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'Pause for thought'

Menopause hits when your periods have stopped for one year or more. Yet symptoms caused by a drop in oestrogen production in the years before and after can be challenging, says Dr Barbara Kearns, of Blackrock Medical Clinic.

She sees the challenges facing menopausal women every day, and says: "It is important for women to be aware of the different stages in life and that eventually menopause will come to us all.

"Recognising these signs and dealing with them in a positive manner can help women get through the menopause," she says.

"While hot flushes and mood swings are the most prevalent symptoms, vaginal dryness, lack of sexual libido, urinary incontinence, crown hair loss and excessive body hair are common place too," she advises.

The average age for the menopause in Irish women is between 48 and 55 with hot flushes, night sweats, irritability and mood swings scoring as the top four symptoms.

Mood Swings:

Depression, anxiety or panic attacks. Some women complain of not feeling like themselves. It is important to keep a keen eye on these symptoms and if you're worried, talk to your GP.

Body shape can change:

The waistline disappears, and feminine lines merge into a different shape. A new stodginess can make a woman feel unattractive to her partner, mentally fragile and insecure. The ideal anecdote is a healthy balanced diet, plenty of exercise and living life to the full.

Hair -- too much where you don't want it, not enough where you do:

Little can be done about excess hair other than opting for higher maintenance on the waxing and bleaching front, however, there are newer hair removal techniques such as laser and IPL which can help.

Losing your crowning glory?

Hair loss around the crown of the head can be a particularly distressing experience for women. Get advice on diet and potential nutritional supplements may help with this problem.

Hot flushes:

A feeling of intense heat with sweating and rapid heartbeat, and which may typically last from two to 30 minutes for each occurrence. Night sweats are excessive sweating while asleep.

Vaginal Dryness:

This is experienced by many women throughout life and not just at menopause. Try a good lubricant during sex or a doctor can recommend some topical oestrogen creams which will help with this.

Where has my sex life gone?

Changing hormone levels can result in a number of sexual difficulties throughout menopause -- low libido, discomfort during intercourse and loss of interest in a sexual partner are common. Your GP can check your hormone levels just to make sure things are normal, however, changes in libido can be down to a number of factors including psychological or physical ones. Feeling good about yourself, using a good lubricant, and working on your sex life can all play a major role in keeping your sex life on track. HRT can also help with these side effects.

Excessive bleeding and tiredness:

Those who experience excessive bleeding such as two bleeds in one month can feel exhausted and wiped out. They will need to ensure their intake iron and vitamin C is sufficient. Plenty of green vegetables, red meat three times a week and potentially an iron supplement if required.

I suddenly need to go to the loo:

A drop in oestrogen levels can result in gradual deterioration of tissues in not just the vaginal area, but the urinary track. Symptoms can present themselves some years after as a sudden urge to go to the loo, or leakage due to sudden movements such as coughing. Pelvic floor exercises when done properly through a good physiotherapist will make all the difference.

Can I get pregnant during the menopause?

The general rule of thumb is, if you are under the age of 50 and haven't had a period for two years you are safe from becoming pregnant. Women who are over the age of 50 are considered safe from pregnancy once they haven't had a period in one year.

Dr Kearns has the following practical advice for women going through the menopause. She says: "Have a good relationship with your GP. Ensure you are comfortable chatting to your GP about your symptoms. A good open relationship is key to finding the best way to manage your symptoms.

"The changes associated with the menopause can affect the whole family; so talking openly with your partner and children can make a massive difference. Talk to other women who may be experiencing the same symptoms, as a problem shared is a problem halved."

She adds: "Be prepared for your symptoms. Feeling flush? Buy yourself a cool water spray and keep a spare set of clothes for emergencies."