I am constantly saddened by my patients telling me stories about how the menopause affects their quality of life. Women I talk to are generally not coming to my menopause clinic complaining primarily about their hot flushes or night sweats; it is the effects of low oestrogen on their brains that has the biggest impact on how they are living.
I see many women who are worried they have dementia as they have a worsening memory and are constantly forgetting things. It can be quite amusing when you find your car keys in the fridge but it is not amusing when you forget to go to an important event or cannot remember details of a work meeting.
The main female hormones oestrogen and testosterone have an important role to play on cognition and memory. When these levels reduce during the perimenopause and menopause, many women find that they have numerous symptoms affecting these functions.
A recent questionnaire undertaken by West Midlands police revealed that around 80% of women had symptoms related to the menopause that interfered with their ability to work. The three most common symptoms that were affecting them were memory problems, fatigue and anxiety.
I have seen women who tell me they have forgotten important appointments, that they are making very important mistakes in their work and other women tell me they are constantly forgetting their children’s games kit to take to school. All of this is very frustrating and can affect not just the women but people close to them too.
The average age of the menopause in the UK is 51 years but around 1 in 100 women have an premature menopause (under 40 years). Many of these women are still not receiving adequate help, support and advice about how best to manage their symptoms. In addition, so many women do not realise that their symptoms are related to their menopause.
Talking to most women about the menopause, they always think about hot flushes and night sweats. However, many women, including Kate Reddy and Allison Pearson’s fantastic novel How Hard Can It Be, blame their symptoms on their stressful lives and being pulled in various directions, often by children and elderly relatives. They often have no idea the psychological effects of the menopause.
One of the most common problems people who see me in my menopause clinic complain of is interrupted sleep. Having disturbed sleep has a huge impact on how women feel the following day. Many women tell me they wake up feeling exhausted and they drag themselves around during the day. Women tell me they have no energy or motivation to do their daily tasks let alone do any exercise.
Brain fog is a very common symptom of the menopause and women have told me that their brains feel like “cotton wool” and they find it very difficult to absorb information. This can be a challenge with high-powered jobs but it can also affect simple tasks like reading a book or listening to the radio.
There has been so much negative publicity in the past about HRT that women are scared of taking it. However, we have clear guidelines based on the available evidence which support the safety of HRT. The majority of women taking HRT find that their motivation, energy, focus and memory really improve. This has a very beneficial effect on the quality of life but also their ability to function and work.
Many employers underestimate the very negative effect the menopause can have on women. I work very closely with West Midlands Police and it is very clear that these women do not want to simply be offered fans or to work with better air-conditioning. What they need is for other people to appreciate and understand the numerous symptoms that can affect women at this stage of their lives.
Women also need better access to menopause care so they can be offered the right dose and type of HRT. Both oestrogen and testosterone are very important female hormones that need to be balanced correctly for women to function better. In addition, taking HRT can lower future risk of diseases such as osteoporosis and cardiovascular disease.
Last updated: February 2018