The menopause is the natural part of ageing, occurring in later years, where a woman stops having periods and is no longer able to become pregnant. Periods usually start to become less frequent and this can happen over months or even years before they stop altogether. However, in some cases, periods can stop suddenly, this is normal and natural. This process usually occurs between the ages of 45 to 55, as a womans’ oestrogen levels decline. Studies have found that in the UK, the average age for a woman to reach the menopause is 51. However, approximately 1 in every 100 women can experiences the menopause much earlier, sometimes before the age of 40. This is commonly known as premature menopause or premature ovarian insufficiency.
The symptoms of menopause can vary in severity and many women will experience one, some, or even all of the following concerns:
- Night sweats
- Hot flushes
- Vaginal dryness and discomfort during sex
- Difficulty sleeping
- Low mood or anxiety
- Problems with memory and concentration
These symptoms can start months, even years before periods cease and can last around four years after the last period stops. Some women can experience these symptoms for much longer and if not treated or given attention, can prove disruptive to daily activities, sleep patterns and life pursuits.
There are now, many treatments and solutions to effectively lessen the symptoms of the menopause, therefore making it a less stressful experience for millions of women. First of all, it is advised to speak with your GP if you are experiencing troubling symptoms, especially if these symptoms are experienced before the age of 40 years of age. Your GP will be able to determine whether these symptoms are a result of premature menopause with a blood test, to measure your hormone levels. Those aged 40 to 45 can also benefit from having a blood test to determine the cause of the symptoms. It is important to discuss, frankly with your GP, the symptoms you are experiencing and how they affect your every day life. There is no need to feel embarrassed, remember, this is a natural process and the more open you can be with your GP, the faster a diagnosis can be done and the right treatment, found for you. If you are suffering with hot flushes, is it worth keeping a diary each time they occur, so your doctor can ascertain whether they are average, or more frequent than average.
Treatments for menopausal symptoms are now varied and there is no need to suffer in silence from any symptoms of the menopause. Your GP will be able to offer treatments and also, suggest lifestyle changes if you have severe menopausal symptoms that interfere with your day-to-day life, including:
- hormone replacement therapy (HRT) – tablets, skin patches, gels and implants that relieve menopausal symptoms by replacing oestrogen
- vaginal oestrogen creams, lubricants or moisturisers for vaginal dryness
- cognitive behavioural therapy (CBT) – a type of talking therapy that can help with low mood and anxiety
- eating a healthy, balanced diet and exercising regularly, maintaining a healthy weight and staying fit and strong can improve some menopausal symptoms
Should your symptoms not improve, or if you are unable to undergo HRT, your GP can refer you to a menopause specialist for alternative advice and treatments, such as:
- Herbal treatments
Look for the THR logo standing for traditional herbal medicines. These products have been approved and you can be sure that the product has the correct dosage, is of high quality and has suitable product information. The guidelines also recommend that many available herbal medicines have unpredictable dose and purity and some herbal medicines have significant drug interactions.
- St John’s Wort:
St John’s Wort has been shown to have benefit in relieving vasomotor symptoms (hot flushes) particularly in women with a history of, or at high risk of breast cancer, although there was no evidence that St John’s Wort had any impact on reducing anxiety or low mood. St John’s Wort however does interact with other drugs, in particular with Tamoxifen and so cannot be used in patients with breast cancer who are taking Tamoxifen. There are also, several other significant drug interactions associated with St John’s Wort which would need to be discussed with a medical professional prior to use.
- Dietary changes:
Many menopausal women will tell you that there is a range of food substances which will trigger hot flushes. These include coffee, tea, alcohol and spicy foods. Hot flushes are narrowing of the thermo-regulatory zone. Learning to avoid those foods or to handle your hot flush when they do occur will help in management of your symptoms.
Plant oestrogens such as Isoflavones do help with hot flushes and in tests, genistein and red clover were found to be more effective in significantly reducing anxiety as compared with a placebo, although the benefits may not last for more than a few weeks. For women suffering with breast cancer, it seems Isoflavones aren’t helpful and there may be concerns about their safety profile. It is important therefore, to discuss this option with a medical professional.
- Bio-Identical Hormone Replacement Therapy (BHRT)
Bio-identical hormone replacement therapy replaces hormonal deficiencies so that optimal balance is created. BHRT is tailor made and designed for each, individual patient and as every patient is unique in their presentation of symptoms and hormone levels, a customized therapy is required. BHRT can come in the form of a capsule, lozenge or cream and each prescription is dependent on several factors. Symptoms must be properly reviewed prior to therapy and each patient must be monitored carefully in case of any changes that are needed to dosage or treatment during the months in which therapy is taking place.