Parenting / 20 October, 2023 / My Baba
NHS GP Doctor Dr Raj Arora talks to us about navigating menopause, the symptoms to look out for, different treatment options and where to get support.
Menopause refers to the time when you stop having periods and can no longer get pregnant naturally. During this time, the ovaries stop producing eggs and subsequently, hormone levels (oestrogen, progesterone and testosterone) fall.
The word menopause refers to the day when your periods stop altogether, when you have not had a period for 12 months in a row. However, symptoms of menopause can begin before this time (as ovarian function declines gradually), and periods can become erratic and less frequent. This transitional phase is referred to as “peri-menopause.” Post-menopause refers to the years after menopause.
Navigating menopause
The average age of menopause in the UK is 51, but it can generally occur anywhere between 45 and 55 years of age.
Approximately 13 million women in the UK are peri or post-menopausal. A survey report from the Fawcett Society in May 2022 found that 77% of women in the UK find at least one symptom of menopause “very difficult.” 84% experience trouble sleeping, and 69% of women experience difficulties with anxiety and depression due to menopause.
Menopause and specifically how to navigate menopause has recently received much more traction in the media and with campaigners and therefore is being talked about a lot more.
It is important to talk openly about this change that takes place in a person’s life and to have clear resources available so that one does not suffer in silence or feel isolated.
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Symptoms of menopause
Every individual may have a different experience of menopausal symptoms, and there are a wide range of symptoms, and some common symptoms to be aware of when navigating menopause. There are more than 30 recognised symptoms of menopause. Symptoms may manifest as psychological and/or physical.
Common symptoms include:
- Change in normal pattern of period
- Hot flushes
- Night sweats
- Mood swings
- Problems sleeping
- Brain fog/Memory issues
- Discomfort during sex
- Low libido
- Palpitaions
- Vaginal dryness
- Joint stiffness – aches and pains
Menopause can also increase your risk of developing weak bones and heart disease.
Lifestyle factor tweaks
- Making lifestyle changes will help to manage and may also alleviate menopausal symptoms.
- Below are some of the lifestyle changes that I would recommend:
- Getting enough rest, sticking to sleep routines and practicing sleep hygiene to combat sleep issues
- Consider changing bed linen materials/lightweight clothing materials to help with hot flushes and also to aid better sleep
- Eating a healthy balanced diet – try to reduce ultra-processed foods and increase fresh fruit and vegetables in the diet
- Reduce alcohol intake and quit smoking, as this will reduce the risks of heart disease
- Exercise regularly and try to incorporate weight-bearing exercise to help strengthen joints and bones
- Speak to friends/family about your feelings and changes that you are experiencing so that they can support you through it
Treatment for menopause symptoms
For a lot of individuals who are going through the peri-menopause/menopause stage, they may find that conservative/lifestyle changes are not enough to keep their symptoms at bay.
It is important to speak to your GP about alternative treatments. The first line of treatment is HRT – hormonal replacement therapy. This replaces the hormones that have declined during this phase. Hormones are chemical messengers. They can affect things like growth, fertility, and mood. Therefore replacing these hormones can provide some relief from the symptoms.
HRT usually includes oestrogen and progesterone and, in some cases, may also include a third hormone – testosterone.
There are two types of HRT
1) Combined – progesterone and oestrogen
2) Oestrogen-only HRT
If you have a womb, then both oestrogen and progesterone must be prescribed, and if you have no womb (have had a hysterectomy), then your doctor may prescribe oestrogen only.
Hormones come in 3 common formats
1) Topical oestrogen – applied with a gel
2) Patches – these may contain combined hormones or just one hormone
3) Oral tablets of the different hormones
4) Progesterone can be given orally/via a patch or via a Mirena coil
It is important to weigh risks vs benefits when starting any new medication or treatment; HRT is no different. Common risks include developing clots in legs/lungs, increased risk of stroke and some cancers – see below.
HRT slightly increases the risk of breast, ovarian and womb cancer, but it is important to stress that this risk is small and depends on a number of different things such as the type of HRT used, the duration for which HRT has been used, age and general health of the patient. Most women commencing HRT will have an in-depth discussion around the suitability of HRT and the risks involved. This allows for an informed decision to be made.
When to get support
If you have made lifestyle changes and find that you are still struggling with symptoms or noted mood changes, you may need more support. In particular, if menopausal symptoms are making you feel unwell regularly and preventing you from daily activities or going to work, then it is really important to reach out to your GP.
Where to get support
Menopausal support is available from a number of resources:
Online
NHS website –
The Menopause Charity
Menopause Support
Wellbeing of Women
Pharmacist
Your local pharmacist can help with some menopausal symptoms such as vaginal dryness or skin changes.
GP
Reach out to your GP to consider medication to help with symptoms, HRT, and discuss any complementary therapies you may be considering.
Some GP surgeries will also have a women’s health specialist GP so you can ask to book in an appointment with them to discuss your symptoms.
Article by Dr Raj Arora
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