Menopause symptoms

This episode is all about the actual menopause, or final menstrual period. Leading endocrinologist, Dr Christina Jang explains what it's like transitioning from perimenopause into menopause, including the varying symptoms you may experience.

Teacher and children's party performer, Michelle, joins us to talk about her symptoms and how they affected her work and personal life.

When does menopause start? Are menopause symptoms different to perimenopause symptoms? What does a hot flush feel like? Listen to find out.

Look out for our next episode about navigating your menopause symptoms along with relationships and sex. Subscribe so you don't miss it!

Feel free to leave us a review too — we'd love to hear your thoughts.

Featured in this episode

Katie May

Our host Katie is a single mum in her late 30s. She is a communications expert with 17 years’ experience and is passionate about health and wellbeing. She is currently studying Italian just for fun and absolutely adores her pet greyhound, Piper.

Dr Christina Jang

Dr Jang is a Brisbane-based endocrinologist treating all endocrine conditions, with a special interest in female reproductive endocrinology, including menopause. She is a staff specialist in endocrinology at the Royal Brisbane and Women's Hospital (RBWH). She is a senior lecturer at the University of Queensland and president-elect of the Australasian Menopause Society (AMS).

For her, endocrinology is an area of medicine which presents opportunities to deliver far-reaching benefits to her patients.

Michelle

Michelle is 59-years-old and has been an English Language Studies (ESL) teacher for 11 years and a children’s party performer for 14 years prior to that. She likes reading Stephen King novels, pretending that she can cook, and being at the beck and call of a fluffy princess cat.

She has been happily married for 25 years to a handsome man who has been very patient with her menopausal moments.

Episode Resources

Australasian Menopause Society (AMS)

The AMS is a not-for-profit member-based society aiming to improve the quality of life for women during and after the menopause. The AMS helps women and their health professionals better understand the transition through this stage of life by providing accurate, evidence-based information about premature menopause, perimenopause, menopausal hormone therapy (MHT) and alternatives, osteoporosis and how to locate a doctor interested in women's health. Find out more from AMS.

Jean Hailes for Women's Health

Jean Hailes for Women's Health is a national not-for-profit organisation dedicated to improving women's health across Australia through every life stage. They work in public health, research, clinical services and policy. Their website has practical and easy-to-understand information for women and for health professionals. Visit Jean Hailes for Women's Health for more information.

Lifeline

Lifeline provides free, 24-hour telephone crisis support service in Australia. Counsellors are available to provide mental health support and emotional assistance, not only via telephone but face-to-face and online. Visit Lifeline or call 13 11 14.

Beyond Blue

Beyond Blue is an Australian mental health and wellbeing support organisation. They offer free, qualified mental health support via chat or phone. For more information visit the Beyond Blue website or call them on 1300 22 4636.

Transcript

Ep. 3 Menopause and life after | Leaving perimenopause and what symptoms will you experience now?

Vox pop:

It wasn't until after my period had stopped, that I got my first hot flush. And that was awful and unmistakable. It was definitely a hot flush.

Katie:

Welcome to It Can't Hurt to Ask, the podcast answering your health and wellbeing questions. I'm Katie and in this season, we're exploring the stages of menopause.

A quick note on terminology. Throughout this podcast we'll be using the terms women and girls. We use these terms inclusively to mean all people who identify as a woman or girl and recognize that people who do not identify as a woman or girl may still be affected by women's health issues.

Before we get started, we'd like to acknowledge the traditional custodians of the land on which we record this podcast. For us, it's Meehanjin, land of the Yagara and Turbul peoples.

Today, we're talking about life after perimenopause, what it feels like to transition into menopause and what symptoms we might experience.

Joining me once again is Brisbane-based endocrinologist Christina to guide us through this important conversation.

Christina, welcome. Let's get right into it. First things first, what exactly is menopause?

Dr Jang:

So, menopause refers to the final period in a woman's life. And that diagnosis can only be made 12 months after she's had that last period. The average age is 51, and it normally occurs between the ages of 45 and 55 but can happen early or later.

