health

An expert answered everything you're too worried to ask about menopause.

Priceline Pharmacy
Thanks to our brand partner, Priceline Pharmacy

Unless you were born in space and raised by a species unfamiliar with the highs and lows of owning a uterus, you've likely heard of menopause. Whether you've watched a loved one go through it, or experienced it yourself, you probably know the basics.

But do you know the difference between perimenopause and menopause? Or that headaches and joint pain are both symptoms of "the change"? If you did, well done you! And if you didn't, don't worry — you're in the majority.

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Luckily for us, October is Menopause Awareness Month, and pharmacist Mel Gannon from Priceline Pharmacy is here to answer everything you're too scared to ask about the big M.

So, if you have a uterus and some burning questions, stick around as Gannon sheds some much-needed light on all things perimenopause and beyond.

Just a note before we dive in: any person with a uterus will experience menopause. We mostly use non-gendered terms throughout this article; however, "women" is used when referring to research and statistics that also use that term.

1. Is there a difference between perimenopause and menopause?

If you've ever felt silly for not knowing what perimenopause was, rest assured, you're in excellent company. Gannon told me she often speaks to people experiencing a range of challenging symptoms who have no idea they're in the thick of perimenopause.

"A great way to think of perimenopause is as a stage — or, as some people call it, a 'transitional time' — before menopause, which is the final period a woman has," explained Gannon. "Then, once you're 12 months past your final period, you're post-menopausal."

Perimenopause usually lasts four to six years; however, it can last for up to 10 years.

2. So, what are the little-known symptoms of perimenopause and menopause?

The list of perimenopause symptoms is vast, to say the least, and Gannon said the experience will vary drastically from person to person.

"It's so individual," she said. "The symptoms vary, but they also vary in severity. 20 per cent of women actually report that they have no symptoms of perimenopause and menopause. But then, at the other end of the spectrum, up to 20 per cent of women can have really severe symptoms that interfere with their daily lives, so there is very much a scale."

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According to Gannon, some of the lesser-known symptoms include:

  • Itchy and dry skin.

  • Headaches and migraines.

  • Joint and muscle pain.

  • Bloating.

  • Gastroesophageal reflux disease (or GORD).

  • Sleep disturbances including trouble staying asleep or waking up feeling as though you haven't had adequate rest. 

  • Forgetfulness.

  • Irritability.

  • Anxiety.

  • Dryness and/or irritation both within the vagina and the skin of the vulva.

3. Why are urinary tract infections (UTIs) more common during perimenopause and menopause?

"Perimenopause and menopause is a time when our oestrogen levels are declining or fluctuating. And oestrogen is really important for the health of vaginal and urinary tract tissue," explained Gannon. "So, as oestrogen declines, the tissue in those areas can thin and you can get dryness and irritation, which makes us more vulnerable to bacterial infections getting into that tissue."

The good news is that symptoms can be managed easily, so it's important to visit your pharmacist or GP if you think you have a UTI.

4. So, if I'm "menopausal", can I finally stop bothering with birth control?

As logical as this might seem, the news on this one is a bit disappointing. It turns out you can still become pregnant while experiencing menopause, and Gannon said that before we can think about ditching birth control, we have to confirm that we're post-menopausal.

"It's important to continue using contraception until that's confirmed, and even then, the length of time you need to continue using contraception will vary depending on your age," she said. Gannon recommended working with your doctor to make sure you're following the right guidelines for you.

5. Okay, what's the deal with menopause hormone therapy (previously known as HRT)?

Gannon said that this is the question she encounters the most. The confusion surrounding menopause hormone therapy (or MHT) is widespread. The origins of this can be traced back to a study that was published in 2002 that has since been widely criticised due to poor study design.

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Gannon explained, "It's important that we have this conversation because we know that for most women between the ages of 50 and 60, the benefits of MHT will outweigh the risks. There are a lot of benefits."

While Gannon said there are many known advantages to MHT, including improvements in bone strength, brain health and cardiovascular health, she still advises that, as with any medical intervention, there are side effects and individual considerations to take into account. So, it's essential that each person works with their doctor to find the right options for them.

6. After menopause, can I stop getting pap smear (cervical screening) tests? 

According to Gannon, the short answer to this one is no. "It's really important to continue your regular cervical screening test every five years," she said. "The recommendation now is that you continue these up to the age of 75. After that, it's important to have a conversation with your GP to decide what is appropriate for you."

7. Do I need to focus more on my heart health during perimenopause and post-menopause?

Gannon explained that despite starting off with a lower risk of cardiovascular disease, as women get older and enter menopause, "our cardiovascular risk factors actually become much more similar to men, in that we have an increased risk of cardiovascular disease". This is largely related to drastic changes in oestrogen, which is very protective against heart disease.

"It's important that we have regular blood pressure checks, particularly after we get to the age of 45," explained Gannon. "If you have any other risk factors as well, your GP may suggest that you monitor your blood pressure more frequently."

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8. Does menopause cause you to lose your sex drive?

While yes, Gannon confirmed that libido can be affected by the hormonal changes brought on by menopause, she also pointed out that it's not just a lower sex drive that could be leading to changes in desire.

She explained that, on top of thinning skin both within and around the vagina, "there are also changes to vaginal lubrication and irritability around the vulva, so sometimes even when you do want to have sex, it can be quite uncomfortable."

She suggested that there are plenty of ways to address this, including a range of different therapies and the use of lubricants. "It's important to address both the sex drive and to make sure that you're feeling comfortable, and that it's pleasurable," she said.

9. What are some lifestyle changes that can help manage symptoms?

When it comes to symptom management, Gannon recommended that we lean on the classics: daily movement (whatever that might look like for you), nourishing food, water, adequate rest and tons of self-compassion.

"There certainly are some complementary medicines that some women may want to talk to their pharmacist about, and they can guide you in that as well," she said.

According to Gannon, this is where your local pharmacist really shines. "Pharmacists are medication experts," she said. "They can provide you with information on medications for perimenopause and menopause and work closely with your GP to ensure you have the information you need to make an informed choice that takes into account your unique experiences and health."

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Mel Gannon's comments have been supplied on behalf of Priceline Pharmacy.

This information is general in nature and does not replace the personalised advice of a healthcare professional. As with any health condition, always seek health and medical advice from your pharmacist or healthcare professional.

Feature Image: Getty.

Priceline Pharmacy
We know change can be tough, but you don't have to do it alone. At Priceline, our pharmacists are here to support you every step of the way. From free health checks, click and collect scripts, vitamins and supplements, and more. We’re here to help you feel great, all year round.
If you want health advice or support, chat to a Priceline Pharmacist. Learn more.