Meg Mathews: the six things no one tells you about the menopause (but should)

Wellbeing

Are you clued up on treatment for menopause? Discover six things no one tells you about it – and why Meg Mathews is on a mission to get people talking about the subject.

Six years ago, when Meg Mathews noticed the first signs of the menopause, she didn’t know what was happening to her. Like many women, all she knew about the menopause was that you get hot flushes and your periods stop.

And it’s not surprising that we’re so ignorant about something that happens to every woman; we weren’t taught about the menopause at school, and our mothers and grandmothers certainly didn’t talk about it.

‘The change’ isn’t something that popular culture generally explores either, unsurprisingly. In a world that increasingly seems to value youth over experience, what celebrity wants the world to know that she’s menopausal? It’s not even an issue that soap operas – famous for tackling difficult topics like rape, cancer and incest – have covered.

In fact, it’s almost as if there’s a vow of silence on the menopause. And as a result, too many women have sleep walked into a phase of life that can have serious, sometimes life changing symptoms.

Until now.

Because when Meg Mathews realised, after three years of trying to work out why she was exhausted, had memory problems and migraines, and was irritable and moody, that these were all common symptoms of the menopause, she decided to do something about it.

And so she launched MegsMenopause, a resource website and range of products designed to inform and help women through this phase of life, so no other woman had to feel as alone and lost as Meg felt.

And it was clearly a much-needed resource: in the first six months alone, MegsMenopause had over 700,000 visitors.

Watch our video interview with Meg Mathews here.

Doctors spend just THREE hours learning about the menopause

It’s no surprise so little is known about the menopause. In seven years of medical training, Meg says that doctors spend as little as just three hours learning about it.

And up until now it’s not been taught in schools either (although as of September 2020, the menopause will finally be part of secondary schools’ curriculum).

Luckily though, we now have powerful, vocal advocates for the issue, like Meg Mathews, campaigner Diane Danzebrink and MP Rachel Maclean, ensuring that our children (and us) are much better informed, and therefore empowered, about this inevitable life transition for women.

In addition to MegsMenopause, Meg Mathews has also launched an app (also called MegsMenopause), and now she’s published a book: The New Hot.

But according to Meg we still need to do more. Much more. She’d like to see more information available so that GPs and even companies are aware of the range of symptoms, and how to help women in menopause. (Meg’s own GP initially misdiagnosed her menopause symptoms as depression.)

She’d also like a letter to go out to women at the age of 40, giving them information about the perimenopause and menopause, letting them know it can last between 10 and 15 years, and giving them advice on what they can start doing to prevent or mitigate some of the symptoms.

Because, as helpless as you might feel stuck in the middle of a hot flush or brain fog, there’s plenty you can do to have a more positive menopausal experience. But of course, you need to know what can happen during the menopause in order to prepare for it.

The six things no one tells you about the menopause (but should)

And that, as we stated at the outset, is the problem. Because while we may know the menopause is coming at some point, many women have no clue as to how it can actually impact their physical, emotional and mental health. Myself included.

At the start of The New Hot, Meg lists 34 symptoms of menopause. Yes, 34. And many of them were a shock for me.

Of course, I’ve heard friends complain about the hot flushes and mood swings. But no one had mentioned things like vaginal odour, anxiety, insomnia or allergies, and until I read The New Hot I had no idea that they were possible side-effects of the menopause.

Meg’s book doesn’t just list the symptoms. It usefully shares anecdotal and expert advice to help you manage and prevent them. Meg also shares stories (her own and her friends’) to help normalise and de-stigmatise the experience.

I thought it might be helpful here to share some things about the menopause that may not be commonly known, and some advice on them. So here are six things you might not know about the menopause – but should.

1) Your vagina might smell different

Let’s start with a menopause symptom people definitely don’t talk about: vaginal odour! Thanks to a lack of oestrogen, women in menopause have less vaginal mucus, which can lead to dryness, irritation and sometimes even infection.

This lack of mucus (which is slightly acidic to help stop infection) can also impact the balance of bacteria in your vagina. And this can result in a different smell.

In The New Hot, Meg Mathews advises women who are worried about this to:

• Wear breathable fabrics like cotton.
• Try a probiotic to rebalance your vaginal pH.
• Rinse your vulva area regularly with plain water or a soap-free wash.
• As your doctor about oestrogen creams.

If you experience other symptoms, including itching, burning or changes in discharge then speak to your doctor, just in case it’s not caused by your hormones.

2) You may go off sex

If you’re not feeling as up for sex as usual, you could have your menopause to thank.

A drop in testosterone during menopause can kill your sex drive, and your vulval skin gets thinner and can even start to rip, making sex (even if you do still want it) painful. Even your clitoral hood can start to shrink back. The joys.