Katie:

So, we've talked about perimenopause and its symptoms in previous episodes. What are the early and maybe common symptoms of menopause itself and how might they differ?

Dr Jang:

So, the perimenopause is really characterized by fluctuating estrogen levels and with that comes fluctuating periods. The periods can be very heavy or they can not be there at all, and you go from having fluctuating estrogen levels to virtually no estrogen levels at all and the symptoms that come with that.

So, women no longer have periods but really the most common symptoms are hot flushes, night sweats, some women get vaginal dryness and discomfort during intercourse, some women have sleep disturbance and fatigue. or some mental health symptoms such as mood changes and irritability.

Katie:

Actually, yeah, hot flushes seem to be the number one thing that a lot of people talk about when it comes to menopause. What does it actually feel like and how do you know that you're having one?

Dr Jang:

Well, often it can be really hard to describe, especially if you've never experienced one, but most women know when they've had one basically. Women will describe it as this burning sensation starting from their chest, going up to their face and literally it feels like they are on fire. It stops them dead in their tracks.

So, they might be in the middle of a meeting or speaking to someone, and all of a sudden, they just feel so hot and they've got this intense desire to cool down. They might be taking off the jumper or their jacket. And it can be really very disruptive. And some women can get that 10 - 20 times a day and even at night. And it can really be very disruptive for their sleep.

Katie:

It certainly sounds that way. It does sound quite scary, a bit horrible, actually, to be fair. At the start of this episode, we heard from Brisbane-based TAFE teacher, Michelle. She shared the first time she believed she was entering menopause, which was when she had her first hot flush.

Since then, hot flushes have been a regular part of Michelle's menopause journey. So let's hear more about it.

Michelle:

I get really cranky and irritable, and I was, and I think I still am, completely impatient with a lot of things. So going to work and particularly with being a teacher, having to, yeah, put on a happy face and pretend that everything's normal, particularly when you're having a hot flush while you're trying to teach something was really very difficult.

I ended up just getting a fan and rolling with it and thought to myself, ‘Okay, everybody's going to go through menopause. It's fine.’ So, I'd take a fan to class and I'd end up having a hot flush and rather than trying to strip everything off, I'd grab my fan and use my fan.

It was interesting because a couple of the students in different cultural groups had different reactions to it and a couple of the ladies that were older would sort of go ‘Yes we understand’ and some of them bought me in some fans and things like that which was really sweet, so that was good.

So, it was hard, you know. You've just got to keep going with things, haven't you? I think the more visible things are, the more people are going to talk about it.

And I just, I don't know, I just had to let go and get to that point and go, you know what, this is what's happening. And I can't do anything because I'm sitting there and I've got sweat pouring off me, you know? And it's just like, ‘Okay, I've got to, sorry, I've got to pick up my fan, I've got to do this, I've got to go and have water.’

And the guys are good. And quite often they'd say, ‘Do you want me to go and get a glass of water for you? Do you want cold water?’

‘That doesn't really help, but okay, thank you. That's so nice of you.’

Katie:

Thank you to Michelle for sharing her story with us as well on this podcast. Christina, why do these symptoms occur? What's happening in our body when this happens?

Dr Jang:

So, after the menopause, the low estrogen impacts on the neural or nerve circuits in the brain. Our brains have a thermostat, and the low estrogen leads to an increase in the neurotransmitters firing into that thermostat. So many women, they don't just feel an intolerance of heat, but they also feel an intolerance to cold. So that comfortable zone where we feel, from a temperature point of view, feel comfortable is really narrowed.

Katie:

So, the brain thinks that it needs to get hot, but it doesn't, or it just gets hot sort of without really realising?

Dr Jang:

It's just the perception of being hot.

So, they have done studies before where they've actually measured women's temperatures around the time of the menopause. I think the temperature only goes up by like 0.7 of a degree. So, there's not really an increase in the temperature. It's the perception.

