How long does menopause last? Age it starts, symptoms and advantages of HRT - according to an expert

The menopause affects millions of women across the UK on a daily basis, with some living with debilitating symptoms that can have a detrimental impact on their quality of life.

Some may receive hormonal replacement therapy (HRT) as a way of treating the symptoms of menopause, but with a current supply shortage, the severe impact symptoms can have on some women’s lives has come to light.

We speak to a women’s health expert to find out more about how long the menopause lasts, symptoms, and pros and cons of HRT.

What age does the menopause usually start and how long does it last?

Perimenopause can start in women in their 30s, although it is more common between the ages of 40 and 45, explained women’s health expert Dr Shirin Lakhani.

The average age of onset of the perimenopause in the UK is 47.5, with the average age of onset of menopause occuring at 51. This can vary between race, ethnicity, demographic and lifestyle.

This means that with the population now generally living longer and healthier lives, women can spend up to one third to half of their lives in the peri and post-menopausal period.

Dr Lakhani noted that although the average duration of vasomotor symptoms - also known as hot flushes - varies between ethnicities, they can last for more than seven years.

One in four women will experience debilitating symptoms that can last up to 15 years.

She said: “Menopausal symtoms can begin months or even years before your periods stop and can last around four years after your last period, but some women experience symptoms for much longer.

“For young women who find themselves catapulted into instant menopause due to surgery, medical treatment or a diagnosis of primary ovarian insufficiency (POI), the menopausal chapter can extend even further.”

Early menopause is when a woman’s ovaries stop making certain hormones such as oestrogen, which results in their periods stopping.

It is considered to be menopause before the age of 45 and can happen naturally or as a side effect of treatments.

Early menopause is diagnosed by a doctor who will do a blood test to check hormone levels.

The cause is often unknown but can be a number of things such as autoimmune disease, certain infections and chromosome abnormalities, said Dr Lakhani.

What are the symptoms of the menopause?

In addition to the characteristic hot flush, which usually occur in the face, neck and chest, Dr Lakhani said there are many related symptoms that can have a “significant impact on a patient’s quality of life”, such as nausea, joint aches, an increase in allergies, memory loss and heart palpitations.

Symptoms also include night sweats, difficulty sleeping, vaginal dryness and discomfort during sex, headaches, mood changes and recurrent urinary tract infections

Early symptoms often include a reduced libido and difficulty concentrating.

“The lack of awareness regarding menopausal symptomatology may result in needless anxiety for patients and a feeling of helplessness,” she added.

For those who think they’ve started the menopause, Dr Lakhani said she strongly urges women to start writing down their symptoms and to make an appointment with a GP or private specialist if they want to discuss their symptoms.

What is HRT and what are the pros and cons of taking it?

Dr Lakahni said there are mainly advantages to taking HRT, but a doctor will determine if it is a suitable medication for you.

““It is a lifeline for many women and protects them from so many other conditions and can stop symptoms in their tracks,” she added.

“There are a lot of myths around HRT but now with body-identical HRT, the formulation has changed and the benefits far outweigh the risks - there is a decreased risk of heart disease, dementia, osteoporosis and many more.”

In the early 2000s, the results of two large studies (The Women’s Health Initiative in the US and the Million Women Study in the UK) raised concerns about the safety of HRT, particularly with regards to breast cancer and heart disease.

However, Dr Lakhani said more recent research has found that bioidentical/body-identical HRT does not carry the same risks as traditional HRT.

When should I see a GP?

It’s worth talking to your GP if you have menopausal symptoms that are troubling you or if you’re experiencing symptoms of the menopause before 45 years of age, said Dr Lakhani.

However, she added that you do not only need to see your doctor if you are struggling, as it is worth seeing your GP so that symptoms can be monitored.

“While not everyone needs or wants medication, this is a significant time in a woman’s life and should be taken seriously,” added Dr Lakhani.