10 questions about the menopause – a doctor answers
Do you live in Liverpool? After what I’ve just learnt, I have only one thing to say – you jammy buggers*! Why? Well, after speaking out about Gwyneth Paltrow and menopausal role models, I was lucky enough to be put in touch with Dr Tracey Sims at the Intimate You clinic in Liverpool and all I can say is: Why don’t I live there anymore?
This sounds a fantastic clinic. It offers both medical and aesthetic procedures to help women as their body changes through life, both menopausal changes and also through giving birth. It’s the first (and only) one of its kind in the UK, which is both heartening and sad. Every town and city should have this type of clinic. (Warning to my family in Birkenhead, I’m coming to visit next year… No ulterior motive. Honest.)
Menopause expert Dr Tracey (above right, with her colleage Anna Bojakowska), who has more than 15 years’ experience and, answers some of your questions.
1. What are the common menopausal symptoms that women can easily miss or mistake for something else?
“Feeling low in mood and/or anxious and having difficulty sleeping (Am I depressed?); forgetfulness and difficulty making decisions can also be problematic (Am I developing dementia?), and skin can also become dry and the vagina poorly lubricated with vulval itch (Have I developed eczema or another skin condition?)”
(Interestingly, three years ago I went to the doctor after suddenly developing eczema around my nose and on my hairline – one of the reasons I think my hairline started receding. It came and went quite quickly and now I’m wondering if it was menopausal-linked.)
2. And what are the atypical menopausal symptoms?
“Increased tension in muscles, breast tenderness, increase or decrease in headaches, indigestion, flatulence, nausea, dizziness, episodes of loss of balance, ringing in the ears (tinnitus), fingernail changes (softer, crack or break easier), burning feeling of mouth and tongue, bad taste in mouth, change in breath and/or body odour.”
(Now a lot of these rang bells. Feeling dizzy, tinnitus, fingernails, headaches – they’ve all been complaints over the last couple of years. Mr 50Sense may also have something to say about increased flatulence…)
3. Are healthcare providers alert for these?
“The majority of healthcare workers that usually deal with female patients are alert to the main symptoms of the menopause e.g. hot flushes, change in periods.
“However, it can sometimes be tricky to piece the picture together when a younger woman presents with symptoms of the menopause or a woman who has had a hysterectomy with the ovaries left behind because in her case there is obviously no menstrual cycle to look at for clues.”
4. What are the biggest mistakes healthcare providers make when dealing with menopausal women?
“To rely on blood tests too heavily to diagnose or exclude the menopause. It’s not just about the values of LH (luteinising hormone)/FSH (follicle stimulating hormone) on a piece of paper. That can be informative in some cases but a woman’s symptoms that she is experiencing are much more important.”
(If you haven’t read Rachel’s comments at the end of 5 Things We Learnt from the Truth About Menopause I highly recommend it. She had terrible trouble getting her doctor to look away from her blood tests to accepting she was menopausal.)
5. How can we help our doctors?
“Keeping a diary of menstrual cycle and symptoms can be really useful and provide doctors with important clues.”
6. What are the biggest misconceptions about living through the menopause? How can we fight them?
“That the menopause is a one-off event and that starts when periods stop then quickly goes away. Nope, it can span ten years leading up to and beyond the cessation of menstruation.
“The symptoms are produced by varying oestrogen levels as the ovaries gradually stop working in a rather erratic fashion, not by a total lack of oestrogen. Those who have no ovarian function at all (eg a woman aged 75) and very little oestrogen at a level that is stable do not get menopausal symptoms.
“There is also a misconception that women can just ‘get on with it’. Women have complex, demanding multifaceted lives and every woman’s experience of her menopause is different. Some may have debilitating symptoms that affect work life, home life and intimate relationships. Women may wish to continue sexual activity through and way beyond the menopause so vaginal dryness and pain during intercourse can be a real problem.
“It’s important that health care providers offer an environment where women feel comfortable coming forward to discuss their difficulties so they can potential access treatments to help them.”
7. Can you exercise your way out of menopausal symptom?
“Some research studies have shown that exercise can reduce the frequency of hot flushes and can improve symptoms such as low mood, anxiety and difficulty sleeping. It can help to maintain muscle mass and ward off abdominal fat gain.
“Weight bearing exercise also helps to maintain bone density so reducing the chances of osteoporosis.
8. Any advice on overcoming weight gain?
“Keep active and go easy on the carbs, drink at least two litres of water per day and incorporate ten portions of fruit and vegetables into the diet each and every day, focusing more on the veg than the fruit!”
9. Do natural remedies work?
“Every woman’s experience varies. However, at the moment NHS practitioners advise that complementary and alternative treatments such as herbal remedies and bio-identical hormones aren’t routinely recommended because it’s generally unclear how safe and effective they are.
“Some remedies can also interact with other medications (sometimes in unpredictable ways because thorough research has not been done) and cause side effects.”
10. What advice do you have for readers who are menopausal?
“Talk about how you feel, pop in to see your GP and don’t be shy to describe exactly what you’re experiencing. If one management strategy doesn’t work for you, go back and explore other options.
“Consider joining social media groups for women experiencing menopause and share ideas. You are not alone; you matter. Be hungry for information and with knowledge comes strength to manage what your body is going through.
“Actively seek solutions for your particular symptoms e.g. HRT frequently doesn’t work that well for vulvo-vaginal symptoms, locally applied oestrogen creams or pessaries can be more effective and if that doesn’t do the trick go back and look at other options!”
Does any of this sound familiar? Let me know in the comments below… If you’ve enjoyed this, please like and subscribe below and share with your friends.
With many thanks to Dr Tracey and Intimate You for giving up your time to chat. If you want to know more about the clinic, click here.
*Disclaimer: Geordie term of affection