A YES® Guide to Understanding and Navigating Menopause

A YES® Guide to Understanding and Navigating Menopause

The menopause talk

Menopause &
mental health

Finding relief

Resources

Understanding Menopause  

 

Menopause is a major life event that will affect all women during their lives. It can be a difficult time for some, and many women will experience a range of emotions and physical symptoms throughout the transition. There are generally understood to be three stages of menopause, explained below, but everyone's experience will be unique. Menopause can also occur because of certain surgeries or cancer treatments. This can sometimes cause symptoms to be more sudden and, in some cases, more severe [1]. 

On average, women will experience menopause symptoms for around seven years in total. 1 in 3 women will experience symptoms for longer [2], but these symptoms can vary considerably in severity. 

Perimenopause

Perimenopause refers to the time during which your body makes the natural transition to menopause. Perimenopause usually begins in your 40s but can start as early as your 30s. During this time, your body starts to produce less oestrogen. Your menstrual cycles may lengthen or shorten, and you may also begin to experience menopause-like symptoms, such as hot flushes, sleep problems, and vaginal dryness. [3] 

 

Menopause

Menopause is confirmed when you no longer have periods. At this stage, your ovaries have stopped releasing eggs and stopped producing most of their oestrogen. Menopause is diagnosed when you've gone without a menstrual period for 12 consecutive months. The average age for reaching menopause is 51. [4] 

 

Postmenopause

The rest of your life after menopause is referred to as postmenopause. Women will experience menopause symptoms for around seven years on average [4], but these symptoms can vary considerably in severity. 

 

References [1] NHS Inform [2] Mayo Clinic, [3] NHS Inform , [4] British Menopause Society  

 

Common symptoms of Menopause

  • Vaginal dryness  

  • Hot flushes  

  • Irregular periods or periods that are heavier or lighter than usual  

  • Night sweats and/or cold flashes  

  • Urinary urgency or bladder weakness  

  • Difficulty sleeping (insomnia)  

More below..

Symptoms

 

  • Emotional changes (irritability, mood swings, anxiety, panic disorders, brain fog or mild depression)  

  • Dry skin, dry eyes or dry mouth  

  • Breast tenderness  

  • Worsening of premenstrual syndrome (PMS)  

  • Thinning hair  

  • Acne and skin changes  

  • Bloating  

  • Decreased fertility  

  • Dizziness  

  • Fatigue  

  • Headaches and migraines  

  • Joint pain  

  • Muscle tension  

  • UTI's  

  • Heart palpitations  

  • Changes in taste and smell  

  • Weight gain  

  • Changes in sex drive  

  • Body odour  

  • Breathing difficulties  

  • Burning mouth syndrome  

  • Changes in breast size and/or sagging breasts and/or sore breasts  

  • Changes in skin texture  

  • Dental problems  

  • Itchy crawly skin  

  • Loss of bone density  

  • Loss of concentration  

  • Nail changes  

  • Nausea and digestive problems  

  • Tingling extremities  

  • Short-term memory issues 

  

Symptoms taken from GenM 

 

The Menopause Talk

Dr Clare Spencer

 

An interview with Dr Clare Spencer, registered menopause specialist for the British Menopause Society, co-founder of My Menopause Centre and GP partner 

Friend of YES®, Dr Clare Spencer discusses how to prepare well for the menopause transition. She explores some common myths surrounding menopause and offers her expertise to help us navigate this transition with greater ease, understanding and self-compassion.   

 

YES®: What does no one tell you about perimenopause and menopause? 

 

Dr. Spencer: It’s not widely known that menopause is a transition that starts in the perimenopause stage and finishes with post-menopause. Perimenopause is the start of the menopause transition. It’s here that hormones start to become erratic, your oestrogen levels fluctuate dramatically and then drop. Menopause is just a single point in time where you look back and say ‘Oh! I have had no periods for 12 months. Then you are immediately plunged into post-menopause. 

Symptoms can start earlier than many women realise so you may be in your early 40s, maybe even late 30s. 1% of women go through the menopause under the age of 40. Symptoms may creep up and can be subtle so you may feel as if you have lost the ability to juggle multiple tasks, or you may have hot flushes for a while and then they settle again as your oestrogen fluctuates. Symptoms often last longer than women think and can last into the post-menopause.  

