health articles Menopause
The menopause is a natural stage in a woman’s life when the monthly periods stop. It typically happens between 45 and 55 years of age, when the ovaries stop releasing an egg and producing the hormones oestrogen and progesterone. Around three-quarters of women experience symptoms as a result of the hormonal changes of menopause including mood swings, sleep disturbance, hot flushes and night sweats.
What is the menopause?
The menopause is defined as the time when periods stop. However, during natural menopause, the periods usually become irregular and infrequent over several months or years before stopping completely. Many women can experience symptoms before the periods stop, which is known as the perimenopause.
The average age for the menopause is 51, but one in a 100 women experiences premature or early menopause before the age of 40. Sudden menopause can also happen due to surgery to remove the ovaries, or because of ovarian damage during chemotherapy or radiotherapy.
Menopause symptoms
Menopause symptoms can happen before and after the final period, with some women experiencing problems for four years or more. Common symptoms include:
- Hot flushes
- Night sweats
- Vaginal dryness, which can cause pain or discomfort during sex
- Sleep disturbance and insomnia
- Emotional problems including depression and anxiety
- Low sex drive
- Brain fog, forgetfulness and concentration problems
Menopause care at Virtually Healthcare
Many women sail through the menopause, but as many as one in three suffers severe symptoms that can affect their physical and mental health. The experienced doctors at Virtually Healthcare can provide advice, support and treatment for anyone who finds the change of life a challenge.
Virtually Healthcare is an innovative GP practice, providing expert care in the comfort, safety and privacy of your home. The Virtually Healthcare service is designed to fit with modern lives. Consultations are easy to access, discreet and convenient with virtual appointments available seven days a week.
The highly-skilled team includes more than 40 clinicians working together to investigate and treat disease and help you optimise your health and wellbeing. As well as experienced GPs, the team includes sexual health specialists, physiotherapists and practice nurses to offer a comprehensive primary care service.
During the pandemic, many patients are finding it more difficult to access Healthcare. Virtually Healthcare provides rapid access video or telephone appointments; with consultations available the same day if you contact us before 3 pm. Our clinicians can provide professional assessment and advice, arrange investigations, prescribe treatment or arrange for a face-to-face review.
At Virtually Healthcare our focus is on you. Our clinicians take a holistic approach to menopause management. They can advise self-help and herbal remedies, arrange hormone tests whenever indicated, and advise about Hormone Replacement Therapy. The doctors will work with you to ease your symptoms, improve your mental and physical health and restore your quality of life.
How to help yourself during the menopause
There’s lots that you can do to help yourself during the menopause:
Stay active: Women who are active may suffer fewer symptoms. Sustained, steady aerobic exercise like swimming, cycling or running can improve fitness and wellbeing and help you sleep. Weight-bearing activities like walking, jogging or dancing can prevent osteoporosis and protect your bones.
Eat well: A healthy balanced diet will prevent menopausal weight gain.
Sleep hygiene: Ensure your bedroom is well ventilated and consider lighter bedding so that you can cope with night sweats and hot flushes.
Cut back on coffee and alcohol: Many women find that alcohol and caffeine can make symptoms worse and try to substitute with herbal teas and caffeine-free alternatives.
Lubricants: Vaginal lubricants can reduce discomfort during sex.
When to see a doctor & menopause testing
When to see a doctor:
If you are worried about the menopause, you are experiencing menopause before the age of 45, or your menopause symptoms affect your health, wellbeing and function, make an appointment with one of the doctors at Virtually Healthcare.
Menopause testing:
Your doctor will usually diagnose you from your symptoms and the pattern of your periods. However, they may arrange a blood test for hormone analysis, especially if you’re younger than 45.
Menopause treatment
Many women suffer in silence during the menopause, but women don’t have to put up with difficult and distressing symptoms. Treatments include:
Hormone replacement therapy:
HRT replaces natural female hormones. There are many different formulations, including tablets, patches, implants and gels. Your doctor can advise on HRT to suit your health and lifestyle.
Women who have a womb need to take combined HRT which contains oestrogen and progestogen. Progestogen, a synthetic progesterone, helps protect the womb from developing cancer of the uterus’ lining.