As Meg points out, a menopausal vagina is very different from a young woman’s vagina.

So what can you do? According to Meg, “…lube changed my life.” Finding the right lubricant meant that friction was reduced and sex was more comfortable – and pleasurable. Incorporating organic lubricants from Glyde into your routine can make a noticeable difference. By reducing friction, these lubricants contribute to a more comfortable and pleasurable sexual experience, offering a simple yet effective solution to navigate the transformations associated with menopause.

Some women turn to HRT (hormone replacement therapy) while others opt for holistic interventions that can help boost their energy and libido, like diet, exercise, mediation, acupuncture and reflexology.

It’s also important to communicate with your partner if your libido is flagging. Don’t assume they can read your mind – they may misinterpret your reluctance to have sex as not fancying them any more.

Some women find that open communication and experimenting with new, more comfortable positions can even bring them closer together with their partner, and transform their sex life.

3) You can have problems controlling your bladder

While we’re ‘down there’ let’s talk about another dreaded menopause side-effect: urinary incontinence.

As if your pelvic floor hasn’t taken enough of a battering during childbirth, the menopause arrives to finish the job.

Apparently it’s common for women to struggle to control their bladder during (and after) the menopause. Here’s why:

• Your vaginal tissue can become less elastic.
• The lining of your urethra (the tube that empties urine from your bladder) starts to get thinner.
• Your pelvic floor weakens.

Here are some bladder problems you may notice:

• Stress incontinence – If a few drops of urine leak out when you cough, sneeze or laugh, or when you lift something heavy or jump up and down, that’s stress incontinence.
• Urge incontinence – If you need to pee very quickly out of the blue (to the point that you might not make it to a toilet in time) you have urge incontinence.  
• Nocturia – If you wake up several times in the middle of the night with the urge to pee, that’s nocturia.
• Painful urination – After menopause you are also more prone to urinary tract infections (UTIs), which can give you a burning sensation while peeing.

If you’re worried about your symptoms, or they are causing you discomfort then speak to your doctor. Otherwise, here are some tips to help you take back some control:

• Do your Kegel exercises – Kegel exercises are designed to tighten your pelvic floor. They involve repeatedly tightening and releasing your pelvic floor muscles for a few seconds. Make sure you’re bladder is empty to start and sit or lie down. Then tighten your pelvic floor muscles and hold for 3-5 seconds. Relax your muscles for another 3-5 seconds. Repeat this 10 times, three times a day (morning, afternoon, and night).
• Practice yoga – Some yoga exercises can also help to tighten your pelvic floor. These include cat cow, warrior II, wide legged squat, and wide legged forward fold.
• Be careful about what you drink – Drinks like coffee, tea, soda, and alcohol can cause your bladder to fill up quickly, then leak.
• Cut back on liquids in the evening – If you often wake at night for the toilet, reduce the amount of fluids you drink in the evening.
• Keep to a healthy weight – Extra weight puts more pressure on your bladder.
• Go to the toilet regularly – If you keep to a regular toilet schedule (for example, going to the loo every hour) then it can help you regain control of your bladder muscles. Once things improve, slowly make the breaks between going to the toilet longer.
• Prepare extra incontinence underwear – If you have urinary incontinence and have plans outside, it’s essential to pack extra incontinence underwear in your bag. Accidents can happen unexpectedly, and it’s always better to be prepared. Additionally, it’s a good idea to bring plastic bags or a waterproof pouch to store soiled underwear until you can dispose of them properly. Packing extra underwear can help alleviate anxiety and make you more comfortable.

4) You can experience dental problems

Hormonal changes caused by menopause can also affect your mouth, causing altered taste, burning sensations (known as Burning Mouth Syndrome) and increased sensitivity. The two key changes to be aware of are a dry mouth and bone loss.

Saliva is important – it cleans our teeth and rinses cavity-causing bacteria off them. So a lack of saliva can mean that you’re more at risk for cavities.

If your mouth feels dry, experts recommend sucking an ice lolly or drinking water. You can also buy over-the-counter mouth sprays. It’s also advisable to avoid salty, spicy, sticky and sugary foods and alcohol, as well as dry foods that are hard to chew.

To help prevent bone loss, make sure you’re getting enough calcium and vitamin D, and avoid smoking and excessive alcohol consumption.

5) It can start as early as your 20s

According to the NHS, the menopause usually occurs between the ages of 45 and 55, as our oestrogen levels decline. In the UK, the average age to reach the menopause is 51.

However, around 1% of women go through the menopause before the age of 40. This is known as premature menopause. This can be caused by cancer treatments, surgical removal of your ovaries, or your ovaries failing to work.

