It is amazing to see the menopause finally being widely and openly discussed. Recognition that the menopause is not some ‘old lady with white hair’. It is everyday women in their 40s and 50s, working women, mothers, daughters.
The impact of the menopause affects women, families, men, and workplaces. Here in Ireland Joe Duffy gave great airtime to the subject and had the excellent Dr. Deirdre Lundy as a guest to bust many myths for Irish women about the menopause.
At McCauley Pharmacy we want to continue this important conversation to 1. educate all women about their health and 2. provide support to women who may have concerns or unanswered questions. So let’s get started…
So what is the menopause?
The menopause is your last menstrual period. However, most women think of the menopause as the time of life leading up to, and after, their last period. In reality, your periods don’t just stop. First they tend to become less frequent. It can take several years for a woman to go through the menopause completely. Women are said to have gone through the menopause (be postmenopausal) when they have not had a period at all for one year.
A natural menopause occurs because as you age your ovaries stop producing eggs and make less Oestrogen (the main female hormone). The average age of the menopause in Ireland is 52. Your menopause is said to be early if it occurs before the age of 45. 1% of women reach menopause before the age of 40.
While doctors can test your FSH (Follicle Stimulating Hormone) levels in your blood for a diagnosis, there is no definitive test to diagnose menopause. Very often your intuition and symptoms will tell you that menopause is on the way.
The term “Perimenopause” is less well known and even less well understood. The perimenopause can be a stage of changing periods and early menopausal symptoms, changes which can often vary from month to month causing confusion and unpredictable inconveniences. You may start to experience mild flushes or mood swings alongside irregular periods. Women often put up with this inconvenience for some time before seeking help. But very effective treatments are available, and I would really encourage women to seek help sooner rather than later. It is important that these early changes are recognised and that discussions take place so that women understand what is happening.
Management of the Oestrogen deficiency symptoms of the perimenopause should start with review of diet and lifestyle. The early changes should alert us to put in place whatever changes are needed for our bodies such as improving diet, losing weight, increasing exercise, stopping smoking, and reducing alcohol and caffeine. Lifestyle changes will help to reduce not only early symptoms but also long term effects of Oestrogen deficiency such as osteoporosis and cardiovascular disease
Doctors in the field estimate that about 80pc of us will experience some or all of these symptoms. More than half of women have symptoms for more than seven years. Symptoms include:
The wonderful women Davina interviewed showed us the menopause can be an emotional rollercoaster, with emotions from recurrent anxiety or mild depression to flashes of anger and impatience. These swings are often compounded by the disturbed sleep patterns that accompany night sweats. Other symptoms such as mood swings, irritability, anxiety, difficulty coping, forgetfulness and difficulty concentrating may be related to hormonal changes, either directly or indirectly, for example due to sleep disturbance. If the symptoms of menopause are impacting your lifestyle, please speak to your pharmacist or GP. Thankfully there are lots of solutions available to support women during this period.
Due to the falling Oestrogen levels which keep the vaginal walls elastic and lubricated, dryness and discomfort especially during sex is an issue for many women during these years. In pharmacy there are lots of vaginal lubricants available including the range Replens.
On prescription from your GP or Doctor there are vaginal creams and pessaries that also work very well for dryness. Again your pharmacist can give you more information on available products. A full list of our Menopause support products can be found here.
Occur in about 3 in 4 women. A typical hot flush (or flash) lasts a few minutes and causes flushing of your face, neck, and chest. You may also sweat (perspire) during a hot flush. Some women become giddy, weak, or feel sick during a hot flush. Some women also develop a ‘thumping heart’ sensation (palpitations) and feelings of anxiety during the episode. The number of hot flushes can vary from every now and then, to fifteen or more a day. Hot flushes tend to start just before the menopause and can persist for several years. Menoforce Sage tablets are a natural product some women find very beneficial for not flushes and night sweats. They also have another general product with soy isoflavones Menoforce too.
A great hack we give our patients is to keep a facial mist handy, they’re not only great to get you through a hot flush but they also keep your skin hydrated and make you feel refreshed. There are many Facial Thermal Mists available but our top seller is the iconic La Roche-Posay Thermal Spa Water, that fits perfectly in your handbag.
Sweats commonly occur when you are in bed at night. In some cases they are so severe that sleep is disturbed, and you need to change your bedding and nightclothes.
If you are suffering with Night sweats that are disturbing your sleep you can talk confidentially to your local McCauley Pharmacist, call our Free Pharmacy Helpline or talk to your GP. They can advise you on any supplements, etc., that may help.
Changes to your periods.
The time between periods may shorten in some women around the menopause; in others, periods may become further apart, perhaps many months apart. It can also be common for your periods to become a little heavier around the time of the menopause; sometimes periods can become very heavy. Again it is important to discuss this with your Doctor as there are solutions available on prescription for very heavy periods.
Skin, hair and weight gain.
