Quality Medical Advice When You Need It


How is menopause defined?

Menopause is that phase in a woman’s life where she ceases to have menstrual periods due to a fall off of the female hormones oestrogen and progesterone. This may be a sudden and abrupt event or her periods may get lighter or heavier and simply peter out. It usually occurs between are age of 45 and 55 depending on what age she was when her periods started (menarche)

Symptoms of Menopause:

The symptoms of menopause will vary greatly from woman to woman but will include at least some of the following:

  • Irregular, erratic and sometimes very heavy periods referred to as menorrhagia.
  • Hot flushes, or in the US ‘flashes’ and night sweats.
  • Lack of libido.
  • Vaginal dryness and low sexual response making intercourse painful or impossible.
  • Palpitations or an uncomfortable awareness of your heart beating.
  • Mood swings, anxiety, depression, panic attack and insomnia.
  • The acceleration of bone demineralisation – osteoporosis and bone fracture.

Management of Menopause:

In spite of many many years of intensive study and literally hundreds of reports and analysis, the treatment or management of menopause remains controversial. The scientific world seems to be divided on the question of benefits outweighing risk for hormone replacement therapy (HRT).Some hold the view that the benefits do outweigh the risks and other are strongly of the opinion that they do not. In the world of science this is known as equivocation.

In 2002 the Women’s Health Initiative Study (WHIS) was dramatically cut short when it was reported that there was a slightly higher incidence of breast cancer among those women taking HRT as against those not taking it. This was immediately picked up by the world media and misquoted in banner headlines as: HRT Causes Breast Cancer. And that simple if misleading headline has stuck in the minds of women and indeed many doctors ever since,

However, when you read the report what it actually says is that:

Among 10,000 women taking oestrogen/ progesterone combination HRT for one year there were eight extra cases of breast cancers when compared to a similar group of women not receiving HRT over one year. The initial study did not show any extra deaths among the HRT taking women.

There were also reported benefits for women taking HRT like reduced hip fracture and reduced bowel cancer but somehow the good news seemed to get buried under all the hysteria.

Whether you decide to take HRT or not for your menopausal symptoms may really depend on the severity of your symptoms. In practise, I have spoken to women so distraught by their menopausal symptoms that not to take HRT would seem ridiculous. So bad can be the symptoms of menopause that it can make a woman’s life a misery and even threaten her marriage. Not to at least consider HRT under such circumstances would be bad practise and cruel.

Bioequivalent HRT

Be wary of the much exaggerated claims often made by vested interests about the benefits of so-called “bioequivalent” HRT as distinct from the HRT made by the pharmaceutical industry. While I’m no fan of that often cynical industry they are strictly regulated by official bodies like the FDA and are bound to good manufacturing practices and research throughout the entire manufacturing process.

So-called bioequivalent HRT on the other hand is by and large unregulated and compounded privately by who knows who. The purity of these products is therefore a matter of faith rather than regulation.

If you are worried by your menopausal symptoms and confused as to how best to treat it then we are here to help and direct you.

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