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The Menopause

What is menopause?

The term ‘menopause’ describes the time when women stop having menstrual cycles (periods) permanently as the ovaries stop producing eggs and the amount of oestrogen put out by the ovaries falls. Following the menopause, women are no longer able to bear children and this usually occurs between the ages of 45 and 55. If it occurs before the age of 40, it is known as premature menopause. Menopause can also be caused earlier if there is surgical removal of the uterus (womb) and/or ovaries, or by taking particular medications, such as those used to treat certain types of breast cancer.

The ‘perimenopause’ refers to the time leading to the very last period, which can last from a few months to years. Many women experience symptoms during this time, mainly due to the changing levels of circulating hormones like oestrogen. These are variable from person to person, and the most typical symptoms include:

  • Hot flushes
  • Emotional instability, including low mood and anxiety
  • Insomnia and trouble sleeping
  • Night Sweats
  • Muscle aches and pains
  • Irregular bleeding
  • Vaginal dryness
  • Loss of interest in sex (often referred to as ‘low libido’)

Many of these symptoms resolve following this perimenopausal period, but this can last up to several years and be hugely debilitating, having a massive impact on day-to-day life. However, there are a wide variety of treatments and strategies available that can help to relieve symptoms and get you back to your day-to-day activities.

It is always a good idea to discuss any problems like this with your GP or one of our Gynaecology Specialist.

5 great strategies used to combat menopausal symptoms and get you back to enjoying life!

1. Lifestyle

The way we live day to day can have a massive impact on our general health and wellbeing, with menopausal symptoms being no exception. It is well documented in medical research that both regular moderate exercise and either weight loss or maintenance of a healthy weight with a healthy, balanced diet is beneficial for both helping to reduce hot flushes and improving mental wellbeing and cardiovascular health.

The key to any lifestyle change is making changes that are small and sustainable for you and your own routine. Here are some tips that can provide some good starting points:

Diet:

  • Try adding an extra portion of vegetables with your main meal
  • Swap white bread and pasta for a wholemeal alternative that will keep you fuller for longer
  • Dried fruit on cereal is great for adding flavour and extra fibre
  • Avoiding caffeine and alcohol can help to reduce night sweats, sleep disturbances and hot flushes

Exercise:

  • Find an activity that suits what you enjoy and your own ability – group classes are often a good place for finding extra fun and motivation!
  • Try to move more throughout the day – taking short walks and making sure you get up and move around every hour can make a big difference
  • Aerobic exercise works best for helping with hot flushes, so something that gets you a bit out of breath is ideal
  • Yoga and pilates are great lower-intensity alternatives for gentler exercise

 

2. Medication HRT

Hormone Replacement Therapy (HRT) is the most commonly prescribed treatment for menopausal symptoms as it directly controls the fluctuating oestrogens that cause the symptoms in the first place. It is also important to replace other hormones, such as progesterone, alongside the oestrogen to reduce some of the side effects and risks of HRT. The hormone replacement is available as a cyclical or continuous scheme and in several different preparations including tablets, patches, injections, creams and pessaries.

HRT is very good at treating hot flushes and low mood associated with the menopause, however, there are several serious risks to consider before starting an HRT treatment. Hormone replacement can increase the risk of developing certain types of cancer (including breast cancer). The tablet form of HRT is also associated with a slightly increased risk of developing a blood clot, which can lead to a stroke or a clot in the lung (known as a pulmonary embolus).

It is important to speak about HRT with your specialist or GP to decide which type of HRT treatment would be most suitable for you, as well as discussing the risks and benefits, as these can vary slightly from person to person depending on your past medical history. However, it can be a very effective treatment for many women and remains an extremely popular strategy for relieving menopausal symptoms.

It is important to note that HRT is not the same as contraception and that you should continue to use contraception for 1 year after your last period if you are aged 50 or over and for 2 years if your last period occurred under the age of 50.

 

3. Herbal remedies

Alternative treatments are popular options, with an estimated 40-50% of women in western countries turning to complementary therapies such as herbal remedies for relief of menopausal symptoms. There has been some interesting research published in the last few years to suggest that some herbal remedies that contain chemicals known as ‘phytoestrogens’ can be helpful in reducing symptoms, particularly hot flushes. Some of the commonly used supplements are:

  • Black cohosh
  • Evening primrose
  • Gingko
  • Fenugreek

Although many of these are classed as ‘supplements’ and are available over-the-counter without a prescription, they can still interact with other medications, so it is best to discuss with your GP or specialist before starting to take any of them. As many herbal remedies are not licensed like conventional medications, you should look for the Traditional Herbal Registration (THR) logo on the label to make sure that what you are buying has been checked for its content.

 

4. Acupuncture

Acupuncture is another alternative therapy that is used to relieve symptoms, and large scientific studies have confirmed that it is an effective strategy, both alone and in conjunction with other treatments. Acupuncture is useful for improving both frequency and severity of hot flushes, as well as increasing the quality of life in women experiencing symptoms.

 

5. CBT

CBT stands for Cognitive Behavioural Therapy, and is an increasingly common strategy used to treat a number of problems, including low mood and anxiety. It is a special type of talking therapy which aims to equip a person with their own strategies for coping with stress and changing their own negative thought patterns.

Several studies looking at both conventional CBT and telephone-based CBT courses found that recipients of this treatment had significant improvement in symptoms like night sweats and hot flushes and improved sleep quality in addition to better management of the emotional and psychological effects associated with menopause.

 

 

What to do next?

Talk to our specialists or GP about optimising your lifestyle, considering medications, and looking into alternatives like herbal remedies, acupuncture and CBT. Often, the right combination of all of these can all help to deal with menopausal symptoms and get you back to yourself and getting on with enjoying life!

The Menopause Consultants