HRT can reduce symptoms and improve quality of life. Research shows that HRT started within ten years of the menopause can reduce the risk of the bone-thinning disorder osteoporosis, arthritis, type 2 diabetes and death from all causes1. Your doctor will explain the pros and cons of treatment and monitor your health during HRT.
Vaginal oestrogen:
Oestrogen creams, gels and pessaries can treat vulval and vaginal dryness and prevent pain during sex.
Cognitive behavioural therapy:
CBT is a talking therapy that can help you manage feelings of anxiety, distress and low mood during the menopause.
Hot topics about menopause The pros and cons of HRT
Hormone Replacement Therapy can ease menopausal symptoms and protect against osteoporosis- but it also comes with some risks. The risks of complications vary between individuals, but any increases are generally small for most women. Your doctor will be happy to discuss the pros and cons of the treatment so that you can make an informed choice.
- Blood clots: HRT tablets are linked with a higher risk of developing venous thromboembolism. Anyone who is at increased of clots, such as smokers, those with a family history, or people who are obese may be offered HRT gels or patches instead of tablets. These do not increase clot risk.
- Heart disease and stroke: The risks of HRT have been extensively researched. Studies show that women that start HRT before the age of 60 are not at increased risk of cardiovascular disease, and HRT doesn’t change your chance of dying from cardiovascular disease.
- HRT tablets slightly increase your risk of having a stroke, but the risk to women under 60 remains low. Anyone at higher risk of cardiovascular disease may want to talk to your doctor about the best choice balancing your symptoms with your individual risk.
- Breast cancer: Research suggests that taking oestrogen-only HRT around the time of the menopause causes little or no change in your breast cancer risk. HRT that contains progestogen may increase your breast cancer risk, especially if you take it for longer. The good news is that the risk falls when you stop HRT.
- Diabetes: HRT doesn’t increase the risk of developing type 2 diabetes and shouldn’t affect blood sugar control in women living with diabetes. However, diabetes increases your risk of cardiovascular disease. Your doctor can provide individual advice so that you can understand your personal benefits and dangers.
- Osteoporosis: The risk of breaking a bone around the time of the menopause is low; taking HRT further reduces this risk. This protection lasts while taking HRT. However, taking HRT for a long time may extend the effects.
- Muscle strength: Women can lose muscle strength around the time of the menopause; HRT may reduce the risk of this. However, staying active and performing bodyweight resistance or weight training can also help you maintain muscle mass.
- Dementia: We don’t know the effects of HRT on the risk of developing dementia. NICE ( the National Institute for Health and Care Excellence) has recommended more research.
HRT alternatives
Some women cannot take HRT or prefer to avoid medical treatment. Our doctors can advise on lifestyle measures, suggest natural therapies or prescribe medication to improve your mood or address other symptoms. However, it’s important to understand that the quality, strength and purity of supplements and complementary therapy can vary.
Treatments include:
Nutrition: The Japanese don’t have a word for the menopause; they are reputed to sail through the change of life because of the high levels of soy in their diets. Soya contains natural plant oestrogens, which have a similar effect to the body’s female hormones. Try to introduce tofu, miso and other soy products into your diet. Phytoestrogens are also found in nuts, seeds especially flax and sesame, hummus and dried apricots.
Soy Isoflavones: If you struggle to eat enough soy, there are supplements to boost phytoestrogens. Research suggests than they can help reduce physical and psychological symptoms in perimenopausal and postmenopausal women.
Red Clover: Red Clover also contains isoflavones. It may help reduce hot flushes and night sweats.
Black Cohosh: May work for vasomotor symptoms like hot flushes and night sweats.
St John’s Wort: There is good evidence that this works well for mild to moderate depression and the vasomotor symptoms of the menopause. However, it is an active substance that can interact with foods and medication. Please read the patient information leaflet carefully and make an appointment to talk to a doctor at Virtually Healthcare if you have any questions.
Many women say that they benefit from other treatments including agnus castus, selenium, vitamin C and herbs such as Ginkgo Biloba, hops, sage leaf, liquorice and valerian root –but there are few studies confirming they work effectively.
Find out more:
- https://www.nhs.uk/conditions/menopause/
- https://www.menopausematters.co.uk
Types of consultations we offer
We offer written, telephone and video consultations with a range of male and female clinicians from GPs, nurse practitioners, and primary care specialists such as physiotherapy.
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