Calls for more awareness of menopause symptom affecting up to 80% of women

A leading menopause expert has called for more awareness of an "under-reported, under-diagnosed and under-treated" menopause symptom.

Urogenital atrophy is the effect of the lack of the female hormone oestrogen on tissue in the vulva, vagina, bladder and urethra.

Although it is difficult to get accurate figures as a result of the under-reporting, some studies have shown it could affect as many as 80% of post-menopausal women.

Many other menopausal symptoms improve with time, but urogenital atrophy can worsen with age.

Dr Paula Briggs says urogenital atrophy is still 'below the radar' in terms of menopause awareness Credit: ITV Granada

Dr Paula Briggs, a Consultant in Sexual and Reproductive Health at Liverpool Women’s Hospital says many women are not being made aware of this potential symptom and it is often put down to ageing.

Cheryl O'Malley from Heswall, Wirral, is a busy mum and bar a few hot flushes thought she thought she had 'finished' with the menopause.

She was offered hormone replacement therapy by her GP but said the possibility of developing urogenital atrophy was not discussed.

'It was not something I had heard of, or ever considered, if I had I would have taken HRT.

Cheryl O'Malley says laster treatment for her has been 'life-changing' but she had to pay privately Credit: ITV Granada

Several years later she started to experience "low mood, low libido and painful intercourse."

She said: "It wasn't until I physically couldn't be intimate, I knew it wasn't right".

Dr Briggs, who is also the Chair of the British Menopause Society wants to more training for clinicians and more awareness for women of the symptoms.

She said: "When women go for their smear tests for example, if they are just asked about vaginal dryness, and pain during sex that should lead to whoever they are seeing to think of this diagnosis."

  • Vaginal dryness occurs in about 1 in 4 women leading up to the menopause,

  • 1 in 2 are affected after the menopause

There are a range of treatments from HRT, oestrogen creams and lubricants but in the most severe cases, laser treatment is an option, but it is not currently available on the NHS.

Cheryl says she had no option but to pay privately and said the laser treatment had been 'life-changing' for her.

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Patients and fundraisers at Liverpool Women's Hospital have raised tens of thousands of pounds to buy a reconditioned laser to provide the treatment.

It will be used in a clinical trials, which the National Institute of Health and Care Excellence (NICE) have asked for, with the hope of making it available to all NHS patients.

The trial will be for breast cancer patients initially, as these women often experience more severe symptoms.

Dr Briggs wants women to be just as confident to talk about vaginal discomfort as result of the menopause as hot flushes and brain fog, so they can access a range of treatments.

"I think we have done a lot with menopause in general but this is still below the radar. But by reassuring women there are treatments out there, they will want to talk about it".

Cheryl said she frustrated and angry, to constantly hear about women of all ages who do not have a clue this is the effect of the menopause and it could have been prevented.

She does not like to think about what would have happened if she had not been able to access the treatment.

"I'm not quite sure where I would be, without the treatment, I'm not sure if I would still be married, I felt very unwell."

Cheryl has shared her personal experience to help women be better informed and consider preventative treatment.

Menopause fact file

What is the menopause?

  • The menopause is defined as 12 months since a woman last had a period.

  • The average age at which women start the menopause transition is 46 years. Periods usually stop by the age of 51.

  • The menopause itself is reached when the ovaries stop producing oestrogen.

  • Some women will experience menopause for reasons other than natural ageing. These include premature ovarian insufficiency or a chronic health condition that causes early menopause, or removal of their ovaries to reduce their risk of certain cancers or to alleviate pain associated with endometriosis.

The perimenopause

  • The perimenopause is classed as the time leading up to the menopause, this can occur for up to 10 years.

  • During this time a woman is likely to be experiencing symptoms due to changing hormone levels.

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What are the signs and symptoms of the menopause?

  • The most common symptoms are heavy bleeding, hot flushes, night sweats, emotional instability, vaginal dryness and bladder problems.

  • A survey conducted by Ipsos MORI, on behalf of the British Menopause Society, revealed 79% of women experience hot flushes and 70% experience night sweats.

  • Symptoms can range from mild to debilitating.

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What treatment is available?

Much can be done to help with symptoms during the menopause transition, including lifestyle changes, hormone replacement therapy (HRT) and treatments for individual symptoms.

Lifestyle changes

  • Get plenty of rest, including a regular sleeping pattern.

  • Have a healthy diet and exercise regularly - weight-bearing activities (such as running and walking) are important to protect your bones.

  • Do relaxing things like yoga, tai chi or meditation which are good for general strength and flexibility and improve the pelvic floor.

  • Eat calcium-rich food like milk, yoghurt and kale to keep bones healthy.

  • Speak to other people going through the menopause.

  • The NHS advise people going through the menopause not to smoke or drink more than the recommended alcohol limit.

Hormone Replacement Therapy (HRT)

  • The main medicine treatment for menopause and perimenopause symptoms is HRT.

  • HRT replaces the oestrogen that you lose during the menopause transition, either aloneor in combination with a progestogen.

  • It helps to alleviate menopausal symptoms and also reduces the long-term consequences of the menopause.

  • HRT can be delivered in many ways including tablets, patches, gels, a spray and implants.

  • From 1 April women prescribed HRT, can get access to a year’s worth of treatment for just under £20, The Department of Health says.

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Where can I get help and support?

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