Many women do not realise that there are psychological symptoms – and they are common. Low mood and anxiety can hit you out of the blue – do talk to a healthcare professional if this is happening to you as there are many options to help these symptoms.  

 

More questions..

 

YES®: What is the best piece of advice you could give someone approaching menopause?  

 

Dr Spencer: Arm yourself with knowledge. Understand what the symptoms are and how they might make you feel. For example, many women feel anxious, but the anxiety might manifest differently than expected. It might show up as not wanting to drive on the motorway, or you might notice that your mood or temper can go from 0-60 very quickly.  

You may not feel yourself in a way that is difficult to put your finger on. Read about what happens to hormones in the menopause transition and how these hormone changes impact chemicals in the brain and the way the brain functions. This way, you won’t be tempted to think that symptoms are personal failings or ‘your fault.You will be less likely to worry that your brain fog is early dementia (which is rare.) Then arm yourself with knowledge to understand how to manage them. Have a look at the symptoms checker at www.mymenopausecentre.com to learn more about each symptom and what you can do about it. Click here.  

 

YES®: What are the main associated myths that you have come across in your practice?  

 

Dr. Spencer: Many women think and may be told that they are too young to be in perimenopause and therefore not get the right treatment or support to help them.  

Blood tests are usually not helpful in diagnosing the menopause transition. Early in the transition hormone levels can fluctuate day to day so a normal blood test does not rule out the menopause. Likewise, an abnormal blood test does not mean you are ‘through the menopause.’ Exploring your history and listening to your symptoms is a better way – have a look at the questionnaire designed by My Menopause Centre as this can help you work out if you are in the transition - Click here to take the My Menopause Centre questionnaire.  

Some women are also very anxious about taking hormone replacement therapy. They are worried about the risk of breast cancer when in fact the risk is extremely low and lower than many lifestyle factors. 

 

 YES®: How can women prepare well for the transition; emotionally, mentally, physically?  

 

Dr. Spencer: It’s important to understand the emotional symptoms of menopause so you are prepared. When in menopause, it’s easy to feel stressed and overwhelmed. Learn how to relax. Learn how to take care of your mental wellbeing and generalised wellbeing so you know what to do to calm your mind. 

Physically, bone density loss accelerates during menopause making fractures more common. Before the transition, we can prepare by doing weightbearing activities; lifting weights, building and maintaining muscle mass. It is important for everyone to take a vitamin D supplement over the winter months at least. 

Have a look at your diet – are you getting enough calcium and Vitamin D? Risk of heart disease increases with menopause as well so take stock of your lifestyle choices such as smoking and alcohol use. Alcohol use makes many menopause symptoms feel worse.  

If your weight needs managing, think of ways to manage it now so you are better prepared for the transition.  

Learn to positively accept limitations. Learn to Be kind to yourself before you enter this period that can be tumultuous.  

 

 

 YES®: What are some questions to ask your GP or gynaecologist about menopause?  

 

Dr. Spencer: Ask them about treatment options and HRT. There are many different types of HRT – ask them what the best for you might be. Think about the practicalities, if they fit into your schedule and what will suit you.   

Contraception often gets forgotten during this time, but most women need to use it during perimenopause. Ask your GP about the different methods of contraception. Is there a method that can form part of HRT? For example, the Mirena coil (also called IUS) is a contraceptive and forms part of HRT.   

Ask them what options are available to treat symptoms if you don’t want to start HRT. 

And finally, ask your doctor to check your general health such as cholesterol, weight, height, and blood pressure to find out whether you are at risk of heart disease and/or osteoporosis, the long-term health risks of the post menopause.  

 

 

 YES®: How important is it to talk to your friends or partner/ loved ones and workplace about it? 

 

Dr. Spencer: It’s really important that we all talk about menopause. If we do, we’re less likely to fall into a vicious cycle of hiding and then worrying about symptoms which in turn makes them worse.  

Speak to your friends because they can help support you. They might also be experiencing the same symptoms. If you find that your behavior is a little more erratic or not as usual, talking will help them to appreciate what is going on behind the scenes. 

In the workplace there may well be adaptations that can help you manage your symptoms. The culture of our workplaces can change if we start sharing our experiences and it might actually help others. Check if there are any menopause support or policies in place.  

Speaking to your partner is also very important because loss of libido is a common symptom of menopause. This can be really distressing and one of the important causes of this is vaginal dryness, painful sex and intimate discomfort.  