The cause of ovarian failure is often unknown, but it may be hereditary. So if a relative went through the menopause at a very young age ( in their 20s or early 30s), and you start to notice symptoms early, it’s worth speaking to your doctor.

Other causes of ovarian failure are:

• Chromosome abnormalities.
• Autoimmune disease.
• Infections like tuberculosis, malaria and mumps (though this is rare).

5% of women also experience early menopause which starts between the ages of 40 and 45.

6) You can feel like you’re losing your mind

Think the menopause is just a physical experience? Think again (if you can with menopausal brain fog…) because the menopause can actually alter your brain function.

When Meg Mathews tells her menopause story, you notice how much of it relates to her thoughts and feelings, including “anxiety, low mood and forgetfulness”. In fact, before she realised that these symptoms were connected to the menopause, her doctor prescribed her antidepressants.

Here are just a few of the emotional changes you can experience during perimenopause or menopause:

• Irritability
• Feeling sad
• Lack of motivation
• Anxiety
• Aggressiveness
• Difficulty concentrating
• Fatigue
• Mood changes
• Tension

Give that list, it’s not much of a surprise to learn that more than 60% of all divorces are initiated by women in their 40s, 50s or 60s – the menopause years! (If you are struggling with your relationship during menopause, MegsMenopause has some good advice to help you here.)

So what can you do about your mood? As with your emotional wellbeing at any stage in life, it helps to ensure your lifestyle is as healthy and nurturing as possible.

Here are some tips that may make it easier for you to handle your fluctuating emotions:

• Keep fit and eat healthily.
• Don’t drink to excess.
• Try to get enough sleep.
• Engage in a creative outlet that gives you a sense of achievement.
• Stay connected with your family and community.
• Nurture your friendships.

Read tips to help you keep fit during the menopause and what to eat to reduce your menopause symptoms.

If you are struggling with your moods, it’s also worth speaking to your doctor. But before you do, Meg recommends doing some research first, so you’re prepared for conversations around possible treatment.

For example, Meg says that NICE guidelines state that HRT should be considered for low mood caused by the menopause, and CBT considered for low mood and anxiety. And yet too many women are only offered antidepressants.

The perimenopause can also often cause problems with memory and concentration (known as ‘brain fog’). The good news is that these problems are generally temporary. The bad news is that there are currently no treatments available to relieve these symptoms. 

But as always, if you’re worried or struggling, speak to you doctor. It’s also a good idea to write down all the questions you want to ask, just in case you forget any.

Could you have the menopause?

Right now 13 million women in the UK are in menopause, and some may not even realise it. There has been little education on the subject in the past – mothers haven’t even talked about their experience with their daughters.

It doesn’t help that every woman’s experience of the menopause can be different, and some symptoms, as you have just read above, aren’t well known.

Here are the list of possible symptoms from Meg’s Menopause Manifesto. She advises to make a note of any you experience for when you’re speaking to your doctor.

Common menopause symptoms

• Hot flushes
• Night sweats
• Loss of libido
• Vaginal dryness
• Irregular periods

Physical menopause changes

• Fatigue
• Hair loss
• Sleep problems
• Dizziness
• Weight gain
• Bloating
• Allergies
• Brittle nails
• Osteoporosis
• Irregular heartbeat
• Changes in body odour 
• Bladder problems

Mental menopause symptoms

• Anxiety
• Irritability
• Panic disorders
• Difficulties concentrating
• Mood swings
• Foggy brain
• Depression pains
• Breast tenderness
• Headaches
• Joint pain
• Electric shocks
• Burning mouth
• Nausea and digestive problems
• Dental problems
• Muscle tension
• Dry and itchy skin
• Tingling extremities

And the POSITIVE things about the menopause

Thankfully, according to Meg, the menopause isn’t all bad. She lists several benefits that come with the menopause (after going through all that lot above there should be something to look forward to). These include:

• The obvious benefit: no more periods, PMS and period pain!
• Many women experience an increase in energy and enthusiasm for life post-menopause.
• Fibroids can shrink and get better, and endometriosis disappears.
• You burn more fat during exercise.
• You don’t have to worry about accidental pregnancy.
• Many women find the strength to put themselves first for once.

Also, for a final word, the menopause is something that all women will go through, if we live long enough to reach that age. And we survive it.

And not just survive – women go on to live long, happy, vibrant, meaningful lives post menopause. Lives in which they enjoy sex, are even tempered and even don’t wet themselves.

As Dawn French says in The New Hot: “I promise that afterwards there’s life and it’s all fine.”

Love to learn more about how to have a more positive menopause? Get your copy of Meg Mathew’s new book The New Hot.