Menopause is when a woman stops having periods as she reaches the end of her natural reproductive life. This is usually a gradual process. The average age of menopause in the UK is 51. However, this varies widely and 1 in 100 women experience premature ovarian insufficiency (menopause occurring before the age of 40 years).
Decreased oestrogen levels in menopause can cause a variety of different symptoms, and varies in severity from person to person. These include: irregular periods, hot flushes, night sweats, mood changes, memory and concentration loss, vaginal dryness, a lack of interest in sex, headaches, and joint and muscle stiffness. Quality of life can be heavily affected.
Most women (8 out of 10) experience some symptoms, typically lasting about 4 years after the last period, but continuing for up to 12 years in about 10% of women. Prolonged lack of oestrogen affects the bones and cardiovascular system and postmenopausal women are at increased risk of a number of long-term conditions, such as osteoporosis.
Around a million women in the UK use treatment for their menopausal symptoms.
Since menopausal symptoms are caused by reduced levels of oestrogen, one of the mainstays of treatment is Hormone Replacement Therapy (HRT).
If HRT is taken after a hysterectomy, usually oestrogen alone is required. If HRT is taken when the womb (uterus) is still present, then oestrogen is taken with a progestogen which protects the lining of the womb.
There many different types of HRT: tablets, patches, gel or implant. People respond differently to different components, routes and doses of oestrogen and sometimes several adjustments of therapy are required. If possible, any type should be tried for 3 months before deciding whether or not a change is required.
Alternatives to HRT
Not every woman chooses HRT, or can have HRT to help their symptoms of the menopause.
Other treatment options are listed here and include:
- Herbal medicine - a practice based on the use of plants or plant extracts to relieve symptoms, e.g. black cohosh
- Alternative medicine - a range of therapies used instead of conventional medicine, such as acupressure, acupuncture and homeopathy
- Complementary therapy - interventions that tend to be used alongside conventional medicine, e.g. aromatherapy with HRT
- Non-hormonal medical treatments - treatments prescribed by your doctor, such as antidepressants
Side effects/ Risks of HRT
In Cherryvalley Group Practice, we aim to keep up to date with current best Practice guidance. The links below are designed to help you weigh up the benefits of HRT in relieving symptoms, against the risks.
As well as above information, we aim to specifically discuss:
Risk of venous clots. A patch is felt to confer a lower risk of clots than oral tablet. This is why we aim to prescribe patches for anyone with risk factors for clots including a Body Mass Index >30. We also aim to ensure BP is well controlled
Breast cancer risk. We also take into account other factors which increase breast cancer risk such as smoking, obesity and alcohol excess, as well as family history of breast cancer.
Once established on HRT, we aim to carry out an annual review to assess your progress, optimise your preparation and dose and ensure there are no new risks to your health due to being on HRT. We aim for annual update of your weight, BMI and Blood Pressure and are happy to accept home recordings of these. We can carry out your reviews over telephone or face to face. Our priority is to ensure you receive the safest possible care during your menopause journey.