AFTER Sun Healthâs menopause special last week, lots of readers got in touch with questions about their experiences of perimenopause and menopause.
It is really great that women are reaching out for information, but it is vital the details and support they need are widely available.
Which is why The Sunâs Fabulous Menopause Matters campaign was launched a year ago, with three crucial aims:
- Free HRT on the NHS for everyone.
- Menopause support at the heart of workplace policies.
- To bust taboos and help women thrive during the menopause.
So here are your menopause questions answered.
Q) MY partner has told me her doctor has recommended a contraceptive Pill to help her with menopause problems.
I thought HRT pills would be the ones, not a contraceptive?
Like HRT, it replaces the hormones the body has stopped making, so can alleviate symptoms.
It is more likely to be recommended if the Âperson is experiencing menopausal symptoms while still having periods (perimenopausal) and requires contraception at the same time. Or it may be the womanâs preferred choice.
The combined oral contraceptive Pill is not Âusually advised if the person is over 35 and smokes, has obesity, or has a history or family Âhistory of blood clots.
A) IâM 51 and am certain Iâm going through the menopause.
I have all of the symptoms and just donât feel like myself any more.
In my family we donât really talk about this type of thing, and I donât know where best to turn for help. I donât think I want HRT, so I havenât seen my GP.
A) We keep hearing we should be âtalkingâ about our menopause and sharing our experiences. â
However, for many people this isnât something they feel comfortable with or able to do.
We have to remember we are all different, with different cultural, religious, ethnic and social Âbackgrounds, which affect how we experience the world around us.
Having said that, it is really important to find a way to share what you are going through and access support.
One way is online via others that are experiencing something similar.
Iâve been working with issviva.co.uk, who have formed a community online for those experiencing perimenopause and menopause.
Thereâs lots of great information there because âknowledge is powerâ when it comes to Âmenopause. You can always speak to your GP, whether thatâs about HRT or the many other ways in which they can support you.
Sometimes people feel more comfortable Âmaking an appointment with the practice nurse to discuss this, and thatâs fine too.
Itâs also worth checking with the reception staff to see if any of the clinicians have a special interest in menopause, especially if you are registered at a large practice.
Q) IT is great The Sun is highlighting the Âproblems women are having, but thereâs never anything mentioned about women who have gone through breast cancer.
I was Âdiagnosed in 2019, had a lumpectomy, then went on to have chemo and radiotherapy.
All went well and now Iâm cancer free. My treatment continues for five years taking Tamoxifen daily.
This is a hormone suppressant so it starts you off into the menopause.
Having had cancer which feeds off your hormones, Iâm not able to take HRT or use treatments that contain any hormones.
I feel this should be highlighted because I know Iâm not the only one suffering but unable to get any help to relieve the Âsymptoms.
A) You are absolutely not alone. In fact one in seven women will get breast cancer, making it a relatively common disease.
With advances in treatment, more than eight out of every ten women with breast cancer will survive. So itâs more important than ever that breast cancer survivors are able to have optimal quality of life.
And to add insult to injury, many of the Âtreatments for breast cancer can exacerbate, or bring on, menopause symptoms earlier.
There are some non-hormonal treatments that can sometimes be prescribed for certain Âsymptoms, such as SSRI antidepressants which can help alleviate hot flushes in some women who canât take HRT, though this may not be Âpossible while taking Tamoxifen.
You may be able to overcome some vaginal symptoms with vaginal moisturisers or lubricants, and some cancer Âspecialists will consider prescribing topical oestrogen pessaries, tablets, cream or a ring, which delivers the oestrogen directly to the vagina.
You can talk to your treatment team about how they can support you, and if you are still Âstruggling, I would advise requesting a referral to a menopause specialist.
In exceptional circumstances, some menopause specialists may offer HRT to women with severe menopausal symptoms when the risks are fully understood.
Q) I AM a 47-year-old nurse going through perimenopause. I am not taking HRT and stopped my contraceptive Pill in May.
Over the past few months, my menopause symptoms have become more noticeable â hot flushes, night sweats, brain fog, fatigue and low concentration.
I have noticed my vaginal area, radiating to my groin and inner thighs, has become extremely itchy. It has got so unbearable, Iâve made myself bleed by scratching myself vigorously.
However, Iâm not experiencing the itchiness internally but more so externally, leaving my skin red, excoriated and very sore.
Do I need any Âfurther creams?
There is a family history of breast cancer and I have suffered from DVT post-operatively, so Iâm quite apprehensive about starting HRT.
Would you suggest the contraceptive Pill?
A) It may actually be safer for you to take transdermal HRT than the combined oral contraceptive Pill, as when HRT is delivered by gel to the skin, there is no increase in risk of blood clot.
Itâs only when taken in tablet form that there is a small increase in risk.
There is no strong evidence that having a family history of breast cancer puts you at any higher risk of getting it if you take HRT.
Oestrogen cream, or other topical oestrogens, such as gel, pessaries or vaginal rings, can be highly effective at treating the genitourinary (genital and urinary) symptoms of perimenopause and menopause, and they are completely safe too, as the oestrogen only acts locally in the tissues of the vagina, vulva, bladder and urinary tract.
Oestrogen is important for maintaining the health and integrity of these tissues.
Loss of oestrogen, due to menopause, can cause the tissues in the walls of the vagina to become thin, dry, and sometimes inflamed.
The skin on the vulva can also be affected.
The cream is applied into the vagina, using an applicator at bedtime.
This allows the medicine to be absorbed into all of the surrounding tissues including the vulva.
However, there is no harm in rubbing some of the oestrogen cream directly on to the affected area too.
If you notice no difference after a few months, return to your GP as there could be another cause behind your symptoms.
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