Menopause: having the time of our lives
MENOPAUSE SYMPTOMS usually affect women between age 45 and 55 and many seek help through hormone replacement therapy. To find out if HRT is suitable for you personally, you will need to visit your GP or a menopause expert. Here are some frequently asked questions.
MUST I STOP MY HRT? I HAVE TAKEN IT FOR FIVE YEARS There is absolutely no reason for this arbitrary time limit. Every patient is an individual — and the risks and benefits of continuing should be discussed at an annual review. The final decision is that of the patient.
WILL HRT REDUCE MY RISK OF ACHES, PAINS AND OSTEOPOROSIS?
One in three women, as opposed to one in five men, will suffer from osteoporosis. This increases the risks of fractures of the hip, spine and wrist. The optimal treatment for menopausal women is HRT, although there are non-hormonal bone treatments available.
WILL HRT GIVE ME CANCER? Sadly women have a one in seven lifetime risk of breast cancer, whether on hormones or not. HRT is generally given as oestrogen only for women without a uterus and recent evidence has shown no increased risk of breast cancer. Women with a uterus need oestrogen and a form of progesterone, which, after seven years of use, slightly increases the risk of breast cancer. The potential benefits to the heart, brain and bones, as well as increasing energy, libido and helping sleep, outweigh this small increased risk and there is statistical evidence that women on HRT live longer than women not taking it.
HOW CAN I TREAT HOT FLUSHES WITHOUT HRT? Other drugs, such as certain antidepressants, can treat flushes, as can a blood pressure medication, Clonidine, as well as behavioural therapy (CBT).
SEX IS UNCOMFORTABLE, CAN ANYTHING BE DONE?
Due to the lack of oestrogen, the vagina becomes less lubricated, often less elastic and the tissues become thinner.
This often causes pain and bleeding and, if appropriate, can be treated with generalised HRT, or hormone creams, a plastic hormone-impregnated ring or a vaginal tablet, allowing a continuing sex life and reducing the frequency of urine infections and perhaps risk of prolapse. Libido tends to improve when sex is pain-free. Testosterone may also help libido.
Richard Sheridan is a consultant gynaecologist and British Menopause Society accredited menopause specialist, practising at Spire Bushey Hospital, call 020 8901 5505