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The Guardian - UK
The Guardian - UK
Bibi Lynch

From hot flushes to weight gain: a doctor explains the common menopause signs and symptoms

Portrait of young woman without makeup in black summer dress smiling in bright photo studio with white background
Understanding the changes your body undergoes during menopause is vital to seeking out the support you need. Photograph: Olga Kozicka/Stocksy United

Menopause is a major life change that every woman goes through. And yet, for many of us, our knowledge of the physical and mental signs and symptoms – and their causes – is pretty minimal.

Yes, we’ve all probably heard mention of hot flushes and weight gain – but few of us are likely to know that these are just two of many possible signs and symptoms of perimenopause and menopause. Of course, every woman’s experience is different, and few will find themselves with more than a handful of these signs and symptoms. But understanding what’s going on in your body as you enter a new stage of life can not only be incredibly comforting and empowering, but also an incentive to seek out the help and support you need and deserve.

We caught up with Zahra Damji, a GP with Boots Online Doctor, who specialises in women’s health, to find out more about the science behind some of the most common signs and symptoms – because, as the saying goes, knowledge is power.

The sign/symptom: hot flushes and night sweats

Dr Damji explains: “Although not fully understood, hot flushes and night sweats are thought to be caused by changes in the part of the brain that regulates temperature (the hypothalamus) in response to low oestrogen levels and changes in levels of natural chemicals in the brain (serotonin and noradrenaline). This seems to make the hypothalamus more sensitive to even slight increases in body temperature, leading it to trigger a chain of events to cool the body down, including increased sweat production, which cools the body as the sweat evaporates. The flushing that women experience is caused as the blood vessels near the skin surface begin to enlarge, increasing blood flow in an attempt to dissipate body heat.”

Products and services at Boots that could help:
No7 Menopause Skincare: Instant Cooling Mist
Boots Online Doctor Menopause & HRT Treatment service*

The sign/symptom: vaginal dryness

Dr Damji explains: “Vaginal dryness occurs due to the effects of oestrogen deficiency. The vagina, urethra, bladder and pelvic floor muscles all contain oestrogen and progesterone receptors, and the reduction in the oestrogen causes the vaginal skin to become thin, losing its collagen and elasticity. At the same time there is also a reduction in natural lubrication and a change in the vaginal pH. This can lead to itching, burning, dryness and painful sex.”

Products and services at Boots that could help:
Boots Online Doctor Vaginal Dryness Treatment service*
Boots Vaginal Moisturising Gel
Gina 10 micrograms vaginal tablets (Contains estradiol for treatment of vaginal atrophy in postmenopausal women aged 50 years and above, who have not had a period for at least one year. Always read the label.)

The sign/symptom: lack of interest in sex

Dr Damji explains: “Reduced libido, painful sex, arousal difficulties and difficulties achieving orgasm are common around menopause. There is some suggestion that this is linked to low testosterone, as levels decline gradually from your 30s, but this is not normally the only cause. There are multiple factors that can also contribute, including vaginal dryness and mood changes.”

Products and services at Boots that could help:
Boots Silky Lubricant
Boots Vaginal Moisturising Gel
Boots Online Doctor Menopause & HRT Treatment service*
Boots Online Doctor Vaginal Dryness Treatment service*
Gina 10 micrograms vaginal tablets. (Contains estradiol for treatment of vaginal atrophy in postmenopausal women aged 50 years and above, who have not had a period for at least one year. Always read the label.)

Women drinking coffee and talking in cafe
While not all aspects of menopause are fully understood, treatments are available for a wide range of symptoms. Photograph: Compassionate Eye Foundation/David Oxberry/Getty Images

The sign/symptom: muscle aches and joint pains

Dr Damji explains: “Oestrogen has an important role in protecting joints and reducing inflammation (pdf), so when levels drop during menopause, inflammation can increase and so does the risk of osteoporosis and osteoarthritis. This causes pain in joints and can affect the ability to exercise, leading to muscle loss and weight gain. Additionally the drop in testosterone can make it harder to maintain muscle strength.”

Products and services at Boots that could help:
Boots Online Doctor Menopause & HRT Treatment service*
Neo G Open Knee Support – universal size

The sign/symptom: difficulty sleeping

Dr Damji explains: “The most common sleep problems reported by women going through menopause include night sweats, insomnia, sleep apnoea and snoring. This is due to hormonal changes such as a drop in progesterone affecting the breathing drive, causing conditions such as sleep apnoea. Oestrogen also has an effect and can alter the sleep-wake cycle through its effects on the metabolism of serotonin, the regulation of body temperature and by altering mood, all contributing to poorer sleep.”

Products and services at Boots that could help:
Boots Online Doctor Menopause & HRT Treatment service*
Boots Sleepeaze Herbal Plus Tablets (A traditional herbal medicinal product used for the temporary relief of sleep disturbance exclusively based on traditional use only. Always read the label.)

Portrait of paraplegic woman in her wheelchair looking away from the camera and laughing
Every woman’s experience of perimenopause and menopause is different. Photograph: Elize Strydom/Getty Images

The sign/symptom: changed body shape and weight gain

Dr Damji explains: “Fluctuating hormone levels around menopause can alter the way we store fat. A drop in oestrogen can affect the accumulation and distribution of fat, with weight gain centred around the abdomen rather than the hips and thighs. But it is not just hormones that play a part. With age, muscle mass decreases and fat increases, which slows metabolism (the rate the body uses calories). This makes it harder to maintain a healthy weight even if eating the same diet. Reduced activity levels, poor sleep and genetic factors can also play a role in weight gain.”

Products and services at Boots that could help:
Boots Online Doctor Menopause & HRT Treatment service*

The sign/symptom: skin changes

Dr Damji explains: “During the first five years after menopause, the drop in oestrogen causes the skin to lose about 30% of its collagen, which normally gives skin its structure and also helps the body with wound healing and muscle repair. Common skin conditions reported during menopause include dry skin and signs of ageing (wrinkles, sagging skin). Additionally the skin becomes more vulnerable to damage, and may bleed and bruise easily. Acne and increased facial hair also occur with the change in the hormone levels, where male hormones increase and oestrogen drops. Worsening of pre-existing conditions such as eczema, rosacea or psoriasis may also be seen.”

Boots products and services that could help:
No7 Menopause Skincare Protect and Hydrate Day Cream
No 7 Menopause Skincare Instant Radiance Serum
Boots Online Doctor Acne Treatment service*
Boots Online Doctor Menopause & HRT Treatment service*

Whether you’re looking for products to ease specific signs and symptoms or for advice, Boots can help. Find out more about its products and services at the Boots Health Hub, or head in-store to speak to one of its pharmacists

Subject to availability. Most Boots. Medicines listed in this article are not endorsed by Dr Zahra Damji

*Boots Online Doctor Menopause & HRT treatment service; Boots Online Doctor Vaginal Dryness treatment service; Boots Online Doctor Acne treatment service: access to treatment is subject to an online consultation with a clinician to assess suitability. Subject to availability. Charges apply.

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