Ask the expert: What happens after menopause and how to cope

29th Sep 2022 Menopause

Tips on what to expect after your menopause and how to cope with this big life change, according to consultant gynaecologist, Tania Adib

How did you become an expert on menopause?

I was a gynaecological oncologist, doing cancer surgery, and became a trustee of a charity that helps women who have been through breast cancer. I learned about the effects of treatment which is often geared to blocking oestrogen.

Low oestrogen is essentially the menopause. From this, I developed an interest in managing menopause symptoms.

To what extent can women expect menopause symptoms to stop when periods stop?

Perimenopausal symptoms—fatigue, low mood, anxiety, low libido—can start years before the last period in the late thirties or early forties.

Around the time women’s periods stop they can get more classic symptoms—hot flushes, sweats, insomnia, joint pain, vaginal dryness. Those symptoms may go on for another six or seven years.

What are the main challenges once women reach menopause?

Menopause's affect on the body can be very stressful, especially if you already have a lot on your plate

The drop in oestrogen, progesterone and testosterone has adverse effects on the body. As well as menopause symptoms, metabolism slows and women can struggle with their weight.

It’s the start of a new era. If you have a high-pressure job, teenagers or sick parents, it’s a lot to take on.

How can they overcome them?

HRT is the most effective treatment. It reduces the risk of heart disease, dementia, osteoporosis, colon cancer, diabetes.

We now use bioidentical, instead of synthetic, hormones—the same as the ovaries produce—so the risk of breast cancer is minimal.

How can women ensure they have a healthy, happy life after menopause?

You can feel fabulous every day if you exercise, eat well and balance your hormones. A Mediterranean diet with lots of vegetables and fewer carbs is the healthiest.

Focus on aerobic exercise to keep your heart healthy, and weight bearing exercise to protect the bones. Take omega-3, a probiotic and vitamin D supplements.

Manage stress with mindfulness or yoga.

Tania Adib is a consultant gynaecologist at The Lister Hospital, London (part of HCA Healthcare UK). For more advice, visit The Lister Hospital's website.

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