Menopause Management
Dr Lamah El-Sharkawi is a GP in Uplands and Mumbles Surgery and her sister Reem El-Sharkawi is a GP Pharmacist, both are part of the Bay Cluster Network.
Following on from last month’s article, this month we will talk about the treatment of menopause. The main treatment for symptoms caused by menopause are hormone replacement therapy otherwise known as HRT. It should be noted that there are other treatments available to manage specific symptoms of the menopause.
Hormone replacement therapy (HRT)
How does it work?
HRT works by essentially replacing the hormones that are low due to the menopause.
Many of the symptoms experienced during the menopause are due to low oestrogen levels and thus this is important to replace. The choice of HRT is dependent on whether you have a womb i.e. if you have a womb then your HRT will be a combination of both oestrogen and progestogen to protect the lining of the womb, if not then oestrogen alone will be sufficient. It is well known that HRT is very effective at relieving menopausal symptoms. HRT can come in many different forms including tablets, patches to apply on the skin, gels and implants.
What are the benefits of HRT?
The main benefit of HRT is the relief people experience of the many symptoms of menopause namely, hot flushes, joint pain, mood swings and vaginal dryness. It can also help by preventing the thinning of the bones (i.e. osteoporosis) minimising the risk of bone fractures.
What are the risks of HRT?
It should be noted that some HRT is associated with an increase risk of breast cancer and blood clots in women. Discussing your risk factors with your doctor or pharmacist would allow you to make an informed decision in managing your own treatment. It should be noted that risks of HRT are small however, you can always discuss both the risks and benefits of HRT with your GP or pharmacist.
Managing the individual symptoms of menopause
Hot flushes and night sweats
Many women complain of hot flushes and night sweats as a result of menopause. We recommend simple measures may sometimes help in relieving these symptoms, including:
- Wearing light airy clothing
- Keeping your bedroom as cool as possible
- Having a cold shower and using a fan
- Keeping hydrated by drinking cold drinks
- Trying to keep your stress levels as low as possible
- Avoiding any particular triggers of flushes including spicy foods, caffeine and alcohol
- Taking part in exercise and trying to lose weight if you are overweight
If your sweats or flushes are frequent and/or severe then do contact your GP as further treatment options can be discussed.
Mood changes
It is often reported that women experience low mood and anxiety during the menopause. There are many ways in which we recommend dealing with these feelings including, getting plenty of rest, doing exercise regularly and practicing relaxing techniques. Some people use medicines whether that be HRT or alternative medication to help with these feelings. Others find Cognitive Behavioural Therapy beneficial as treatment. All of these options can be discussed with your GP.
Other symptoms of menopause
Many women complain of a reduced interest in sex around the time of menopause, but many find that HRT can help with this. Vaginal dryness and discomfort is often experienced as a result of menopause and an oestrogen treatment in the form of a pessary, cream or vaginal ring that can be directly applied to the vagina can be used. This is sometimes used alongside HRT and can be used in combination with over the counter vaginal moistures or lubricants which can also be used alone if beneficial.
Women who have been through menopause are at increased risk of osteoporosis. This is due to the lower level of oestrogen in the body. Ways in which this can be reduced are taking HRT, keeping active and regularly exercising and maintaining a healthy diet and lifestyle and getting sunlight.
When you are initiated on treatment for your menopause, the GP may request seeing you more frequently at the start of treatment to ensure safe and effective management of your menopause. During these appointments, your symptoms will be discussed, side effects and bleeding patterns, checking your weight and blood pressure and further discuss the medication and management of menopause.
It is important to stress, any symptoms that you are concerned about should always be discussed with your GP and any questions about your medication can be discussed with your pharmacist.