EIGHT SIMPLE STEPS TO TREATING YOUR SYMPTOMS

From night sweats to weight gain, Dr Louise Newson, aka, ‘The Menopause Doctor’ tells you everything you need to know about how to cope

MANAGE LOW MOODS In my experience, psychological symptoms can be the most difficult. Oestrogen helps to regulate our mood, so when levels fall you can be more prone to anxiety, and irritability. Every week, I’ll have an emergency appointment with a woman who is feeling suicidal because of her menopause. A lot of this is down to the fact that women just don’t feel able to talk about the menopause openly. It’s one of the reasons I founded the Menopause Charity (themenopausecharity.org) to pave the way for every woman to have access to treatment.

Some women find cognitive behavioural therapy (CBT) effective – ask your doctor for a referral to your NHS talking therapies service or refer yourself.

SWOT UP ON HRT

HRT – hormone replacement therapy – is the gold standard treatment for menopausal symptoms and can be taken as soon as you recognise you’re having issues. HRT is available as a skin patch, gel, spray or tablet. Most women can get a menopause diagnosis from their symptoms alone, without the

need for blood tests. The dose and method of HRT you are prescribed will depend on the severity of your symptoms and personal choice.

Oestrogen is the most important hormone for HRT.

If a woman still has their womb and hasn’t had a hysterectomy, they also need to take a type of progesterone. The other hormone women can benefit from is testosterone, which declines as we age. It helps with sexual arousal, libido and bone strength. Body identical HRT is preferable and is available on the NHS. It’s derived from yams, a root vegetable, and has an identical molecular structure to the oestrogen produced by our bodies. You may have read about bioidentical HRT, a “custom-blended” treatment offered by some private clinics. However this is not regulated.

Some women will see an improvement in symptoms within a few weeks. Symptoms like vaginal dryness or urinary issues usually take about three months to a year to resolve. If you don’t see an improvement, go back to your doctor. They can do a blood test to check how well your body is absorbing HRT before altering your dose. My free app Balance (balance-app. com) is an easy way to track your symptoms to show your doctor.

BOOST SEX DRIVE

The menopause doesn’t need to spell the end of your sex life, but it’s common to have reduced libido. Half of the women I see in my clinic haven’t had sex with their partner for at least a year, so if you’re feeling like this, don’t worry. Low libido is mainly due to falling testosterone levels. On top of this, low oestrogen can cause painful sex and weight gain, making the idea of sex less appealing. HRT is your first port of call to help restore your libido. If, after three months, things aren’t helping, you might benefit from taking testosterone (usually a specialist will prescribe this). Try a water-based lubricant and don’t put yourself under pressure. Cuddling or kissing is a good way to reconnect.

FIND RELIEF FROM DRYNESS

Oestrogen is nature’s lubricant, so falling levels in menopause thins the tissues in the vagina, leaving it dry, itchy and inflamed. Vaginal dryness can be one of the most painful symptoms, yet the least talked about. It makes sex painful and going to the toilet difficult. Vaginal dryness can persist, so you must take a long-term approach to keep symptoms at bay. HRT will correct the hormone imbalance and ease symptoms, usually within three months. Another option is topical oestrogen applied directly to the vagina, as well as a vaginal moisturiser. Steer clear of perfumed products like scented shower gels as these can cause further irritation.

BEAT THE HEAT

Hot flushes are the most common symptom, and night

sweats make it impossible to get a good sleep. HRT corrects the hormone deficiency and should help to ease hot flushes within weeks, but there are other simple measures to try. Wear thinner layers of cotton clothing to keep you cool – cotton pyjamas will help at night. A warm shower or bath before bed can actually help cool down your body and regulate temperature.

Try to keep your environment well-ventilated by opening windows and using a desk fan. Alcohol, caffeine and spicy foods can exacerbate hot flushes, particularly before bed – and if you smoke, now is the time to quit as studies show smokers have more severe flushes.

BE OPEN ABOUT YOUR NEEDS

Make conversations clear and constructive. Many GPs haven’t had the menopause training to recognise the range of symptoms. Get to know the symptoms and treatments so you can be fully involved in decisions about your care. Ask to see a GP or nurse who has had menopause training. Don’t be afraid to push for a second opinion, either at your practice or by requesting a referral to a specialist menopause clinic. At work, speak to your line manager about adjustments you might need; would a later start time help with fatigue? Could a colleague pick up part of a project that is proving difficult because of brain fog? At home, talk to your loved ones about how they can support you (the Balance app has lots of easy-to-read articles breaking down symptoms and treatments).

KEEP BONES STRONG

Exercise releases endorphins and can help with low mood and maintaining a healthy weight, but one of the most crucial benefits is that it helps to protect our bones. Women are more at risk of developing osteoporosis, where bones lose strength and break more easily, in later life. You need to combine weight-bearing exercise (jogging, dancing or tennis) with muscle strengthening exercise (yoga, Pilates or weights). Don’t feel like you must rush out and join the gym. Even a gentle walk around the park is a start.

EAT THE MED WAY

There are many reasons why we become prone to weight gain. When oestrogen levels fall during menopause, our body tries to build up a reserve found in fat cells. You might also be fatigued, less likely to exercise and find yourself comfort eating because you’re tired. An occasional treat is fine, but avoid highly processed, fatty, sugary foods. A Mediterranean diet with fresh fruit and veg, lean meat and “good” fats like olive oil and avocados is a great basis. A lot of women tell me they drink more to try to “numb” their symptoms and help them sleep, but alcohol is just empty calories and can disrupt your sleep cycle so reduce your intake. Unlike HRT, most natural remedies for menopause haven’t been thoroughly tested so you have to be careful. There’s a bit of evidence to suggest folic acid can help with symptoms and some women find sage and evening primrose oil helpful.