- Hormonal fluctuations can cause cyclical breast tenderness and causes irregular menstrual cycles.
- Hormones affect the ocular tissues and the composition of tears which the eyes produce, resulting in excessively dry eyes and changes in vision.
- Epinephrine and Norepinephrine, the neurotransmitters that regulate heart rate and blood pressure, tend to fluctuate in menopausal women causing flutters and palpitations.
- Lower oestrogen levels cause the lining of the urethra to thin and this can contribute to leaking of urine.
- Less oestrogen causes acne and dry and thinning skin for many women.
- A drop in oestrogen levels tricks the hypothalamus gland into thinking that the woman is overheated, signaling your body to sweat more and causing body odour.
- Migraines may start for the first time or worsen as the women starts going through the menopause because of new hormonal fluctuations.
- Lower oestrogen levels cause thinner, drier and less-elastic vaginal tissue and decrease blood flow to the area. This can result in vaginal dryness, itching and painful sex.
- A woman’s weight gain and altered distribution throughout her menopausal journey is impacted by five factors: hormones, diet, exercise, stress, and genetics.
- Irregular periods also increase the risk of pregnancy. “The second highest unintended pregnancy age for women is during their 40s”.
- The less oestrogen the ovaries produce, the more the acceleration of loss of bone mass there will be.
Take a past surgical history, check BMI and obstetric history.
Mood changes could also be due to;
Take an assessment for these e.g HAD scale.
- Forgetfulness/difficulty concentrating.
Studies suggest that these symptoms are unlikely to be related to the menopause (NICE 2017).
- Loss of Libido – also check for;
- androgen deficiency
- inadequate sexual stimulation
- life stresses
Take a sleeping history.
Ask about sexual relationship if appropriate.
Muscle and Joint pains could be due to;
- osteo arthritis
- rheumatoid arthritis
Ask about pain history.
Any morning stiffness of joints.
Family history of above conditions.
Carry out a muscular skeletal exam.
- sun exposure
- ask if they smoke, vape or ex smoker
- ask about sun exposure
Weight gain increases with age.
Women gain on average 2.25 – 4.19kg as they get older.
There is also fat redistribution with age which can be mistakenly thought the menopause is causing.