“Chaos” for women in 40s, undiagnosed with beginnings of menopause

World Menopause Day is on October 18 

Women aged in their mid to late forties are often undiagnosed as they face a turbulent time of upheaval when their hormones fluctuate in the transition from reproductive and fertile, to post-menopausal.

Research studying Australian and Swedish women, highlights as never before, the chaos which takes place in this segment of the female population over many years.

While many women tolerate disabling symptoms, their condition is little understood. Testing hormone levels is of little use and in many women their symptoms are often attributed to stress and family life.

New research reveals the hormonal chaos faced by many women and the symptoms that relate to these wide fluctuations, clarifying the world of peri-menopause – the years before women have their last periods.

The research has been published by a group of investigators, particularly including Professor Henry Burger, an internationally recognised hormone specialist with the Jean Hailes Foundation and based at the Prince Henry’s Institute of Medical Research.

They have found that women can begin to experience symptoms for four or many more years prior to menopause.

“The real message that menopause is down the track is when her period becomes irregular and the time to the final menstrual period is often called the menopausal transition,” Prof Burger says.

At this stage, many suffer migraine and severe pre-menstrual syndrome and breast tenderness, weight-gain and depression. Symptoms can come and go, making it hard to diagnose and treat.

“Even after periods become irregular, some women are still ovulating and therefore are also fertile. A few women do still get pregnant in their late 40s or early 50s.”

“Our understanding is now much improved, but we still have some way to go,” Prof Burger says.

“Until recently, the transition was thought to be a time of gradually declining oestrogen levels, but this research demonstrates that this theory is incorrect and shows the wide variation in hormone levels and the impact this has on women at a time in their lives when they are flat-out caring for others and often also managing careers.”

The publication of Prof Burger’s and the group’s findings appeared in Climacteric, the Journal of the International Menopause Society; Menopause: the Journal of the North American Society; and the Journal of Clinical Endocrinology and Metabolism, the journal of the US Endocrine Society.

The menopausal transition: a 9-year prospective population-based study. The Melbourne Women's Midlife Health Project.
Guthrie JR, Dennerstein L, Taffe JR, Lehert P, Burger HG.
Climacteric. 2004 Dec;7(4):375-89.

Women with peri-menopausal symptoms can be helped through education, reassurance, weight management advice and for those with healthy hearts who don’t smoke, low-dose contraceptives which effectively smooth out these hormonal fluctuations.

Significantly, hormone therapy (HT) may not be appropriate early in this transitional phase as the low doses of hormones in HT do not suppress the woman’s own hormones which continue to fluctuate and cause symptoms.

The research could have widespread implications for many women. Australia is home to 3.9 million women over the age of 45.

Prof Burger, considered by many to have pioneered proper care for women with menopause with the late Dr Jean Hailes, is available for interview.

Contact Aleeza Zohar at the Jean Hailes Foundation for Women’s Health on (03) 9562 6771.

A snapshot guide to dealing with peri-menopause
Positive actions  Minimise negatives
Keep a diary of symptoms to share with your doctor if needed

Include Omega 3 fatty acids in your diet
Eat a small amount of protein at every meal
Increase your calcium intake
Walk for half an hour at least three times a week to control your weight and strengthen your bones
Seek out accurate information through books and websites.
Try www.jeanhailes.org.au and Menopause Management Resources
Ask your doctor to run prevention checks, ie blood pressure, cholesterol, blood sugars.
Find out whether you would be helped by a low-dose contraceptive.
 Don’t waste money on hormone level testing
Avoid bioidenticals (see 'Bioidentical' Hormones)
Quit smoking (see Lifestyle Resources)
Limit caffeine
Hormone therapy is often not suitable while a woman is still regularly menstruating
Check out the nature of any herbs you may be prescribed
Don’t consider irregular periods as the end of your fertility.

Page created October 17, 2005
Content October 17, 2005