What's the menopause? Dr Zoe explains...

The menopause is when a woman’s periods have permanently stopped. It can only officially be diagnosed when a woman has not had a period for twelve months or more.

However, women may experience menopausal symptoms for up to ten years prior to the menopause, a period called the perimenopause. During this period symptoms are related to the changes in three different hormones; these are oestrogen, progesterone and testosterone.

Dr Zoe says that you do not need to wait until ‘the menopause’ to start treatment if you’re having symptoms. For years women have suffered in silence unnecessarily, in the lead up to the menopause.

Symptoms of the menopause/perimenopause

Common symptoms are changes to your periods, night sweats and hot flushes, vaginal and bladder symptoms, poor sleep, psychological symptoms such as low mood, anxiety, irritability, loss of self esteem, reduced sex drive, difficulty losing weight, brain fog, changes to hair and skin and practically just about anything else that is unpleasant can potentially be linked to the menopause/perimenopause.

So what do about it?

There are lifestyle changes that can help to combat some of the symptoms and the importance of a healthy diet, regular exercise and stress reduction is highly advised. Some women choose to use natural remedies that can be purchased in health shops, such as black cohosh or Ginkgo-biloba.

Dr Zoe advises caution with these as even though they are from plants, they can still sometimes cause problems such as liver problems and the evidence to support their effectiveness is not fantastic. Claims have been made that naturally occurring oestrogens in some food such as mung beans and yams can help, however, the evidence is not clear and would suggest huge quantities would need to be eaten to have an effect.

What about HRT?

It has been well document that there are some risks associated with HRT, these include a very small increased risk of breast cancer or some women, but not all and an increased risk of blood clots with some forms of HRT, but again, not all.

“For the majority of women, hormone replacement therapy (HRT) is an effective and safe treatment.” - Dr Zoe Williams__The media have been less enthusiastic to report that HRT is also protective - it protects the bones, the heart (in women under the age of 60) and there is also evidence of a reduced risk of dementia and bowel cancer in those taking HRT.

HRT is absolutely necessary as a treatment for women who have the menopause at an early age - either naturally or due to medical/surgical factors. Below the age of 51 HRT has more health benefits than risks, even if the woman has no symptoms of the menopause.

The average age of a woman to have menopause is 51, however, one in a hundred women will experience menopause before the age of 40. 1 in 1000 before the age of 30. This is called premature ovarian insufficiency, and requires proper diagnosis and treatment with hormone replacement therapy.

Doctor Zoe advises any woman who thinks she may be suffering with symptoms of the menopause to book an appointment with their GP or practice nurse, who can help them to weight up potential pros and cons of HRT.

When making a decision regarding to HRT, it is important to consider each woman’s personal factors. Having said this, for the vast majority of women who have menopausal symptoms, the benefits of HRT will outweigh the risks.