So-called menopause symptoms are not what they seem

Do all women really suffer from a whole cluster of dreadful menopause symptoms when they reach their late forties and early fifties? Is there really a midlife syndrome that requires medical intervention?

The fear is much worse than the reality

Many women dread the M word because they worry they will suffer bad menopause symptoms. But what evidence is there for that?

Just about any discomfort that middle aged women get tends to be called a symptom of menopause. But all the quality medical evidence suggests that only TWO (and a half) discomforts can really be blamed on menopause itself.

All the other so-called menopause symptoms have just given menopause a bad name. Just to be clear: here we’re talking about the strict medical definition of menopause ie: the permanent end of periods.

Forests of words

Menopause has received massive attention in the last few decades. Lorry loads of articles, books, expert reports, studies and conference proceedings have been filled with theories and counter theories as well as pure fiction about what happens to women and their bodies around midlife.

So what do we know for sure about the effect of the end of ovulation on women's well-being and quality of life?

From amidst all these printed forests of felled wood, the answer is: …

Surprisingly little!!!

Thousands of studies into the melting pot.

In 2005 a team of researchers from Oregon, USA reviewed the summaries of 10,000 studies of menopause.

Amongst the 10,000 or so studies, over 6000 reported on menopause symptoms.

The Oregon team chose the 48 highest quality studies from the thousands according to strict quality criteria.> They painstakingly combed through each one and published their summary in an extremely thorough review. This review was the basis of a State-of-the-Science Conference Statement by the US National Institutes of Health.

If you are looking for authoritative information on menopause rather than just hearsay and opinion, the Oregon review and NIH Conference Statement are about as expert as it gets.

There were 10 experts on the Oregon review, the majority medical doctors and all women. To add to that, there were 12 expert members on the conference panel and over 60 other contributors from different areas of clinical practice and research.

The Oregon experts asked several questions including this one:

"What is the evidence that the symptoms women commonly report at middle age can really be blamed on menopause itself?"

After they had carefully examined the findings of 48 high quality studies, the researchers concluded that there are only TWO symptoms that are consistently associated with the menopause (ie ovarian aging):

The only REAL menopause symptoms:

The 2 symptoms that are most consistently reported by women as being part of the menopause experience are:

1. Vasomotor symptoms (hot flushes or hot flashes, and night sweats)

2. Vaginal dryness

So that's it! Just two symptoms that have strong scientific evidence saying they are linked to menopause and aging ovaries.

And the half?

There is also moderate evidence that insomnia in some middle aged women may be related to menopause. There is a theory that for many women insomnia happens because of night sweats. So maybe it's the vasomotor symptoms that are really at the bottom of this complaint - although this is not proven.

So how common are these symptoms of menopause?

The Oregon experts found evidence that up to 50% of women going through the menopause transition may experience hot flushes (hot flashes) and/or night sweats. And they can persist for quite a while: nearly 30% of 60 year-old women report hot flashes. Interestingly these figures vary a lot around the world and in some cultures very few women get hot flushes.

The other menopause sign consistently reported by women in perimenopause and beyond is vaginal dryness, which is reported by up to one third of middle-aged women.

And sleep disturbance? Between 40 - 60% of women have some insomnia during menopause and beyond.

So what about all those other so-called menopause signs and symptoms we hear so much about?

You can read more about the symptoms that menopause is accused of causing

by clicking here.


The Oregon Review: Nelson HD et al. Management of Menopause-Related Symptoms. Evidence Report/Technology Assessment No. 120. (Prepared by the Oregon Evidence-based Practice Center). Agency for Healthcare Research and Quality. March 2005.

NIH State-of-the-Science Panel. National Institutes of Health State-of-the-Science Conference Statement: Management of Menopause-Related Symptoms. Ann Intern Med, 2005; 142: 1003- 13.

Nelson HD. Menopause. Lancet 2008; 371: 760-70.

Published February 2010. Updated 27/3/2011

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