Katie:

The brain's perception of feeling hot. Yep.

So, let's go back and hear from Michelle again, where now she's going to speak about the support she received from her work colleagues, her husband Mark, and her family during her menopause journey.

Michelle:

From colleagues, it was really good because I work with a lot of women who are older than me, so I can ask them things. But, you know, like so different for everybody. One woman, like I said, was on HRT for eight, nine years, and she said she couldn't live without it. And then another woman I asked had one hot flush and that was it and it was all over and done with for her. So, I never asked her again. That was the end of asking her anything!

So, everybody had really different symptoms and it was really hard to try and get this whole ‘Oh okay what I'm going through is normal’ or this feeling or that feeling or whatever was normal because it didn't seem to be a normal for anybody, just similar symptoms.

My mum was just very non-committal about everything. Anytime I'd say to her this is happening she'd say, ‘I've got no idea’.

So, Mark has finally clicked with the fact that I'm not necessarily angry with him. I'm just cranky and grumpy. That's not really angry, it's just grumpy and impatient. He's been quite supportive of that in the long run. It took a little bit to get used to, but he's okay with that now.

And support from my daughter, I think it's probably going to be a little bit the other way around, that when she starts going through menopause that she's going to start coming to me. I think... I think I just want to make sure that I'm there for her, for any questions that she might have, but I think that I'd probably have similar answers to my colleagues in that, you know, everything's different. You know, I'd probably do all of the normal things of make sure you still continue with Pap smears and breast checks and all of those sorts of things, and that stopping your period doesn't just mean you can stop all of that sort of stuff. I think just emotional support and just say to her, ‘Yeah, I know the world's crazy and everybody's a bad driver and it's just really hard to deal with a lot of people a lot of the time and you just have to be a bit kind to yourself’. I think pampering yourself a little bit more is okay, I think, especially when you get impatient with the world. So, I'd probably talk to her about that sort of thing.

Katie:

Thanks to Michelle again.

I mean, I must have been a bit concerned to hear that being angry at the world is maybe a sign of menopause and I'm not quite in it yet. What I found interesting though about Michelle's comment was that intergenerationally between her and her mother, perhaps the symptoms not being the same for either of them, and then as she said for all of her colleagues as well. I imagine that would be kind of further isolating I think when you can't fully relate to someone's experience.

Dr Jang:

Oh definitely. I think also when Michelle's mum went through it, it was a different time. These days, the symptoms would have gone on unnoticed. She might have attributed it to something else. Whereas Michelle's obviously got a bit more awareness and education about it now. And she's even talking to her work colleagues about it. And that probably wouldn't have happened even as close as to five, ten years ago.

Katie:

Yep. Once again, it's all about speaking up and sharing our experiences and normalising all of these varied experiences with the menopause and other conditions as well.

Dr Jang:

Absolutely. It's a normal life event. It's a normal life event and all of us women will go through it.

Katie:

Yeah. And kudos to Mark, to her husband, for being so patient. And all the partners and carers out there who are supporting the women in their lives going through this. Thank you to them.

Dr Jang:

Absolutely. It's a bit of a journey for them, too.

Katie:

If you'd like more information on what we've talked about today, there are some links in the show notes.

That's all for today's episode. Christina, once again, what's the key takeaway you'd like our listeners to remember?

Dr Jang:

Well, menopause is a natural life event and it's not necessarily a bad thing. It's a very individual experience. And for many women, it's a big relief to not be having a period anymore.

Katie:

Yeah, that makes sense. And certainly, they're going to save a little money month to month, not having to buy period products.

Dr Jang:

That's true.

Katie:

In our next episode, we'll discuss how to manage symptoms of the menopause and go into detail about what life after menopause looks like. So, make sure you subscribe to stay up to date with all the latest.

Thanks again to Christina for joining us today and to the team at Queensland Health who make this podcast possible.

Thanks for joining us here today. We'll catch you next time on It Can't Hurt to Ask.