It’s easy to put off going to the doctor when you notice something’s not quite right. Do you really want the hassle of getting an appointment? Are you so busy, it’s hard to brush your teeth let alone spare the time for the GP? Anyway, won’t it just clear up and go away if you ignore it long enough? During menopause, it’s important to make the time to look after your health and we’ve taken a look at symptoms that need a chat with your doctor. No matter the pressure on health services, doctors want to hear from you.
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It’s not making a fuss
Finding your voice is one of the most important tools you need during menopause. As women, it’s unfortunate that we have the double whammy of being conditioned not to speak up over centuries and live in a country where deploying your stiff upper lip is a default.
You don’t have to live by the “keep calm and carry on” mentality and wait for your symptom to become a crisis. Going to the doctor when you first notice a symptom doesn’t mean you are being a bother and a nuisance. In fact, doctors prefer to see patients as early as possible before symptoms impact on your wider physical and mental health
Menopausal symptoms are varied and every woman’s experience is different. It can be difficult to determine which are down to hormonal changes, perimenopause and menopause, and which need further investigation. We recommend seeing a doctor if you experience any of the following symptoms. Read more about the stages of menopause.
1. Abnormal vaginal bleeding
The difference between normal and abnormal bleeding depends on you, your cycle and which stage of menopause you are in. See a doctor if you notice:
- Postmenopausal bleeding, no matter how little the amount or the colour of the blood. You are postmenopause when your periods have stopped for more than 12 months
- You are taking HRT and have a change in your bleeding pattern
- You’re in perimenopause and bleeding between periods. Your cycle can be really erratic at this time, so keep a note of your cycle so you can tell what is normal or abnormal for you
- You bleed after sex and do not have your period and your partner is uninjured
- You are bleeding from your bottom or urethra
It’s a challenge, but if you notice blood in your knickers, try to work out if the blood is coming from your urethra, vagina or bottom.
2. Changes in vaginal discharge
Vaginal discharge is normal and its colour and smell varies from woman to woman. During perimenopause, what can look like discharge can sometimes be the beginning of a period. During postmenopause, your vagina will have less lubrication and discharge. Keep an eye on your knickers and see what is usual for you.
Changing sexual partners and even your washing powder can change the pH levels inside your vagina. What you need to look out for is a change in colour or smell. If you smell fishy or strongly, or the discharge is blood-stained, you may have an infection that needs checking out by your doctor or local sexual health clinic.
3. Vulva and or vaginal changes
Your genitals change as you age – it’s fascinating. Get a front-row seat by grabbing a mirror and taking a look. It’s important to understand what your genitals look like so you can spot anything that is unusual for you.
As you go through menopause, your genitals lose lubrication, plumpness, fade in colour to a paler pink and can become shiny as you lose pubic hair. Your shape might change with a less pronounced labia. The skin becomes thinner and wiping after going to the toilet can cause micro-tears.
See a doctor if you notice:
- Pain, discomfort, soreness or irritation
- Lumps or bumps
- Abnormal discharge
- Recurrent urine infections
4. Incontinence issues
You may have bladder problems if you suddenly get an urge to pee, pee frequently or leak pee when you sneeze, laugh or cough. Read more about leaking.
Some women may have faecal incontinence, where you leak poo or cannot control having a poo. This can be the result of muscles not recovering properly after having a baby.
See your doctor if you have urinary or faecal incontinence. They are not something you need to live with.
5. Breast lumps, nipple changes and nipple discharge
During menopause, your breasts go through a lot as your hormone levels fluctuate all over the place. They may become really tender and sore, just like when you started puberty or in the first weeks of being pregnant.
Checking your breasts and chest regularly may help you pick up on any changes or lumps. Once a month is a good guide. Avoid checking them when you are on your period – if you still have periods.
The shower or bath is a common place to do this, as soap makes it easier to run your hands over your breasts. Make sure to:
- Feel your chest, both breasts and armpits. You are looking for any changes. This includes lumps, thickenings, sore areas, or changes in texture
- Look at your breasts in the mirror. Look out for any rashes, dimples, puckering, nipple discharge and changes to size or shape.
Sometimes changes are obvious, but other times you may be unsure – you should always see a doctor if you notice anything or have any questions.
Read more about menopause and sore breasts.
6. Bloating, abdominal weight gain and loss of appetite
If you find you bloat quickly after starting to eat, or get full really quickly during a meal for a few weeks, then talk to your doctor.
An important sign to look out for is if you put on weight around your middle but are eating and exercising your usual amount, or even eating less. If this is the case and your trousers are getting difficult to do up, then let your doctor know. It could mean there is a problem with your ovaries that needs looking at.
7. Weight loss and/or loss of appetite
If you experience a sudden and unexplained weight loss, head on down to the doctor to make sure everything is ok.
8. Pain
Don’t get used to living with pain – remember pain is a warning sign that something isn’t right. Whether it is breast, chest, joint or pelvic pain, see your doctor or A&E if it’s severe.
Pain can be a sign of inflammation, which is caused by declining oestrogen. You can talk to your doctor to see if hormone replacement therapy (HRT) can help.
9. Heart palpitations
We’re not usually aware of our heart beating but in certain circumstances, you may begin to feel it. This can take the form of a thumping, fluttering or pounding sensation in the chest, which is also known as palpitations. You may also feel ‘missed’ beats or an increased heart rate.
This is common during menopause, especially with hot flushes and night sweats. If you do experience this, talk to your doctor to check there isn’t other medical conditions such as a problem with your heart or thyroid gland. You should seek urgent help if you have palpitations with shortness of breath, chest pain, fainting or have a history of heart problems.
Final word
Ignoring symptoms doesn’t mean they are going to go away. Menopause is a time to be proactive about your health. Keeping your appointments for cervical and breast screening programmes is an easy way to get checked out.
Find out more about menopause on our blog or view our menopause symptoms library.
There has been some interesting research into why men and women engage in different health-seeking behaviour. This study explores why some midlife women do not seek treatment for incontinence across the menopausal transition. Another interesting set of research is associated with pain. In general, women report more severe levels of pain, more frequent incidences of pain, and pain of longer duration than men, but are nonetheless treated for pain less aggressively. This study explores why this might be the case and what can be done about it.
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