can be helpful, with Anjanette highlighting that research now recommends that, at this stage of a woman's life, it's more important to do a frequent amount of exercise but for a shorter duration. "So, try and avoid saving up the exercise for the weekend. Just do shorter bursts every day where possible," she points out.

Equally, it is important to think about bone health. "In addition to keeping walking, do something simple like gardening or household chores. What about also doing some weight-bearing exercise because that's important for the bones to reduce the risk of osteoporosis, but it's also very important for muscle mass," Anjanette advises.

Anjanette Fraser is a menopause specialist from Stretching the City.

Nic Paton is one of the country's foremost journalists on workplace health, safety and wellbeing, and is editor of Occupational Health & Wellbeing magazine. He also regularly writes on the health and employee benefits and health insurance markets.