It’s something that 50% of the population will experience, but it isn’t always talked about enough. We take a closer look at menopause, and how it affects women with pulmonary hypertension.

In simple terms, the menopause is when a woman stops having periods and is no longer able to get pregnant naturally. The process itself though can be complex, and just like pulmonary hypertension, it can affect people very differently.

A natural part of ageing, the menopause (sometimes referred to as ‘the change’) normally starts when a woman is aged between around 45 and 55 – but this can vary either side. It is caused by a change in the balance of the body’s sex hormones, when your ovaries stop producing as much oestrogen and stop releasing an egg each month.

Symptoms can begin a long time (even years) before your periods stop, and this is known as the ‘perimenopause’. They then continue, on average, for around four years – although some women experience them for much longer.

If you’re reading this whilst going through the menopause, you probably don’t need to be told that symptoms can have a significant impact on your life. Women commonly experience hot flushes, night sweats, difficult sleeping, vaginal dryness, low mood or anxiety, reduced libido, heart palpitations, and problems with memory or concentration.

You might already be experiencing some of these symptoms because of your PH, which can make it harder to identify if you are starting to enter menopause – but a simple blood test, available with your GP, can provide the answer.

Dr Karen Selby is a Consultant Obstetrician and Gynaecologist who works closely with a specialist PH centre in Sheffield. She said: “The early signs of menopause can be very variable. Some people may have no signs at all. But things that may have been just put down to age before – such as loss of concentration, forgetfulness, and trouble sleeping – are now increasingly being recognised as perhaps being signs of early menopause.

“I think this increase in recognition and understanding is making it easier for people to access support but there is still a bit of stigma around it all, and a sense of ‘just getting on with it’.”

This stigma can be even stronger in certain communities. Wellbeing coach Meera Bhogal (pictured above) runs guided menopause programmes and is passionate about raising awareness of menopause within South Asian communities. She said: “Menopause is seen as a ‘western disease’ and there is a real taboo around women’s health in general. So many women don’t even know what menopause is, what the symptoms are, or how to get help.”

Meera believes this ‘mystery’ surrounding menopause is an issue across society in general, and that because some women feel unable to openly discuss the changes they are going through – and the impact on their lives – it makes it even more scary.

Despite these challenges, Dr Selby is keen to stress that if you are struggling with menopause, you shouldn’t suffer in silence.

“With a lot of gynaecological symptoms that women have, whether it’s menopause, incontinence, or heavy periods, they are still seen by many as ‘just part of being a woman’”, she added. “It’s only recently that women are starting to think ‘hang on a minute, why should l put up with this?’ The help is there; as women we just need to ask for it.”

What’s in a number?

The average age for a woman to reach the menopause is 51, but around 1% of women experience it before the age of 40. If you are experiencing menopausal symptoms under the age of 45, please see your GP, who will be able to run a blood test to confirm your hormone levels.


Managing menopause

Symptoms of menopause can be managed in several ways, including:

Hormone replacement therapy (HRT): HRT treatments are either a combination of oestrogen and progesterone, oestrogen / progesterone alone, or a medicine called tibolone. Interaction between oestrogen and PH is not fully understood, and it is not suitable for those with certain types of PH. Consultant Pharmacist Neil Hamilton explains more on page X .

Oestrogen creams, lubricants or moisturisers: These can all help with vaginal dryness (which can also be a cause of painful sex during menopause).

Cognitive behavioural therapy (CBT): This is a type of talking therapy that can be helpful in managing low mood and anxiety.

Lifestyle modifications:  Regular exercise (within your capabilities) and eating a healthy balanced diet can improve some menopausal symptoms.

If you are struggling with menopausal symptoms, do not be afraid to ask for help.

When things are heating up…

Hot flushes and night sweats can be frustrating and make some PH symptoms feel worse. recommends the following measures to cool down:

  • Wear light clothing
  • Keep your bedroom cool at night
  • Take a cool shower, use a fan or have a cold drink
  • Try to reduce your stress levels
  • Avoid potential triggers, such as spicy food, caffeine, smoking and alcohol

More on menopause and PH…

Expert advice on Hormone Replacement therapy for women with PH

Personal stories

Online support

Tips for supporting someone experiencing menopause