You tend to lose some skin protein (collagen) after the menopause. This can make your skin drier, thinner, and more likely to itch. You can also get change in weight and distribution of fat; more fat tends to be deposited around the waist rather than the hips leading to a change to the “apple” shape rather than “pear” shape.
If you have any supplement or skincare concerns you can talk to one of our pharmacists or skin experts in your local McCauley Pharmacy or call our Free Pharmacy Helpline
Risk of Osteoporosis
After menopause, women should be on high alert for osteoporosis, the loss of bone density and weakened bones. It is known as the silent disease – it comes upon us without warning symptoms and is exacerbated by the drop in oestrogen levels after menopause. Ensuring regular weight-bearing exercise and a diet rich in calcium will protect your bones. Taking a Calcium and Vitamin D supplement can also help. Your pharmacist can advise you on the best product for you. HRT can help to prevent bone loss and reduce the risk of fracture and is particularly useful for prevention of osteoporosis in women who have had an early menopause and for those women with menopausal symptoms.
Your risk of disease of the heart and blood vessels (cardiovascular disease), including heart disease and stroke, increases after the menopause. Again, this is because the protective effect of oestrogen is lost.
It is always important to remember that we should always be keeping the body nourished and looking after our health. We recommend taking a multi supplement in all stages of life. One of the most popular and effective multi supplements available is Irish brand Revive Active, they also offer a Beauty Complex supplement packed with essential vits, mins and Collagen!
Although women become less fertile as they get older, it is still possible to get pregnant around the time of the menopause. So, if you are sexually active and don’t want to become pregnant, you will need to consider contraception:
Until a year after your last period if you are 50 or over.
Until two years after your last period if you are under 50.
Depending on age you may be prescribed HRT and a contraceptive together.
HRT ( Hormone Replacement Therapy)
Without treatment, the symptoms discussed above last for several years in most women. HRT is a very effective treatment for the symptoms of the menopause. It has benefits and risks and has been previously surrounded in controversy.
Seeing Davina show her HRT patch for me was a real taboo breaker for women.
HRT has been ‘linked to Breast cancer’ and that makes the decision to accept treatment more difficult for some women. The relationship between HRT and breast cancer is complex and further complicated by misinformation, perception, and overgeneralization of data.
Women need to be able to have open conversations with their Doctors about the risks and benefits and their treatment options.
HRT can treat the symptoms of menopause and protect against cardiovascular disease and osteoporosis for women under 60 with a slight increased risk of breast cancer. Also HRT tablets are associated with an increase in blood clots.
Each woman is individual, and treatment should be tailored with the women’s needs. Individual baseline risk should be considered.
Risks are related to treatment duration and they reduce after stopping HRT treatment.
Other risk factors, e.g. obesity, alcohol, smoking should be considered when making treatment decisions.
Risks must be weighed up against the enormous benefit that HRT use can give to women with regard to improved quality of life as well as protection against osteoporosis and heart disease.
For the treatment of menopausal symptoms the benefits of short-term HRT outweigh the risks in the majority of women, especially in those aged under 60 years.
The choice of HRT for an individual depends on an overall balance of indication, risk, and convenience. A woman with a uterus normally requires oestrogen with cyclical progestogen for the last 12 to 14 days of the cycle or a preparation which involves continuous administration of an oestrogen and a progestogen (or one which provides both oestrogenic and progestogenic activity in a single preparation).
Going through the Menopause and even in the years leading up to the menopause can be quite daunting and lonely but you are not alone and it is a life stage that your fellow sisters, friends, colleagues, neighbours, etc will all go through.
The taboo about speaking openly on this subject has lifted and information and shared stories are widely available.
And at McCauley Pharmacy, as always, we are available to offer you care and support in a private and confidential space if you are looking for more advice.
McCauley Pharmacy Recommended Products:
Vitamins and Minerals:
There are many skincare brands with products we highly recommend depending on your skin complaint during this time.
The Neovadiol range from Vichy is a top seller.
Our best advice is to pop into your local Pharmacy for a free skin consultation with a skin experts.
This is a pre-test you can use before visiting your GP if you think you are showing signs/ changes in your body that may be associated with the menopause.
As for increasing vaginal lubrication and reducing urinary incontinence, you can begin training your pelvic floor muscles before menopause or perimenopause even begin. A stronger pelvic floor contributes to better bladder control and vaginal elasticity – what’s more, regular sexual activity can also help to keep the vaginal walls thick and moist.
For a cheaper option we recommend trying Lovehoney Embrace Silicone Kegal Balls.
While many of us may not associated the menopause with our sexual wellbeing being in the same category it is and is a big part of our intimate health.
Research has shown having a healthy sex life can increase self-confidence and give you a deeper knowledge about your intimate health and as the menopause may feel like an intimating time it is also a time to start exploring our bodies again. For more information on the benefits of sex products and sexual wellbeing and products that we recommend visit our blog HERE.