Menopause’s hidden symptoms – anxiety, depression, brain fog and a low sex drive affect more women than hot flushes.
When you think of menopause symptoms the first things that usually come to mind are red-faced women, drenched in sweat as they suffer yet another hot flush or night sweat, but a recent survey shows that mood, mental health and brain function symptoms could be affecting more women than these vasomotor symptoms.
Some 60% of respondents to a survey of 100 perimenopausal and post menopausal women conducted by Harley Street Emporium said hot flushes and night sweats were an issue for them, but 65% were also experiencing multiple brain function or mood/mental health symptoms.
Mood swings and ‘brain fog’ topped the list with 69% of women saying were affected by them.
Anxiety/panic attacks were the second most common affecting 68% of respondents.
Memory loss was an issue for 61%, and 60% said low mood/depression was a concern.
The mood and brain function symptoms varied with age, with those under 44 years of age tending to experience more mood swings, anxiety and low mood that their older counterparts.
Some 70% of women aged between 45-54 said memory loss was a concern and 64% mentioned brain fog but these tended to improve in women over the age of 55 with around 50% mentioning these.
The older group also experienced less mental health symptoms with 37.5% saying low mood was an issue and 43.7% mentioning anxiety.
While it is a small sample it delivers a disturbing snap shot of the mental health of women during this period with on average two thirds experiencing multiple symptoms – but very few are receiving treatment.
Just 3% of respondents were taking HRT, leaving 97% without any prescription medications to help them cope.
Of those who specifically mentioned mental health symptoms, just 12% were taking antidepressants and only one was taking both HRT and antidepressants. NICE guidelines recommending that HRT be considered as a treatment for women in this age group who present with low mood along side CBT. The guidelines only recommend anti-depressants for women who have been diagnosed with depression.
“Too many women are receiving inadequate advice, support and treatment for their menopause. This urgently needs to change,” menopause doctor, Louise Newson said. “Sadly these results echo what we hear from women using our free menopause app ‘balance'”.
Often women may feel like they are ‘losing their minds’ or may be worried that they are in the early stages of dementia, but in many cases, declining oestrogen levels may be the cause, Dr Newson says.
Low libido, or a lack of sex drive, is also extremely common among all age groups with 65% of all respondents saying it was an issue for them.
The good news is that for many woman “it may be easily treated with the right dose and type of HRT which includes estrogen. A small dose of testosterone is often beneficial too,” Dr Newson says. Testosterone is a hormone women naturally produce, but like estrogen, it too declines with age. Cognitive Behavioural Therapy is another treatment option.
Body and bowels
In addition to the mental health symptoms, fatigue, digestive issue and joint pain also affect more women than the hot flushes and night sweats in certain age groups.
Generally it’s thought that digestive issues like bloating or gas affect women in their 20-30’s more than those in later life, but the survey showed that 59% of women said it was an issue.
On average 68% said they had gained weight and 54% said thinning or receding hair was a symptom they were experiencing.
Women in their early 40’s were mostly likely to mention it as a symptom.
Women aged 40-44 were more likely to mention hair loss as a concern but it affected 54% of all respondents.
Another area of the body affected by menopause is the pelvic floor, vagina and water-works.
Symptoms that affect these are known as the genitourinary syndrome of menopause or GSM. Just over 40% of women who responded to the survey said that stress urinary incontinence or peeing when you laugh, sneeze or exercise, was a concern.
This and vaginal dryness tended to be more of an issue for the older women with 56.25% of women over 55 saying dryness was a concern.
Dryness may be a reason for sex becoming painful which was an issue for around 25% of the over 55 years olds, but it was also mentioned by 27% of women who were under 40 who may be going through premature menopause.
Vaginal atrophy can take a huge toll on relationships, but is managed with HRT or local oestrogen creams or gels. It is important to get any symptoms like these checked by your doctor to rule out other conditions. It is also important to note that if they are related to oestrogen deficiency they will not improve without treatment.
Vasomotor Symptoms Don’t Stop With Age
A common menopause myths is that night sweats and hot flushes stop shortly after their periods stop, but they can persist and the survey backed this up showing they can go on well past the average age of menopause, which is 51 in the UK.
Generally it’s thought that these symptoms plague women more in the lead up to menopause (known as perimenopause), and only go on for a few years after the last period.
But the survey showed that 58.5% of those aged 45-54 were having these symptoms while 75% of women over 55 said they were still experiencing them.
When it came to fatigue 63% of women said it was an issue while 54% said they had difficulty sleeping.
Joint pain increased with age which may indicate other factors associated with ageing are involved. Vitamin D and Magnesium may be helpful with some of these symptoms.
The Cost of Untreated Symptoms
Some 28% of women said their symptoms affects their work, their relationships or were a source of embarrassment for them.
This is a time of great change and it can put enormous stress in relationships and affect self-confidence, but it is surprisingly difficult to get help.
“Many women still find it difficult to talk about their symptoms, but those who do often say how hard it is to get their health care practitioner to take them seriously,” said Fiona Clark, the founder of Harley Street Emporium.
“I can’t tell you how often I hear women say ‘my GP just said no’ or said ‘I’m too old, or too young’ or they ‘only offered me anti-depressants’ or ‘I should just put up with it because it’s just a natural part of ageing.’ This isn’t an easy time and these symptoms can’t just be brushed aside. They have a personal, social and economic cost.”
They also have a high health cost.
“The menopause can cause many symptoms and more importantly can lead to health risks such as increased risk of developing heart disease and osteoporosis,” Dr Newson said, highlighting why it is so important for women to get the right treatment for their symptoms.
“Women are suffering here. They are in pain mentally and physically. It is affecting their families, relationships and their work life. They need help and support,” Mrs Clark said. “Better public education about HRT is needed as is better training for GPs as this is an issue that effects 51% of an ageing population.”