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Am I going mad or is it the menopause?

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Sponsored feature | Nuffield Health Cambridge Hospital

In recognition of International Women’s Day this month, we talk to national menopause expert Dr Imogen Shaw, private GP, who specialises in the menopause at Nuffield Health Cambridge Hospital.

Dr Imogen Shaw, a GP who specialises in the menopause at Nuffield Health Cambridge Hospital
Dr Imogen Shaw, a GP who specialises in the menopause at Nuffield Health Cambridge Hospital

The menopause is a vital part of women’s health and occurs in all women at an average age of 51. The resulting estrogen deficiency can cause menopausal symptoms which, for some, will lead to considerable difficulties in their relationships and working lives. With increasing life expectancy, many women will live for decades after the menopause, so it is important to optimise postmenopausal health to minimise the impact of diseases associated with aging.

I don’t recognise myself anymore

The menopausal transition can be difficult as symptoms do not just consist of the commonly acknowledged hot flushes and night sweats, which affect 85 per cent of women. There are many psychological issues that can have a major impact on women's mental health, such as increased anxiety, irritability, mood swings, depression, tearfulness, irrational thoughts and memory problems. Women experiencing this for the first time can feel like they’re undergoing a complete personality change, thankfully these symptoms also respond to appropriate doses of hormone replacement therapy (HRT).

I’ve been told I am too young to be going through menopause

On average, women begin their menopausal transition between the age of 45 and 55. However, 1 per cent of women under 40 have premature ovarian insufficiency and although this is relatively rare, an early menopause at 40-45 is much more common. Not infrequently these women are told they are too young to be experiencing the menopause, consequently they suffer in silence without the benefits that HRT has on their bones and cardiovascular systems. This is particularly important in women with early menopause, as their life expectancy is two years shorter than that of women with menopause after the age of 55 years. Any changes in your menstrual cycles or any menopausal-type symptoms, which may start when periods are still regular, should be discussed with a healthcare professional at the earliest opportunity.

How can I get support and advice?

Take time to book an individual assessment that is focused on your symptoms and the impact they are having on your quality of life and your ability to work. A risk assessment should be undertaken looking at any family or personal history of breast, ovarian and endometrial cancers, blood clots, migraines and risk factors for osteoporosis, heart disease and stroke. Women who visit the Cambridge Private Doctors at Nuffield Health Cambridge Hospital can choose to see Dr Imogen Shaw in her Menopause Clinic to support and empower them to make informed choices, helping to construct a personal health plan for the menopause and beyond.

The menopause is a vital part of women’s health and occurs in all women at an average age of 51
The menopause is a vital part of women’s health and occurs in all women at an average age of 51

Is it too late to start HRT?

One of the main benefits of HRT is the improvement in menopausal symptoms, so once you are through the menopausal transition and your symptoms settle, you will no longer obtain any symptomatic benefit from the treatment. It is not usually appropriate for women over 60 to be starting HRT, unless there are troublesome symptoms, as the cardiovascular benefits of HRT for women in their 50s diminishes with age, and the risks of heart attacks and strokes increase. However, every woman should be assessed on an individual basis, so please seek advice.

What types of HRT are available?

HRT is composed of estrogen, which is the hormone that improves menopausal symptoms. This can be taken as a tablet, gel, patch, or spray. For those still having periods it needs to be taken in a cyclical form for half the month, inducing a bleed once a month. Once women no longer have periods they can take a continuous daily dose of progesterone which keeps them bleed free. Women experiencing local vaginal symptoms can use lubricants, moisturisers or estrogen as a cream or pessary, which alleviates vaginal dryness.

How do I help myself through the menopause?

By optimising your health and wellbeing. There is increasing evidence that lifestyle factors such as nutrition, sufficient physical activity, stopping smoking, and keeping alcohol consumption to under 14 units per week can all have a profound effect on health and menopausal symptoms. The menopausal transition provides a good opportunity to address these issues and set the path for a healthier life, so it is good to take part in national screening programmes for breast and cervical cancer too.

Dr Imogen Shaw from Cambridge Private Doctors holds her Menopause Clinic at Nuffield Health Cambridge Hospital, 4 Trumpington Road, Cambridge CB2 8AF. For more information, call 01223 967995, email enquiries@cambridgeprivatedoctors.co.uk, or visit nuffieldhealth.com/hospitals/cambridge.

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