BACK TO BALANCE
Working out how to manage (peri) menopausal symptoms can be complicated. Our expert-informed menopause meds guide will help make the process a little simpler
How do I talk to my doctor about HRT?
Dr Newson has created resources for patients frustrated by a lack of effective menopause treatments available – and for NHS GPS too busy to comb through medical journals for the latest science. She recommends bringing her prescribing guide to your GP appointment, and using the symptom tracker to clearly demonstrate a pattern of perimenopausal symptoms – both resources are available at menopausedoctor.co.uk.
Is there a class of hormones that’s best? Body-identical hormones are safe, regulated forms of oestrogen, progesterone and testosterone that are naturally derived (as opposed to synthetically, as with hormonal contraception) and regarded by Dr Newson as the gold standard in terms of maximal efficacy and safety, with minimal side effects. They’re derived from yams (a starchy root vegetable) and have the exact same molecular structure as the hormones in your body.
What about ‘bioidentical’ hormones? These are hormones that have been compounded – or tailored – to your unique profile, as determined by a saliva test. While that sounds good, they’re not regulated, haven’t been subject to randomised control trials and don’t get the green light for efficacy or safety from the British Menopause Society or the NHS.
Will I need to have oestrogen in a gel?
Not necessarily. While it’s usually given as a gel or a patch, to be absorbed through the skin into the bloodstream, it can also be taken via a spray or tablet. Dr Newson warns patients that taking oestrogen as a tablet incurs a small increased risk of blood clots. All forms are available via prescription on the NHS.
And I need some progesterone, right?
Yes, unless you’ve had a hysterectomy, it’s essential to take a type of progesterone to protect the lining of your womb. That’s because taking oestrogen can increase the thickness of the womb lining and increase the chance the cells might become cancerous. Dr Newson recommends women take micronised progesterone, a bodyidentical hormone, as an oral capsule, or have it delivered via a Mirena coil, which doubles up as contraception. There are also other types of synthetic progestogens available, which can be given if a patient is experiencing side effects.
What’s the deal with testosterone?
Women produce more testosterone than oestrogen and it’s an important hormone to improve mood, energy, concentration and libido. Yet, it’s not licensed for women in the UK. It’s available privately, but only for some women via the NHS – ask your doctor for more information.