Why every woman should be screened for menopause at FORTY
IMAGINE if, at 12 years old, girls were invited to their doctors for a health check-up to discuss the changes they might experience in the coming years, and during that chat their GP failed to mention periods.
There would rightly be a national outcry. How could the medical establishment fail to educate young girls about something so fundamental?
And yet exactly that is happening to midlife women. Once they reach 40, they are invited by the NHS for an over-40 health check, an appointment created to encourage midlifers to think about lifestyle and future health — but perimenopause and menopause don’t get a mention.
This beggars belief when you consider that for 52 per cent of the population, the menopause transition is the one certainty in terms of future health challenges.
Over the past few years, while writing my book, Cracking The menopause, and campaigning for menopause support for women, i’ve been shocked by many things. But the shortsightedness of the over-40 health check is at the top.
That’s why yesterday, menopause mandate launched our new campaign, mm40+, at the Houses of Parliament, asking that it is automatically included in the over-40 check.
Established in 2009, the NHS Health Check is offered to all eligible adults between 40 and 74 every five years.
Usually taking 20-30 minutes, it’s conducted by a healthcare professional and looks at lifestyle risk factors — such as diet, physical activity, smoking and alcohol — and physical risk factors including high blood pressure, blood sugar, weight and cholesterol, which can contribute to cardiovascular disease, dementia and some cancers, among other things.
I attend any health check offered. There is heart disease in my family and tracking my blood pressure makes sense. But perimenopause meant i had two years of insomnia and anxiety, which made me utterly miserable, until, after a series of doctor’s appointments, it was finally diagnosed. That’s also when i discovered that i had osteopenia — the precursor to osteoporosis.
Over the next few years i was able to reverse it with a combination of lifestyle and HrT. But how much easier it would have been to have learned this might happen beforehand.
THIS is where the mm40+ plan comes in. There are around two and a half million women aged 40-45 in england and wales — that’s a huge potential reach.
We suggest giving healthcare practitioners a fact sheet on the basics, available as a download, which we’ve devised with the menopause experts and NHS GPs at my menopause Centre.
Another free-to- download leaflet will be available for women attending the health check. we’ve also produced two free videos, one for patients and one for healthcare professionals.
Most women will experience at least one of the expanding list of symptoms — anxiety, sleep issues, depression and brain fog, to name a few — that are frequently among the first indicators. women often question whether they have early-onset alzheimer’s.
There’s also fatigue, joint and muscle pain, period changes, palpitations, skin changes, problems with teeth, dry eyes and mouth. The list goes on . . .
Many of these can occur for other reasons of course, and we specify this, but healthcare professionals must also keep menopause in mind.
The fact sheets also include information about the fact that, without oestrogen, our risk of osteoporosis rises and our heart disease risk becomes the same as men.
Excess weight, too, can mean more severe hot flushes, and palpitations can be down to menopause.
If women are armed with the facts, they may wish to see a GP to discuss treatments, and i’d remind them that guidelines from the National institute for Health and Care excellence (NICE) recommend HRT as a first-line treatment for menopause symptoms.
There are plans afoot for a digital health check, which were announced by the Department of Health and Social Care last year. Hopefully, this will be implemented shortly, as our menopause information would sit solidly within that.
and to anyone who claims not to see the benefits of systemic change in the way the NHS treats menopause, then let me point out that such a move could save the health service millions.
WITH small changes in midlife, women are less likely to suffer chronic conditions later. if more women used HRT to maintain bone density, prevent heart disease and improve low mood, as well as stopping smoking, cutting down alcohol, keeping an eye on diet and doing weight- bearing exercise, it could save money later with GP visits, hospital investigations, surgery and at-home care.
The menopause doesn’t have to be difficult. There are huge positives to this time of life; women can become more driven and, according to studies (plus personal observation), we are frequently happier and more confident.
It’s just that many of us might need a nudge and a dollop of education to help us through the turbulent times. it doesn’t seem too much to ask that our doctors provide this.