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Around three-quarters of women experience problems associated with the menopause. Dr Preeti Tandon helps you deal with the varied and unpredictable symptoms.
Each woman's experience of the menopause is unique and therefore a "one size fits all approach" to managing the menopause does not work effectively. The age at which symptoms begin together with their severity and the length of time it can take to pass through the menopause will vary greatly from woman to woman. The menopause is the time when a woman stops producing eggs and which can herald significant hormonal and physical changes. Symptoms include flushes, sweats, tiredness, lack of sleep, headaches, memory and cognitive changes, mood lability and anxiety, vaginal dryness and sexual problems. Modern HRT regimes are extremely effective at controlling these problems and the impact can be quite literally life-changing.
When production of the hormone oestrogen falls to a very low level the uterus stops responding, periods cease and this is called the menopause. For around ten years before and several years after the menopause, the decline of oestrogen production can result in very distressing symptoms as well as erratic or heavy menstrual bleeding.
What are the symptoms?
Symptoms relate to low levels of oestrogen and occasionally testosterone and varies from person to person. Even the most determined and active women can be laid low and completely incapacitated by symptoms which can take them completely unawares.
The most common symptoms are:
HRT (Hormone Replacement Therapy) replaces the oestrogen that was produced by the ovaries before the menopause. The level of oestrogen in HRT is designed to reduce or stop altogether the symptoms of the menopause outlined above, though it does not restore oestrogen levels to pre-menopause level.
Unlike the contraceptive pill, oestrogen replacement in HRT mimics the natural oestrogen molecule in a similar way to thyroid replacement. It is known that the contraceptive pill is 50 to 100 times stronger than HRT in all its effects as unlike HRT it is synthetic, takes a long time to be cleared from the body and therefore stays in the body much longer.
What are the benefits or HRT?
What are the risks of HRT?
Some women have concerns about the possible associated risks due to the bad and sometimes inaccurate publicity in the press, this leads to poor understanding of the treatment and a consultation is advised.
Is there a risk of breast cancer?
Recent concern about the effect of some HRT preparations increasing breast cancer risk means that for many the risks of HRT are not worth the benefits. However, most reliable studies have shown that oestrogen-only users do not have a significantly increased risk of developing breast cancer, although the addition of a progestogen can increase the risk significantly. The risks of breast cancer may also be smaller than many women think. It is however always sensible to be breast aware and to have regular mammograms.
Is there a risk of cancer of the cervix and/or ovaries?
There is no evidence that HRT causes cancer of the cervix or ovaries.
How is HRT tailored to the individual?
This will often mean prescribing the oestrogen and progestogen separately, building up the dose until the symptoms have disappeared. This way, the lowest dose required for each individual is given after which the blood levels are checked.
Some women find that natural treatments are adequate in obtaining symptom relief and some of them are also shown to provide some benefit in protecting the bone and heart.
They can also be used for example in conjunction with vaginal oestrogen local treatment where HRT is not wanted but where bladder and vaginal symptoms or poor sensation or low libido problems exist.
Dr Preeti Tandon wants to ensure that her patients obtain a good understanding of the menopause whilst tailoring and individualising their treatment to deliver the best quality of life without compromising safety. The benefit of attending a menopause clinic means that your specific case can be assessed and the HRT preparation altered according to the your response.
Her clinic also offers screening for uterine, ovarian, cervical cancer, breast cancer and pre-cancer. Bone density and cardiovascular screening are also available where increased problems are observed after the menopause.