 

 

 YES®: Why do women experience vaginal dryness during menopause?  

 

Dr. Spencer: Loss of oestrogen is the key to vaginal dryness. Vaginal tissue becomes more delicate, prone to tearing and dryer, as the cells lining the vagina change and the balance of bacteria changes. You can also get other symptoms like itching, burning, soreness and pain in the vaginal area.  

There are many other symptoms of menopause, explore them here.  

 

 

YES®: How is vaginal dryness treated?  

 

Dr. Spencer: Firstly, a non-hormonal vaginal moisturiser such as the very wonderful YES® VM can be prescribed. Vaginal moisturisers will help moisture to cling to the sides of the vagina, increasing comfort and reducing dryness and pain. You can use them every day. For intercourse or penetration, try a lubricant- oil based or water based, or use them together.  

Another option is using oestrogen which is applied directly into the vagina in the form of a pessary, cream, gel or ring which releases oestrogen slowly. It doesn’t have the risk of systemic HRT and you hardly absorb any into your system. A vaginal oestrogen can be taken alongside systemic HRT – and many women need both. 

Another important consideration for vaginal dryness is to use a soap free feminine wash. The vulval tissue on the outside becomes more delicate as well as the vaginal tissue on the inside. Soap free washes can help to sooth and protect this delicate tissue.  

My Menopause Centre is an online hub providing free evidence-based information, including an interactive menopause questionnaire to help you identify if you are in the transition. You can also choose to access private menopause clinics with teams of expert menopause doctors working to support and care for women going through menopause.   

 

Blog: Menopause after hysterectomy

Guest Blog by Dr Sarah Ball:Testosterone Replacement in Menopause – is it the ‘missing’ female hormone?

blog: sex after cancer

Blog: Mind over menopause. The effects on mental health

blog: managing vaginal dryness post cancer treatment

Blog:The best over-the-counter menopause products for 2023 

Menopause and Mental Health

Menopause and mental health

Menopausal Mental Health Symptoms

Anxiety during perimenopause and menopause

 

As much as 51% of women aged 45-55 [1] experience symptoms related to anxiety and studies have shown 58% of women aged 45–55 who were experiencing perimenopause had anxiety symptoms [2]. Physical symptoms, sleep disturbances and hormonal changes are the most likely culprits, but remember, anxiety during perimenopause and menopause is extremely treatable. 

 

Speak to your doctor about what treatment options are available to you. 

Brain fog during perimenopause and menopause

During menopause, your testosterone and oestrogen levels decline [3]. These hormones play a vital role in memory and cognitive function. When they start to decline, your brain can go into a state of deprivation. Brain health can be supported through diet and exercise as well as supplementing with vitamins such as vitamins B, D, folic acid and omega 3. [4] 

 

Confidence and self-esteem decline during perimenopause and menopause

 

The physical and emotional effects of menopause, as well as changes in work and personal life, can all impact self-esteem and confidence. Not only is your body going through some major hormonal changes, but you may experience a knock-on effect in your personal and professional life. 45% of women say menopause has negatively impacted them at work [5]. Finding the right support is key to navigating drops in self-esteem during menopause. Speak to a trusted friend, your therapist or doctor if you are struggling. Reach out to your HR team if you are struggling at work. Some workplaces have policies and practices in place to support women going through the menopause. 

 

GenM provides excellent resources on navigating menopause in the workplace. 

Depression during menopause

Depression is not just a feeling of sadness. You may feel sensitive, teary, and even hopeless at times. Depression can affect all areas of life from appetite to libido, and everything in between. Studies show [6] a correlation between depression and menopause due to the extreme hormonal fluctuations that take place during this time. Talk to your doctor who will be able to provide you with a treatment plan. This may include talking therapies, online self-help, group support, or medications such as anti-depressants or HRT. 

 

Irritability and mood swings during menopause

 

Around 70% of women report that irritability is their main emotional menopausal symptom [6]. Declining oestrogen levels are to blame, and you might find it harder to control your moods as a result.  

 

References: [1] National Library of Medicine | [2] Medical News Today | [3] National Institute of Medicine [4] NHS | [5] NHS Inform | [6] Everyday Health 

 

Diagnosis and treatment of menopause

 

If you are experiencing menopause symptoms, speak to your GP. If you are aged 40 to 45, your doctor might conduct a blood test to measure your hormone levels.

