Women’s Health

Menopause is a time in a woman’s life when her menstrual periods stop.   The menopause is when you have gone 12 months without a menstrual period.    It is a natural event that occurs when your ovaries stop producing reproductive hormones and it marks the end of a woman’s reproductive years. 

The average age of the menopause in the UK is 51 years of age

This is the time leading up to the menopause.  This usually starts in your 40s and can last for months or years.   Many women begin to experience irregular periods, hot flushes and mood changes. 

Each woman’s menopause experience is different, and some women experience minimal physical symptoms apart from cessation of menstrual periods.  Other women may experience significant symptoms which may include: hot flushes, night sweats, mood changes, memory changes, poor sleep and vaginal dryness.

Your GP may suggest a blood test if you are under the age of 45 years of age to check your hormone levels and exclude other causes for your symptoms.

If you are over the age of 45 years and are experiencing typical menopausal symptoms, then a blood test is usually not needed. 

Yes, regular exercise can improve sleep and hot flushes.

Giving up smoking and cutting down on caffeine and alcohol can help to reduce hot flushes.

Eating a healthy diet can prevent weight gain and help to keep the bones healthy.

Potentially yes.   If you are over 50 years of age, then it is recommended that you use contraception for a year after your last menstrual period. 

If you are under the age of 50 then it is recommended that you use contraception for 2 years after your last menstrual period.

The main treatment for menopausal symptoms is hormone replacement therapy which helps replace the hormones that are at low levels.

HRT usually involves giving oestrogen (often as a patch, gel or spray).  If you have a womb, you will also need another hormone called progesterone which helps to keep the lining of the womb thin and healthy.  This normally comes as a tablet or a mirena coil.

HRT can be very effective at improving menopausal symptoms.  Hot flushes often improve after a few weeks.  Other symptoms like mood changes and vaginal dryness can take several months to improve.

HRT can help to reduce your risk of osteoporosis and heart disease

For most women the benefits of HRT far outweigh any small risks. 

HRT can slightly increase the risk of breast cancer (approx. 5 extra cases of breast cancer for every 1000 women who take combined HRT for 5 years).

There is no increased risk of breast cancer in women who take oestrogen only HRT (this can be taken in women who have had a hysterectomy)

There is no increased risk of breast cancer in women who take HRT and are under the age of 51 years.

HRT patches, gels and sprays do not increase the risk of blood clots.

Many women have low testosterone levels around the time of the menopause.

Your doctor may suggest a blood test to check your levels if you have typical symptoms of low testosterone such as low libido.   Some women benefit from testosterone replacement which is usually given as a gel or cream. 

There is no fixed limit on how long you should take HRT for.  Some women take it for 2-5 years and then come off it.  Other women remain on it longer term as they feel better and want to protect their future health from conditions such as osteoporosis and heart disease.  We would recommend a yearly review to discuss your symptoms and current HRT regime. 

For some women HRT is often not recommended first line (i.e. Women who have had breast cancer).  There are other treatments available that can help with menopausal symptoms.  These include:

Antidepressants (SSRIs, SNRIs), gabapentin and clonidine.