World Menopause Day last week caused a big spike in articles and awareness of the menopause; its symptoms, treatments and some practicalities, but naturally there were still some questions remaining. We asked you to submit your questions to Dr Louise Newson, a leading menopause specialist and founder of balance-app.com, and here you can find her answers across a range of topics...
Q. When does the menopause end? Does your body return to some sort of normal, or do these symptoms last the rest of your life?
A. The menopause never “ends”: it’s a long term hormone deficiency with health risks. Many women find that their symptoms last several years; others for decades. But symptoms tend to change over time. For example, hot flushes and night sweats may improve but, on the other hand, you might then start to suffer from poor sleep, memory loss, urinary symptoms or headaches.
Q. I have stiff and aching joints, which I’m sure are menopause-related. But I’ve been on HRT for five months now, and it doesn’t seem to help. What should I do?
A. The female hormones oestrogen and testosterone affect every single cell in the body, and they work as anti-inflammatories in the muscles and joints. Many women find that symptoms of joint pain, stiffness and muscle aches really improve with the right dose and type of HRT. It could be that you need a different dose of oestrogen. You may also benefit from testosterone.
Q. I am now in my early 50s but experienced menopause in my late teens due to Premature Ovarian Insufficiency (POI). I’m pleased that people are finally talking about menopause, but inevitably ‘the conversation’ is going to be geared towards older women. Any advice?
A. Menopause under 40 affects around one in 100 women in the UK. It is really important that these women are given adequate advice, information and timely treatment: delay in starting treatment comes with health issues including an increased risk of heart disease and osteoporosis. For more on this, see my website.
Q. Can menopause affect your teeth?
My teeth seem to crack and I have so many problems. Is there anything I can do to improve this?
A. Yes menopause can affect your teeth. Oestrogen is important for dental health, and a shortage of it can lead to pain and inflammation in the gums. You might see your gums change in colour; they might become paler or, more often, a deeper red. Gums might bleed on brushing, or start to recede, and you might notice bad breath, pain on chewing, or bite problems. Taking HRT will help reduce these symptoms, as well as guard against a dry mouth, gum and bone problems.
Q. I have suddenly started to get bad body odour. Nothing else has changed: might this be related to the menopause?
Which deodorants are best if you’re going through the menopause?
A. Yes, body odour is a common symptom of the menopause. It may just be due to increased sensitivity on your part: your sense of smell can really change as a consequence of low hormone levels, so women often report noticing smells that others don’t. HRT can really help with this. I also recommend Sure Maximum Impact, which I use myself.
Q. ‘Should I supplement my coil with oestrogen?’
I am 51, my periods have stopped and I’m feeling angry, flustered and hot, with dry skin. My doctor finally gave me a blood test, but it came back normal. I’m on the Mirena coil which gives me progesterone, and am wondering whether I should supplement with oestrogen. I am happy with the coil, which I’ve been told will last 10 years, but I don’t want to be experiencing other issues like bad skin and sore joints. Many of my friends are in the same situation.What are your thoughts?
A. As you are experiencing symptoms, then it is likely you will benefit from taking oestrogen and possibly also testosterone. Perimenopause or menopause itself can be diagnosed by symptoms alone: you don’t normally need a blood test. Visit my website to download a free health report, which you can take to your GP or healthcare professional. The Mirena coil will work as the progestogen part of HRT for five years and then can be replaced.
Q. Should you take HRT even if you’re not experiencing severe menopausal symptoms and a bone scan has shown you’re not suffering from osteoporosis either?
A. There are many health benefits of taking HRT including a reduced risk of developing heart disease, type 2 diabetes, arthritis, bowel cancer and dementia, as well as reducing the risk of osteoporosis.
Q. What help is there for women who are unable to take HRT?
For example, if they are on tamoxifen or similar but are experiencing menopausal symptoms. Please don’t say exercise, diet and sleep!
A. Some women who have had breast cancer choose to take HRT for the benefits to their symptoms and also their future health – but you will need an individualised consultation with a menopause specialist. For more information on menopause and breast cancer, read my specialised booklet.
Q. How long should I take HRT for?
A. HRT is prescribed to replace missing hormones, but it also has significant health benefits. Women who take HRT have a lower future risk of heart disease, osteoporosis, diabetes and dementia. In my view, it can be taken forever.