If you’re under 40 and have menopausal symptoms, you may be offered a blood test to help diagnose suspected premature menopause.

HRT

Hormone Replacement Therapy (HRT) is the most common medicinal treatment for vaginal dryness during menopause. HRT replaces hormones that are low which include the use of replacement oestrogen. There are different types and doses of HRT, including skin patches, gels, or sprays to apply directly onto the skin, tablets, and implants. If you have a womb (uterus), you also need to take progesterone to protect your womb lining from the effects of oestrogen. Taking oestrogen and progesterone is called combined HRT.

Progesterone comes as: 

  • patches, as part of a combined patch with oestrogen 

  • IUS (intrauterine system, or coil) tablets 

  • If you have low sex drive because of menopause and HRT does not improve it, you may be offered testosterone. 

Read more about the use of testosterone in menopause here.

Many women may choose not to take HRT, if this is the case, there are many alternative ways to treat the symptoms of menopause.    

 


YES® TIPS FOR FEELING BETTER DURING MENOPAUSE

Eat a balanced and nutritious diet.

A diet rich in calcium and vitamin D is important to prevent the bone loss that can occur during menopause [1]. Avoid smoking and excessive alcohol consumption [2]. Gaining excess body fat increases the risk of developing cardiovascular and metabolic disease [3]. In addition, data suggests that increased body weight may affect vasomotor menopause symptoms such as hot flushes.[4] 

Find the right supplements for your body.

There are many menopause supplements on the market. It's important to do your research and ensure the ingredients are as pure and natural as possible. Vitamin B6 and B12 are said to be of particular benefit during this time. Magnesium relaxes the muscles and can support sleep. Omega 3 fatty acids are said to ease psychological symptoms, help to reduce joint pain and protect heart and bone health [5]. 

Stay hydrated and exercise regularly.

Everything from our joints, skin, gut to our brain needs to be properly hydrated to function well. Hot flushes and night sweats will increase the amount you are sweating so keeping hydrated is key. Regular exercise can improve mood and reduce the risk of getting certain diseases. It can also strengthen your joints and muscles. 

Prioritise sleep and rest.

As much as 50% of menopausal women experience sleep disturbances [6]. Oestrogen plays a role in the metabolism of serotonin and other neurotransmitters that affect our sleep-wake cycle. Oestrogen also helps keep our body temperature low at night, and therefore improving sleep quality. The drop in oestrogen during menopause can wreak havoc on our sleep cycle. [7] 

Use a vaginal moisturiser if you are dry.

Oestrogen is the main hormone that helps to maintain the vagina’s lubrication, elasticity, and thickness. The natural decline of oestrogen during menopause can cause vaginal dryness that can be sore, uncomfortable, and sometimes painful. Using a daily vaginal moisturiser and good lubrication during sex can bring natural relief from uncomfortable symptoms. 

Look after your mental health. There are many emotional and psychological symptoms of menopause. Finding the right support and treatment is key to improved mental health and well-being.

 

Vaginal dryness during menopause

Vaginal dryness is one of the most common symptoms of menopause and its onset can be fairly sudden at any stage of the menopause. Studies show that as many as 90% of postmenopausal women are affected by vaginal or vulval dryness [1].  

The dryness occurs because of hormonal changes that are a natural part of menopause and can cause discomfort and pain, particularly during sexual intercourse. While there are several products available on the market, some contain ingredients such as glycerine, glycols and even perfume which can potentially be irritating to your delicate tissues. YES® WB our water-based lubricant can be used during sex to alleviate vaginal dryness and discomfort, hydrate and soothe the delicate tissue of the vagina and improve pleasure. 

The mucous membranes of the vagina produce a fluid or natural lubricant that keeps the vagina moist, elastic, and strong. Oestrogen in the body encourages the vaginal tissues to produce this lubricant which is acidic to help protect the vagina from bacterial and fungal infections. As oestrogen levels fall during menopause, the vaginal tissues produce less of this lubricant which can cause the vagina to become dry and the tissues to lose their elasticity and strength. As the vaginal tissues become thinner, they become more fragile and sensitive, this can result in dryness, itchiness, irritation, and pain. 

 

Ease Menopausal Dryness with YES®

Dr Naomi Potter -

BMS Accredited Menopause Specialist

 

"There are so many lubricants and moisturisers on the market, but their content varies enormously. Some contain substances known to be harmful or irritant but market themselves to the contrary. I recommend Yes to my patients because it is the product I have the most confidence in. I know it has a body similar pH which is so important for the vaginal microbiome and also that it does not contain any substances known to cause irritation or harm."

