Your HEALTH
Got a medical problem or need health advice? Ask GP Dr Philippa Kaye
Q I would like to avoid HRT, but I’m really struggling with hot flushes in particular. If I go to my GP, is HRT the only option I will be given?
ANo, a number of non-hormonal treatments are available for menopause-related symptoms. Doctors often use medications for conditions that the medications were not originally designed for.
For example, selective serotonin reuptake inhibitors (SSRIs) are traditionally used for depression and anxiety, however they also seem to work for 20-50% of women with flushes, whether or not they also have depression or anxiety, so can be used to treat these symptoms. Other options can include anti-seizure medications, which again, even though you don’t have epilepsy, can be useful. Some people report benefit from using herbal remedies, but there’s not a lot of evidence that they’re effective. If you do use herbal treatments, then please check with your pharmacist that they are not likely to interact with any other medication that you are on.
Lots of my patients are wary of taking HRT, often due to things they have read, for example about the risk of breast cancer. However, these risks are small and, for many women, the benefits of HRT will outweigh the risks.
There is also some misinformation about HRT, for example having a family history of breast cancer generally is not a contraindication to you having it, and you can still take it if you have migraines with aura (unlike the combined oral contraceptive pill). See your GP, as there are both hormonal and non-hormonal options available.
Q How much fibre should I be aiming to eat a day, and how do I get it?
AWe should be aiming to eat 30 grams of fibre per day, and research shows that in the UK, women tend to consume on average 17.2g and men 20.1g, so we are a bit of a way off! There are lots of health benefits to eating enough fibre. Firstly, it helps move things along your gut, so will prevent and treat constipation. Eating the recommended amount of fibre is associated with a lower risk of type 2 diabetes, heart disease and stroke, and also decreases your risk of developing bowel cancer. Added to this, eating fibre-rich foods helps us feel full. Our intestines are full of bacteria, called the gut microbiome, and eating lots of fibre-containing foods helps the good bacteria to thrive, which improves your health.
Up the amount of fruit and vegetables, wholegrains, nuts and seeds you eat, and try to include fibre sources within each meal. Two Weetabix gives 3.8g fibre, Shredded Wheat with milk 6g, a carrot 3g, and an apple about 4.5g. Changing white pasta for brown can deliver almost 7g of fibre per portion. It can take a little time for your gut to get used to a fibre-rich diet. If you start too quickly, you may notice some bloating and gas, so gradually increase the amount of fibre you eat.
Q My husband has received a letter inviting him for a AAA scan but, apparently, even though I’m older than him, I’m not eligible. Why is this and do I need to do something?
AThe AAA stands for abdominal aortic aneurysm, which is when there’s a swelling in the aorta, which is the main blood vessel that runs down the middle of your tummy from the heart to supply the body.
This is potentially extremely serious as it may not present with symptoms for years while gradually increasing in size.
Eventually, if the aneurysm gets big enough, it can rupture, which has an extremely high mortality rate. Because of this, men are offered screening with an ultrasound scan the year they turn 65. Screening is not offered to women or men younger than 65, as AAAs are less common in those groups, so you don’t need to do anything.
In most people the result will be normal. If there is a small aneurysm it can be monitored annually to see if it grows, while if there is a large aneurysm you’ll be offered surgical repair. Aortic aneurysm repair is a big operation, but the risks involved are smaller than the risks of an emergency aneurysm repair. Do encourage your husband to attend!