If you’ve lost your memory, confidence, vaginal lubrication, and are flushed and sweaty 24/7, then welcome to the menopause. A survey of 3,275 women by Nuffield Health found that more than 60% of women between the ages of 40 and 65 had menopausal symptoms that were making them behave differently or had a detrimental impact on their lives. For something that’s natural, it can feel depressingly pathological. Yet, despite many women struggling to cope at work, with one in five taking days off, the survey found only just over a third of them saw their GP about their symptoms. Other studies show that just one in 10 seek medical help. So should you just wait for the menopause to be over (bearing in mind it can last two to five years) or visit your doctor? And now that hormone replacement therapy (HRT) has had a bad press for increasing the risk of breast cancer, is there any useful treatment anyway?
The solution
The average age for periods to stop is 52, but menopausal symptoms, largely due to crashing oestrogen levels, start at least one year beforehand. Hot flushes – the unpleasant experience of heat swarming over the upper body, causing drenching sweats and skin flushing, followed by palpitations – are worst in the year after periods stop and is the symptom most likely to make women seek help. HRT was the magic bullet for the menopause until studies such as the Women’s Health Initiative in 2002 and the UK Million Women Study showed increased rates of breast cancer, stroke and blood clots in the veins. Prescribing of HRT dropped by between 40 and 80%.
Yet in the past decade, opinion has shifted once again. The menopause can be a breeze for some women but, as this latest survey shows, it can also be horrible. The latest National Institute for Health and Care Excellence guidance says that HRT may provide more benefit than risk for some women with severe symptoms (hot flushes, night sweats, mood swings, urinary symptoms and vaginal dryness). But only if they do not have risk factors – for example, for breast cancer or blood clots.
Nice recommends two to three years of treatment – with either tablets or patches. But it also advises that all women around the menopause could reduce hot flushes by regular exercise (aerobic, such as running or swimming), weight loss, wearing lighter clothes and avoiding caffeine, smoking and alcohol. Regular, sufficient sleep can help reduce mood swings. Nice says there is no evidence that complementary therapies such as soy, red clover or black cohosh work and that women should discuss them with their doctor as they can interact with other drugs. If you don’t like the idea of HRT, there are other drugs that can help with the flushes. You should get your symptoms reviewed regularly to make sure any treatment is worth taking.
