Menopause

Menopause is a naturally occurring phenomenon and is defined as the cessation of menstruation (periods) for more than 12 months. The average age for this to occur is 52 years. The changes in menstrual function prior to complete cessation of periods is called the peri-menopause.

Menopause can be induced surgically if both the ovaries are removed in women who are still menstruating. If you were menopausal prior to surgery to remove ovaries, your menopausal status will not change.

Symptoms of menopause include hot flushes, insomnia, vaginal dryness, decreased libido, urinary frequency and incontinence, altered mood, skin thinning, joint aches and bone density loss (osteoporosis).

Menopause can be treated in a variety of ways, however not all women need treatment. If your symptoms are not problematic then you do not need to treat the menopause. If no treatment is chosen, the risk of osteoporosis can be reduced with weight bearing exercise, a calcium rich diet and/or calcium supplements.

The menopause can be treated with hormonal or non-hormonal therapies. In women whose uterus is still present Combined Hormone Replacement Therapy (HRT) is prescribed. For those women with no uterus Oestrogen only HRT is prescribed. HRT can be taken in many forms including tablets, skin patches, skin gels, nasal sprays or implants.

The advantages of taking HRT are that it will decrease the symptoms of menopause, reduce the risk of bowel cancer as well as protect bones from osteoporosis. As with all medications there are disadvantages of HRT. HRT can increase the risk of breast cancer, heart disease and venous thrombo-embolism (blood clots). These risks can be reduced by regular health checks, regular mammograms, cessation of smoking, healthy diet and exercise. The risks are more common if HRT is used for a period of longer than 5 years.

If HRT is declined or not suitable there are non-hormonal methods of treating the menopause. Natural remedies are available and these include herbal preparations, vitamins and phyto-oestrogens (naturally occurring oestogen-like substances). Research into the natural remedies is still ongoing. Other non-hormonal options are to treat symptoms individually rather than as a whole. Various different medications are available to treat hot flushes, joint aches, mood swings and vaginal dryness.

Your local doctor or Dr Andrea Garrett can assist you with information or prescribing HRT.