Dr Paula Briggs
Chair, British Menopause Society
Women should expect to live a third of their lives after menopause, which is a natural life stage. Declining levels of oestrogen following menopause can also be associated with symptoms; and for some women, these symptoms are extreme.
In reproductive life, the ovaries release eggs, capable of developing into a pregnancy, if fertilisation occurs. The ovaries also produce the hormones oestrogen and progesterone.
The levels of oestrogen in perimenopause — a time of transition from reproductive to post-reproductive life — are variable, and this can result in problematic symptoms including abnormal bleeding, headache and breast tenderness.
Menopause symptoms and HRT treatment
Women must be given balanced information about all possible treatment options to manage common symptoms of menopause, including hot flushes and night sweats.
If eligible and willing, hormone replacement therapy (HRT) is the most effective treatment for symptoms. Current NICE guidance recommends this form of treatment for the shortest time in the lowest effective dose. Some women choose to continue treatment for longer, but they should not feel pressured into using HRT.
For all women, the role of having a healthy
lifestyle cannot be underestimated.
Alternative menopause treatment options
The majority of women can use vaginal oestrogen treatments to manage the effect of low levels of oestrogen on tissue quality. This common problem is often referred to as genitourinary syndrome of menopause, and this is an area where long-term treatment is recommended to maintain tissue quality in the vulva, vagina, bladder and urethra.
For women in whom HRT is contraindicated (eg. women with a history of hormone receptor-positive breast cancer), other options include some antidepressants — usually in a low dose — for the beneficial effect that these drugs confer on hot flushes, night sweats, sleep pattern and mood. Newer drugs are coming to market very soon, which will reduce hot flushes.
Lifestyle changes to aid menopause management
For all women, the role of having a healthy lifestyle cannot be underestimated. Important interventions include BP and BMI measurements, as well as blood tests to check a lipid profile. Vitamin D supplements, diet and exercise play an important role in midlife health. A midlife MOT and individualised care are just as important as being able to access HRT.
To access reliable information that can help them, women can refer to trusted resources such as Women’s Health Concern (WHC), the patient-facing arm of the British Menopause Society. WHC recently launched a menopause wellness hub with a focus on lifestyle interventions to optimise midlife health.
