Dr Harry On Managing Menopause
Part 1 of our menopause series
- Written by Dr. Harrison Weisinger MBBS, Ph.D.
When my content editor messaged me to say she needed an article about menopause and the management of menopausal symptoms (due to popular demand), I was eager to deliver for our female customers, despite the obvious fact that I'm a male.
For starters, while I can relate to experiencing some unpleasant physical changes over my lifetime, I’m not so insensitive as to compare hair loss to hot flushes. Typically, I have found in practice that female patients tend to select female doctors for their female issues (and the same applies for male issues), but all GPs are well studied in the area, as every single woman will experience the menopause.
In this article, I will give an overview of the biological changes associated with the menopause and describe some of the therapeutic and complementary treatments that are available.
What is Menopause?
Normal menopause is defined as the permanent cessation (i.e. after 1 year) of menstrual periods, without any other obvious pathological or physiological cause. This typically occurs in the 52nd year of life and corresponds to complete, or near-complete, ovarian follicular depletion. Menopause results in low oestrogen and high follicle-stimulating hormone (FSH) concentrations.
Menopause before 40 years of age is considered to be abnormal and is referred to as primary ovarian insufficiency (or “premature ovarian failure”). The transition to menopause, referred to as “perimenopause”, is characterised by symptoms such as hot flushes and irregular menstrual cycles.
Not all women experience the same menopausal symptoms.
It is often said that about 60% of women have mild to moderate symptoms, 20% have severe enough symptoms that it disturbs daily life, and 20% get no symptoms at all. In terms of symptoms, menopause affects women in a multitude of ways - physical, emotional and cognitive. If that isn’t bad enough, even in the absence of symptoms, there are physical and anatomical changes that should be attended to - and I will discuss these later.
More Associated Symptoms:
One of the most common physical symptoms of menopause is “hot flushes”, which are known as vaso-motor symptoms in the medical profession. In some populations, up to 80% of women experience hot flushes - though far fewer see a doctor about them (and even fewer report them to a male doctor). Night sweats occur when the hot flushes happen during the night.
Other physical symptoms, in no particular order, include vaginal dryness, pain during sex, insomnia, itchy or “crawling” skin, headaches, aches and pains, breast soreness, joint pain, lethargy and tiredness, bloating and susceptibility to urinary tract infection. The emotional symptoms of menopause are reportedly just as bad as the physical symptoms and include depression, anxiousness, irritability, decreased libido and mood swings. The cognitive changes of menopause include difficulty concentrating, forgetfulness and overall cognitive decline.
Depletion of ovarian follicles ultimately results in a complete drop in oestrogen secretion from the ovaries. This, over time, can lead to the consequences of long-term oestrogen deficiency which include osteoporosis, cardiovascular disease and possibly dementia.
While there is nothing I can think of that’s good about menopause, there are definitely some things you can do to manage yourself through this challenging stage in life.
One of the most common physical symptoms of menopause is “hot flushes”, which are known as vaso-motor symptoms in the medical profession. In some populations, up to 80% of women experience hot flushes - though far fewer see a doctor about them (and even fewer report them to a male doctor). Night sweats occur when the hot flushes happen during the night.
Other physical symptoms, in no particular order, include vaginal dryness, pain during sex, insomnia, itchy or “crawling” skin, headaches, aches and pains, breast soreness, joint pain, lethargy and tiredness, bloating and susceptibility to urinary tract infection. The emotional symptoms of menopause are reportedly just as bad as the physical symptoms and include depression, anxiousness, irritability, decreased libido and mood swings. The cognitive changes of menopause include difficulty concentrating, forgetfulness and overall cognitive decline.
Depletion of ovarian follicles ultimately results in a complete drop in oestrogen secretion from the ovaries. This, over time, can lead to the consequences of long-term oestrogen deficiency which include osteoporosis, cardiovascular disease and possibly dementia.
While there is nothing I can think of that’s good about menopause, there are definitely some things you can do to manage yourself through this challenging stage in life.
Dr. Harry’s Top Tips for managing menopause
#1 See your doctor, even if he’s male!
I say this for two reasons. The first is to just make sure that the symptoms you’re experiencing actually relate to the menopause, and not another condition masquerading as the menopause. This is especially true for women that haven’t yet turned 50 years old and are experiencing abnormal uterine bleeding. The second reason to discuss things with your doctor is that treatments for menopausal symptoms are available - they are very safe and well-tolerated by most women.
#2 Do your research.
I don’t mean consult Dr Google, nor do I mean wade through a discussion thread written by non-medical, non-expert strangers that apparently have exactly what you have! (see my blog on “Dr Google” here). There are some fantastic online resources for women undergoing the menopause. My suggestions are to check out, in Australia: Jean Hailes, The Australasian Menopause Society and The Royal Women’s Hospital websites. In the UK, look up The British Menopause Society and Menopause Support websites.
#3 Consider medical therapies.
The symptoms of the menopause are a direct result of a lowered oestrogen level in the body. Accordingly, hormone replacement therapy (also known as menopausal hormone therapy, MHT) forms one of the foundations of symptom control - and is safe for a period of 5 years and often recommended for women within 10 years of the menopause.
Before you ask, the risk for blood clots, stroke and breast cancer while taking MHT are very small, however, there are a lot of technical details about MHT that doctors need to know, particularly regarding the contraindications (especially those with migraine, high triglycerides, active gall-bladder disease or clotting disorders).
Still, the basics are fairly simple. MHT essentially involves taking oestrogen to partially replace what was previously being produced by the ovaries. There are various forms of oestrogen replacement including pills, patches, creams, sprays and vaginal rings and pessaries. The form that a woman takes MHT in is a matter of personal preference (often including that of their doctor!).
One thing to note, though, is that if a woman’s symptoms are more-or-less limited to genito-urinary issues, then a topical cream or pessary often does the trick. For more diffuse symptoms, a pill or patch is warranted - and for women with an ‘intact’ uterus, this is always combined with a progestin (the progestin prevents endometrial hyperplasia or cancer).
Additionally, there are various non-hormonal medical therapies for women that experience hot flushes who are unable or prefer not to take hormonal treatments. These include antidepressants such as escitalopram, the neurogenic pain reliever, gabapentin, and clonidine, which is a drug generally used for high blood pressure or migraine.
Check out part 2 now:
Have any other medical topics you would love discussed?
Please email us - talk@truthorigins.co.uk
- Truth team 🌱
Dr. Harrison Weisinger (MBBS, Ph.D.)
Dr. Harry is the Medical Director for Truth Origins, and a practicing medical doctor in Australia. Throughout his working career as medical doctor, university professor, and scientist, Dr. Harry has committed his life to improving human health. Each month he reads the various journals and studies being conducted across the world’s leading universities and research hospitals to bring you the latest research surrounding the truth about plant-based medicine.
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