DON’T LET THE MENOPAUSE PUT YOUR LOVE LIFE ON HOLD

SOME women sail through the menopause. however, many others experience symptoms that can last up to a decade.

These can be crippling for women in the workplace. Night sweats and low libido, in particular, can also affect relationships. Up to 48 per cent of women aged 40 to 80 lose interest in sex, and 41 per cent have difficulty with orgasm, the Global study of sexual Attitudes and Behaviors found.

‘Women deserve to have a good sex life into their 50s and 60s and the menopause is too early to give up on it,’ says Dr Pixie McKenna, a GP and regular contributor to Channel 4’s Embarrassing Bodies.

‘Most accept the myth that sex is less important after the menopause and are put off by vaginal dryness, pain, loss of libido and the increased risk of cystitis.’

so what can you do about it?

HOT FLUSHES

THE menopausal symptoms for which women most often seek treatment are hot flushes and night sweats.

‘ Normally, body temperature is tightly regulated by hormones and is kept within a specific range. oestro- gen is one of the hormones involved,’ says haitham hamoda, a consultant gynaecologist and clinical lead for menopause services at King’s College hospital in london.

A recent U.s. study, involving 749 women aged 45 to 60, suggests losing weight can help. It found the obese suffered more from hot flushes.

‘HRT can eliminate hot flushes,’ says Mr hamoda, a member of the Council of the British Menopause society. ‘But it’s not suitable for all.’

he suggests the lowest risk combination is transdermal estradiol (oestrogen cream), which doesn’t seem to increase the risk of stroke or blood clots, and micronised natural progesterone (the hormone derived from plants, taken in tablet form).

There are also ‘ bioidentical’

forms of HRT (see above) and drugs specifically for hot flushes, such as gabapentin.

Meanwhile, researchers at Imperial College london have developed the drug MlE4901, which has been tested on women suffering more than seven severe hot flushes a day and which was found to reduce them by up to 73 per cent.

It targets brain receptors, blocking the chemical neurokinin B.

The pill is not oestrogen-based so won’t have the side-effects associated with that, according to lead researcher Professor Waljit Dhillo.

WHEN SEX HURTS

‘WHEN oestrogen levels start to drop, vaginal tissue becomes thinner, drier and less elastic,’ says Con Kelleher, a

consultant obstetrician and gynaecologist based at Guy’s and St Thomas’ Hospitals in london.

The lack of lubrication can make sex painful and vaginal tissue can become damaged during intercourse, making it prone to infection.

‘Cystitis is more common in women after the menopause. This can often make sex uncomfortable or even impossible,’ says Dr McKenna.

As well as standard HRT, another option is oestrogen creams or tablets inserted into the vagina to provide ‘local relief’.

Drugs known as selective oestrogen receptor modulators (SERMs) can also counter painful intercourse by amplifying or inhibiting the body’s own oestrogen.

Some studies have shown that plant- based therapies can provide ‘modest reductions’ in dryness.

An analysis of more than 60 studies found that plant oestrogens such as soya and soya extracts, as well as herbal remedies including black cohosh and red clover, can reduce dryness.

Fennel is also a safe and effective treatment, according to a study published by the North American Menopause Society in May. A test group of 79 women aged 45 to 60 took capsules containing 100mg of fennel twice daily for eight weeks.

‘Silicon-based lubricants can help reduce friction during intercourse and counter the effects of vaginal dryness and narrowing,’ says Dr McKenna. These can be bought in pharmacies and online.