Changing attitudes to the menopause
The menopause used to be something of a taboo subject, coyly referred to as “the change”. But celebrities like Zoe Ball and Meg Mathews talking openly about their experiences will hopefully encourage more women to stop suffering in silence. Mini Nair, our consultant gynaecologist, says women don’t need to grit their teeth and put up with symptoms as medical help is available. She tells us more here.
“As we get older the level of progesterone and oestrogen – the hormones that regulate our reproductive system - start to decrease. The menopause usually happens aged around 51 or 52, but many women start to experience symptoms in their mid to late forties.
“Often the first signs are erratic periods – they may go from light to heavy or vice versa and become more or less frequent. This can last for several months or even a few years but eventually you will stop ovulating and having periods altogether. If you haven’t had a period for 12 months then you are considered to be postmenopausal.
“You may start having other symptoms – hot flushes are the one that everyone associates with the menopause although not everyone has them by any means. You may get night sweats, headaches and tiredness. But not all symptoms are physical – many women experience mood swings, feel depressed or find it hard to focus on a task. You may also find that having sex is difficult or even painful. All these things are normal, but that doesn’t mean that you have to put up with them.
“Hormone replacement therapy (HRT) is undeniably the most effective way of managing the unpleasant symptoms of menopause and has help many women get through a difficult time. Unfortunately the bad press in recent years about the associated risk of cancer has made some women nervous about taking it. However, while there is a slight increased risk of cancer, in many cases the benefits if HRT outweigh this and you need to look at the whole picture.
“HRT replaces the body’s natural oestrogen which we can no longer make after the menopause. Oestrogen helps to protect us against heart disease and is important for keeping our bones strong. Given that we are now living much longer than we used to – it’s not uncommon these days to reach 100 – means some women could spend 50 years living without oestrogen. This in itself poses many health risks as well – not least osteoporosis and heart disease. Women who have taken HRT are less likely to get osteoporosis and some forms also improve heart health.
“Before making a decision about whether HRT is right for you, your doctor will explain the pros and cons, talk about the risks and the benefits, both in the short term and the long. Whether or not you choose to take HRT, you can improve your general health through your lifestyle – keeping active and maintaining a healthy weight are key factors to looking and feeling well at any age or stage of life.”