If you think menopause symptoms stop after 55, think again! Here’s a snapshot of the first results of the reproductive health and menopause survey for those age 55 or over.
Once you’ve ‘gone through” menopause there seems to be a persistent perception that menopause symptoms fade away in the first few years after your periods stop and life goes blissfully on. That may be the case for some people but it’s not always everyone’s reality. Some symptoms seem to persist and they can cause a significant amount of physical and mental pain.
Studies have shown that some people continue to have symptoms for around 4 years after menopause. With the average age of menopause in the UK being 51 you’d expect that many symptoms would have abated by 55, but we know that vasomotor symptoms can continue for up to 11.8 years after menopause. Some women however report having hot flashes well into their 70’s and 80’s.
But it’s not just hot flushes and night sweats that are causing problems long after the periods have stopped.
Harley Street Emporium has launched a survey to see which symptoms are causing those over the age of 55 the most grief – and the list is long.
Here are the preliminary findings. If you would like to take the survey you can access it here and your de-identified results will be added to this first pool of 70 respondents.
“Thought I was doing OK! Worst symptoms post menopause!”
The demographics
First up, who are the first 70 respondents?
The vast majority – 68 out of 70 were aged 55-65. Two were 65-75. Twenty said they were perimenopausal.
Around 61% live in UK postcode areas that are classified as deprived.
Of those who answered about their level of education 16% had finished school, 19% had completed technical training or an apprenticeship, 45% has an undergraduate degree and 20% had a post-graduate qualification.
Some 43% were employed, 26% were self-employed, 21% were retired and 10% were unemployed.
Two respondents identified themselves as non-binary while 13 gave no answer on their gender identity. The remainder identified as female.
The symptoms
“Menopause took my marriage, career and almost my sanity.”
Respondents were asked which symptoms or conditions they had and were able to tick as many as were applicable. On average each respondent had six symptoms each.
From most prevalent to least, these were the answers (rounded to the nearest percentage point):
76% – poor sleep
74% – anxiety and low mood
73% – brain fog
67% – low libido
63% – vaginal dryness
47% – stress urinary incontinence/urge incontinence
40% – night sweats
37% – itchy/burning sensations
34% – unexplained bleeding
30% – hot flashes
23% – painful sex
17% – increased frequency of urinary tract infections (UTIs)
12% – prolapse/s
7%. – tearing and bleeding labial tissue
4% – bacterial vaginosis
4% – cancer (breast, uterus, cervix, ovarian).
There is a symbiotic relationship between poor sleep, anxiety and low mood, brain fog, hot flushes and night sweats as well as the bladder symptoms and vaginal/labial discomfort.
All of them will disturb sleep and poor sleep will in turn amplify the brain fog, anxiety and low mood.
This highlights the need to ensure all of these symptoms are adequately addressed or treated in order to see an improvement and break the cycle.
This may involve hormone replacement therapy or other medications, lifestyle changes, CBT or even hypnotherapy for vasomotor symptoms like the hot flushes and night sweats, and CBTi for sleep.
For the bladder, pelvic floor physiotherapy can help with leakage and urge incontinence as can certain medications.
Sexual activity – 58% said sex was painful
Lack of sleep, vaginal dryness, low libido and painful sex are a perfect storm for a lack of sexual activity, but despite that, 30% had had sex in the past 7 days and a further 18% in the previous month and 13% in the past 6 months.
That said, 6% hadn’t had sex for 6 months to a year and 33% hadn’t had sex for more than a year.
The vast majority of those who answered the question on why they hadn’t had sex answered that it was too painful – 58%. A further 16% said they had no interest in sex and an equal percentage said they chose not to have sex. Just on 10% said they had no partner.
Interestingly 25% of those who had had sex within the previous week said that sex was painful. For all the time periods 58% of the respondents reported that sex was painful.
Another way of putting this is almost one in three women over the age of 55 finds sex painful.
Vaginal dryness, a burning/itching sensation in the vagina or around the vulva, tearing of the skin and bleeding and low libido can have an impact on sex lives and relationships, but they can go beyond that too. They can make day to day activities like sitting, walking and exercising more difficult. This can have an impact on the ability to work as well as quality of life.
Treatments such as topical oestrogen are very effective in relieving these symptoms and need to be given for long term use.
Treating low libido is complex. For some people testosterone therapy may be helpful but for others there may be psychological or physical reasons for the lack of interest in sex. In these instances, studies show that talking therapies or physiotherapy may be useful.
Accessing help
“I suffered hugely as I didn’t know about it. Low mood and anxiety and had quite a struggle to get HRT.”
The vast majority (80%) of respondents sought help from their GP however this was not the only place people went for help and information – and equal number went to at 2 places for assistance with their symptoms while around 10% went to four or more places for help.
Who people saw (they could choose multiple options):
80% – NHS GP
7% – Private GP
23% – Specialist menopause clinics
4% – Sexual health Clinics
3% – Women’s Health Hub
21% – Social media
17% – Hospital gynaecologist
1% – Bio-identical hormone provider
6% – Online menopause clinic.
In terms of satisfaction with the service or information they received those who saw multiple practitioners were the generally the least satisfied.
When it came to satisfaction with their GP 42% said they were satisfied with their doctor, 4% said they were very satisfied and 16% said they were neither satisfied/nor dissatisfied.
Just on 13% said they were very dissatisfied with their GP and 25% were dissatisfied.
Specialist menopause clinics scored better with 64% of attendees saying they were satisfied or very satisfied.
Online menopause clinic were only used by a handful of respondents but although they were regarded as ‘very easy’ to access not one person was satisfied with the service they received. In fact, 75% were dissatisfied or very dissatisfied, the other 25% were neither satisfied/nor dissatisfied.
Hospital gynaecologists were seen by 17% of respondents who were split in terms of satisfaction levels with 57% saying they were satisfied or very satisfied while 14% were neither satisfied or dissatisfied, and equal numbers were dissatisfied or very dissatisfied.
About one third of respondents (34%) said it was difficult or very difficult to get access to their GP, 30% said it was neither easy/nor difficult and 25% said it was easy or very easy (4%).
Support networks
For those who were employed support in the workplace varied. Some 17% said they were very supported, 20% said they were supported, 40% said they were neither supported/nor unsupported and 23% said they were unsupported.
For the unemployed or self-employed 46% relied on family members or partners, 22% said friends helped them and an equal number (22%) said they had no support. Just 4% named their doctor.
Other conditions
Just over a third of respondents (36%) had other conditions that affect their gynaecological health. Fibroids and prolapses were the most common, affecting 10% respectively. Gynaecological cancers affected 3% and an equal number had endometriosis or polyps.
Summary
“I thought I had coped well to 58 but now it feels as if I am falling apart mentally and physically!”
Menopause symptoms do not stop being an issue for women over the age of 55.
Mental health, sleep and brain fog are significant issues for this cohort. The symptoms that impact on the bladder, vagina, vulva and libido are also very common. The vast majority of respondents had multiple symptoms, all of which impact on quality of life, the ability to work and relationships, as reflected in the comments given.
Women need help and support post menopause. We are living at least one third of our lives in post menopause and it should not be spent in physical or mental pain.
