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Got menopause symptoms? This doctor’s guide will make you feel better

hot flash woman, got menopausal symptoms what this doctor has to say will make you feel better by healthista

This week BBC Radio 4 Women’s Hour delves into the topic of menopause. Gynaecologist Dr Gabrielle Downey says plenty can be done about symptoms, yet many women suffer in silence. Don’t be one of them

This week BBC Radio 4’s Women’s Hour has put together a special show about menopause with women phoning in and talking about the severity of their symptoms. The show will be revealing the results of a poll conducted by BBC Radio Sheffield which will delve into the ways women are affected by the menopause at work, in their relationships and the treatment they’ve found effective. ‘I’ve already had a little cry because I’ve realised I am not going mad all on my own,’ said one listener of the show. Don’t suffer in silence, Dr Gabrielle Downey reveals what to do about your symptoms.

There are currently ten million women in the UK who are menopausal, and eight out of ten of those will have symptoms of some form or another which can range from the crippling depression suffered by Carol Vordeman, 56 to hot flushes, night sweats, weight gain and vaginal dryness (or all of the above). How severe they are and how well one can cope with them is as individual as our fingerprints. That means that the advice given and options offered must also be individualized, according to the National Institute of Health and Care Excellence (that’s NICE – the people who look at all the evidence and advise doctors what to do.)

What exactly is the menopause?


All women are born with a finite number of eggs, which typically range from 100 to 300,000. Our bodies get rid of them over time, so when there are only around 1,000 left, we start to feel menopausal symptoms. Quite simply, the menopause is when our ovaries start to fail to produce eggs. This failure means our oestrogen levels fall, and this fall feeds back to the brain telling it to send more signals to the ovaries to try and get them to work. The brain reacts by producing a hormone signal called Follicle Stimulating Hormone (FSH) and then the sweats and flushes result. Eighty percent of women experience these with 20 percent being severely affected. How long they persist for depends on how long it takes for the brain to realize that the ovaries are not going to work. Somewhat shockingly, the average length of time for them to occur is 5.2 years.

Quite simply, the menopause is when our ovaries start to fail to produce eggs.

For reasons that are unclear, some women sail through the menopause whilst others suffer from profound symptoms that significantly interfere both with their quality of their life and their ability to function in the workplace. Cognitive function is impaired with insomnia, anxiety, “brain fog,” depression and loss of concentration. These are disturbing given that over 3.5 million of us are still working yet having to cope. Or do we? No, we don’t! Yet only 50 percent of menopausal women ever visit a doctor for advice.

MORE: 10 perimenopause symptoms that could explain your moods, aches and low libido

How to cope with the symptoms


So what help is there? The most recognizable option is hormone replacement therapy (HRT). If you have a womb, then both oestrogen and progesterone are required as oestrogen used alone can increase your risk of cancer of the womb lining. HRT can alleviate menopausal symptoms but also protects against osteoporosis (thin bones), lowers cholesterol and reduces the risk of some cancers.

HRT can alleviate menopausal symptoms but also protects against osteoporosis (thin bones), lowers cholesterol and reduces the risk of some cancers.

HRT can increase the risk of breast cancer if used in its combined form of oestrogen and progesterone. The risk increases over time, and it is usually safe to take combined HRT for less than five years. The risk then increases for each year you continue over five years with an increase of at least six new cases per 1000 women over five years and 24 over ten years. Oestrogen-only HRT does not increase your risk of cancer. If taken any way other than by tablet, there is also no increased risk of heart attacks or strokes.

There are other options that don’t involve taking hormones. For vaginal dryness, there are local oestrogen creams. For those women who can’t take oestrogen HRT, there is a synthetic hormone called Tibolone.  As bone density decreases at this time, your GP can undertake a test called bone densitometry, which measures bone thickness and can protect them by drugs called bisphosphonates. Calcium supplements are only useful if you’re over 70 years old.

MORE: Vaginal dryness: what you need to know

Other self-help options


For sweats and flushes

Lifestyle changes with increased aerobic exercise (cardio) protect against osteoporosis and help sleep patterns. Interestingly, yoga and Pilates decrease sweats and flushes.

yoga and Pilates decrease sweats and flushes

Although they go through phases of popularity, magnets, reflexology, acupuncture and vitamin E don’t actually work apart from the ‘placebo’ effect!

For vaginal dryness

here are two types lubricants – those that help with moisture at sex only with no long-term benefits and ‘Replens’ and ‘Sylk,’ which attach to epithelial cells and have long-term benefits.

Natural help?

Popular ‘biological’ hormones such as yams and creams have no evidence base. As the Chinese tend not to suffer much with menopausal symptoms, there is currently research into the role of phytoestrogens (plant oestrogens) found in foods such as cereals, legumes, fruit and wheat.

Although they go through phases of popularity, magnets, reflexology, acupuncture and vitamin E don’t actually work apart from the ‘placebo’ effect!

There is some benefit from natural remedies Red Clover and Agnus Castus for flushes and sweats. There is no evidence for the use of Black Cohosh, Dong Quai, Ginseng and St John’s Wort. They not only do not work but also can potentially cause harm.

So, those nice people at NICE say that you should talk about your issues with your GP, and you should take treatment for your menopausal symptoms for as long as you wish provided you have been fully informed of the risks and benefits of the option you choose, even if that is nothing!


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Gabrielle Downey Why sex hurts and what to do about it - the gynaecologist’s guide Healthista

Dr. Gabrielle Downey is a Birmingham-based consultant gynaecologist. She has been a consultant gynaecologist at the Birmingham City Hospital for over 15 years. Dr. Downey publishes regularly in renowned journals and writes for medical textbooks, was a co-author to the current NHS cervical smear program, and has specialist expertise in problems such as abnormal smears among many other conditions.

Click here to read more about Downey.

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