Gynaecology & Menopause
Perimenopause symptoms no one talks about
From perimenopause onwards, the body can go through some fairly interesting changes. Some of these we know and talk about – the skin changes, brain fog, hot flushes etc. Is there a group of symptoms and consequences of declining oestrogen in menopause that we don’t really talk about, out of fear, embarrassment, or maybe shame? These are the really personal intimate symptoms that can impact periods, libido, vaginal health, pain, and dryness.
Our skin changes in menopause, getting thinner and drier, this includes the vagina, vulva, and urethra tube that carries wee from the bladder. Thinning can cause vaginal dryness in menopause, which maybe makes sex painful, and can be part of the loss of libido. Laughing and leaking, as a result of a menopausal bladder is never funny. Nor is prolapse in menopause.
Can vaginal dryness be treated?
Because these are the taboo menopause symptoms, too few of us know how to deal with them. That said in our experience once you start talking about these symptoms with someone who knows something about this or has experienced similar they don’t stop talking. And the good news - most of these conditions are treatable, including urinary leaking and vaginal dryness, so it really is important to get informed and feel confident to ask for professional medical support.
Perimenopause and period changes
Flooding, spotting, extended or short, irregular periods, and bleeding, all can be experienced during perimenopause leading up to the day of your menopause (12 months without menstruating) when you can celebrate their end!
Menopause weakens your pelvic floor
Perimenopause and menopause can weaken pelvic floor muscles, causing those ‘key in the door moments’ when you think you’re not going to get to the loo in time. These muscles support the pelvic floor. It’s not only continence that can become problematic, lack of muscle strength can result in even more embarrassing prolapse problems.
Did you know pelvic floor weakness can be reversed in almost 85% of cases? Probably not – adverts tell us to buy pads to improve our quality of life. We really need to be doing, are the appropriate pelvic floor exercises. Women’s health physio Christien Bird explains all - find out from her but will help you feel less pain discomfort and dryness whether it’s through exercise or low-dose vaginal oestrogen that can relieve symptoms.
Find out how to make meaningful changes to help you to manage the symptoms that we don’t talk about enough.
What about post-menopause bleeding?
If you experience bleeding post-menopause you should look out for signs to rule out gynaecological cancer.
Endometrial cancer and menopause
One of the largest studies carried out in 2018 by the National Cancer Institute looked at the extent to which vaginal bleeding is associated with endometrial cancer in women who have gone through menopause, “90% of women diagnosed with endometrial cancer reported bleeding before their cancer diagnosis. Approximately 9% of postmenopausal women who saw a doctor for bleeding later received a diagnosis of endometrial cancer.”
If endometrial cancer is found early, a woman has a 95% chance of surviving cancer for at least 5 years. If you have bleeding after menopause, you should see your doctor and let them know to rule out endometrial cancer.
Symptoms of ovarian cancer to watch for post-menopause:
Menopause pelvic pain is not uncommon in the earlier stages as periods cease, but pain in the pelvic or abdominal areas post-menopause could be a sign of something more sinister. Ovarian cancer is an umbrella term for different cancers that have similar symptoms. Post-menopausal women are at more risk of developing ovarian cancer (but some types of ovarian cancer are more common in younger women). Endometriosis may also be a risk factor.
9 out of 10 women with ovarian cancer have no family history. Common Misdiagnoses of ovarian cancer are irritable bowel syndrome (IBS) or constipation, gastritis, stress, depression, and bladder problems such as urinary tract infections (UTIs).
According to the World Ovarian Cancer Coalition ‘About 20–25% percent of those diagnosed with ovarian cancer have a hereditary tendency to develop the disease. Of those cases, 10–15% are linked to an inherited genetic mutation in one of two genes which are called BRCA1 and BRCA2. Those genes are linked to both ovarian and breast cancer.’
Symptoms of ovarian cancer to be aware of post-menopause:
• Increase in tummy size
• Bloating
•Abdominal/back/pelvic pain
•Needing to pee more often or urgently
•Bowel changes
•Fatigue
Whilst many of these symptoms are common in perimenopause, if you are experiencing a combination of them and you are post-menopause, it is important you discuss symptoms with your doctor to rule out ovarian cancer.