 

Dryness and discomfort experienced during menopause can be eased with the use of water-based vaginal moisturisers and intimate lubricants. 

  

YES® VM vaginal moisturiser has been designed to alleviate symptoms of vaginal dryness, gently replenish vaginal moisture levels, and improve comfort without compromising intimate health. Moisture is released slowly at the rate the body needs keeping the vagina hydrated for up to three days. YES® VM can be applied internally using applicators, or externally to the vulva. 

  

YES® WB water-based lubricant can be used during sex to alleviate vaginal dryness and discomfort, hydrate and soothe the delicate tissue of the vagina and improve pleasure. It is rapidly effective for mild to moderate vaginal dryness. 

 

YES® OB: YES® OB plant oil-based is a natural alternative to synthetic chemical lubricants such as silicone or petroleum-based products. It is long-lasting, richly nourishing, and designed to protect and soothe dry intimate tissues, creating a protective emollient over the skin.  

 

YES® CLEANSE is our certified organic, ultra gentle intimate foam wash. It is pH matched to the vagina and designed to be side-effect free. Find out more about the benefits of CLEANSE here.  

  

All YES® products are certified organic, free from glycerine, parabens, hormones, synthetic chemicals, silicone, propylene glycol and all known skin or mucosal irritants. Our ingredients occur in nature and contain no genetically modified ingredients. All of our products are either vegetarian society or vegan approved. 

 

Communities and resources


Find us on NHS Prescription!

 

Did you know that YES® WB and YES® VM are both available on UK NHS prescription?  

 

Your GP will find YES® WB and YES® VM on the Drug Tariff Part IXa under vaginal moisturisers or in MIMS. 

 

Use the following PIP codes when asking your pharmacist to stock YES® VM and YES® WB. 

  

YES® WB Pre-filled Applicators Pip code: 345-5805 

YES® WB Tube Pip code: 345-5789 

YES® VM Applicators Pip code: 402-3420 

YES® VM tube Pip code: 402-3412 

 

You may also wish to take advantage of our subscription package to receive 15% off your order every time you purchase.

 

The menopause talk

Menopause &
mental health

Finding relief

Resources

YES® TIPS FOR FEELING BETTER DURING MENOPAUSE

Eat a balanced and nutritious diet.

A diet rich in calcium and vitamin D is important to prevent the bone loss that can occur during menopause [1]. Avoid smoking and excessive alcohol consumption [2]. Gaining excess body fat increases the risk of developing cardiovascular and metabolic disease [3]. In addition, data suggests that increased body weight may affect vasomotor menopause symptoms such as hot flushes.[4]

Find the right supplements for your body.

There are many menopause supplements on the market. It's important to do your research and ensure the ingredients are as pure and natural as possible. Vitamin B6 and B12 are said to be of particular benefit during this time. Magnesium relaxes the muscles and can support sleep. Omega 3 fatty acids are said to ease psychological symptoms, help to reduce joint pain and protect heart and bone health [5].

Stay hydrated and exercise regularly.

Everything from our joints, skin, gut to our brain needs to be properly hydrated to function well. Hot flushes and night sweats will increase the amount you are sweating so keeping hydrated is key. Regular exercise can improve mood and reduce the risk of getting certain diseases. It can also strengthen your joints and muscles.

Prioritise sleep and rest.

As much as 50% of menopausal women experience sleep disturbances [6]. Oestrogen plays a role in the metabolism of serotonin and other neurotransmitters that affect our sleep-wake cycle. Oestrogen also helps keep our body temperature low at night, and therefore improving sleep quality. The drop in oestrogen during menopause can wreak havoc on our sleep cycle. [7]

Use a vaginal moisturiser if you are dry.

Oestrogen is the main hormone that helps to maintain the vagina’s lubrication, elasticity, and thickness. The natural decline of oestrogen during menopause can cause vaginal dryness that can be sore, uncomfortable, and sometimes painful. Using a daily vaginal moisturiser and good lubrication during sex can bring natural relief from uncomfortable symptoms.

Look after your mental health.

There are many emotional and psychological symptoms of menopause. Finding the right support and treatment is key to improved mental health and well-being.