In this Health Hub article, we explore the signs of menopause and offers her advice on how to manage these symptoms.
- Menopause marks the end of a woman having menstrual cycles. It is clinically diagnosed when a woman has gone 12 months without having a menstrual period. This is usually when a woman is in her 40’s – 50’s
- The months or years leading up to menopause is referred to as perimenopause. It is important to note that during this transition, periods are irregular and conception becomes harder, however ovulation still occurs and a woman may still become pregnant during this time.
What Causes Menopause?
The ovaries make the hormones oestrogen and progesterone. These are in control of menstruation and ovulation. Menopause happens when the ovaries no longer release an egg every month and menstruation stops. Menopause is considered a normal part of aging when it happens after the age of 40. Otherwise the patient is seen to be premature-menopausal.
Signs of Menopause
During perimenopause, a woman may experience one or all of the following:
- Hot flushes
- Vaginal dryness
- Depression or low mood
- Memory loss and difficulty concentrating
- Night sweats
- Difficulty sleeping
- Weight gain
- Thinning hair and dry skin
- Weakening of the bones (osteoporosis)
The above symptoms may begin months before your periods begin to stop, and last up to four years after your last period finishes.
If you experience menopausal symptoms before the age of 45, it is advised that you see your GP. The GP will carry out a blood test to test your hormone levels and diagnose you as being premature-menopausal.
Managing Symptoms of Menopause
Lifestyle measures will help reduce some symptoms associated with menopause:
- Regular exercise will help reduce hot flushes and improve sleep. It will also help boost your mood if you’re feeling anxious or irritable. Weight bearing exercise will help keep your bones strong
- Having a ventilated and cool bedroom will help reduce night sweats
- Stopping smoking will help to reduce hot flushes and reduce the risk of developing serious health conditions
- A vaginal lubricant will help to reduce vaginal dryness and irritation
Hormone Replacement Therapy (HRT)
Not everyone will require menopausal treatment, however if you find that menopause is interfering with your day to day life there are a variety of treatments which may be offered. Some people cannot have HRT as it may cause:
- Clots in the lungs and legs
- Heart attack
You must tell your doctor if you have a history of breast lumps, heart attack, stroke, hypertension, high cholesterol or diabetes.
The choice of HRT varies from person to person and will be determined by the symptoms they’re having, and also the stage of menopause that person is at. Treatments may be cyclical or continuous.
How it Works: Relieves hot flushes, prevents vaginal dryness and maintains bone strength
Who is it for? For continuous use in women who don’t have a womb
Some Products Available: Premarin, Progynova, Oestrogel, Femseven
Forms Available: Tablet, patch, gel or implant
OESTROGEN & PROGESTERONE
How it Works: Oestrogen only can cause overgrowth of the lining of the womb which may leads to cancer so progesterone (a second hormone) must also be added to prevent this
Who is it for? For women who still have a womb and also those who have not had a total hysterectomy (some cervix remains)
Some Products Available: FemSeven Conti Patches, Indivina tablets, Elleste- Duet, Evorel Conti
Forms Available: Tablet or patch
How it Works: Combines effects of oestrogen, progestogen and testosterone to relieve menopausal symptoms and prevents bone loss
Who is it For? It is usually prescribed at least 12 months after the last menstrual period. Many women switch to this after taking a sequential HRT
Some Products Available: Tobilone/ Livial
Forms Available: Tablet
Side Effects of HRT
Spotting and irregular light bleeding is common if you are taking combined HRT or tibolone for the first 6 months, however if you experience heavy bleeding, bleeding that lasts longer than 6 months or sudden bleeding after a long period without bleeding then you should consult your doctor.Other more common side effects include breast tenderness, leg cramps, nausea, bloatedness, irritability and depression.
Advice From The Pharmacist
HRT should be stopped if you experience any of the following:
- Sudden severe chest pain
- Sudden breathlessness
- Unexplained swelling or severe pain in the calf
- Severe stomach pain
- Prolonged headache
- Prolonged immobility after surgery (increased risk of clotting)