Dr Dale Garred, one of our female GP’s at MVM explains what to expect around the time of Menopause and what you can do to help manage your symptoms…

“Since having my second baby, I have unfortunately suffered from postpartum night sweats.  The experience has given me a new appreciation for the terrible time that some women have as they approach Menopause – Ladies, I hear you!”

What is ‘The Menopause’

Menopause means that your ovaries no longer contain eggs.  Eggs produce oestrogen and so at menopause, you stop producing oestrogen.  It is the lack of oestrogen that leads to menopausal symptoms.

Perimenopause is the time leading up to your final menstrual period.  During this phase oestrogen levels can vary causing ‘menopausal’ symptoms.  Perimenopause and its symptoms for some women can last 5-10 years before their final menstrual period i.e. in perimenopause you will still experience menstrual bleeding (often irregular) in addition to other menopausal symptoms.

Menopause is a natural event that all women experience.  We can be sure your ovaries contain no more eggs when you have not had a period in 12 months. This generally occurs between the age of 45 and 55. Menopausal symptoms however can persist well beyond this age – because the oestrogen doesn’t come back.

What are the symptoms of Perimenopause/Menopause?

The consequences of Menopause vary.  The majority of women report some symptoms of menopause and 10-20% of these women describe their symptoms as severe.

Common symptoms include        

• Hot Flushes (most common)
• Poor sleep (often due to drenching nights sweats)
• Muscle and joint aches and pains
• Poor concentration/memory
• Vaginal dryness (painful intercourse) and associated lowered libido
• Overactive bladder
• Mood changes
• Changes in skin / hair

What can we do?

Women whose Perimenopause/Menopausal symptoms are so severe that it impacts seriously on their quality of life have various options available to them to help manage their symptoms.

Your doctor will take a thorough history to assess your own needs and individual risks to advise you of the choices available to you.  These might include –

 Lifestyle Changes

 Small and simple lifestyle changes may improve your menopause experience.  You should –

• Adopt a Mediterranean diet, reduce salt intake and reduce portion sizes
• Exercise regularly, at least 2.5 hours of moderate intensity physical activity per week
• Avoid alcohol and coffee
• Avoid spicy foods
• Wear breathable clothing such as cotton and linen
• Consider discussing your experience with a psychologist or counsellor

Non-hormonal treatment options

Occasionally we may recommend non-hormonal prescription medicines to manage your menopausal symptoms.  There is good evidence that antidepressant and antiepileptic medications can help with mood changes and also hot flushes that may be associated with Menopause.  These medications may also improve sleep quality.

 Menopause Hormone Therapy (Hormone Replacement Therapy)

 Hormone therapy is the most effective treatment for menopausal symptoms and may be an option you consider, particularly if other lifestyle measures have been ineffective.

Menopause Hormone Therapy (MHT) is safe, simple to use and has good evidence that it works.  There are creams, patches and oral tablets available.  In addition to controlling menopausal symptoms, MHT improves bone density, has beneficial effects on cholesterol and delaying the onset of cardiovascular disease.

Bioidentical Hormones and Complimentary Therapies

While there are many products available without prescription that claim to help Menopause symptoms, unfortunately evidence of their efficacy is lacking.  Most of these products are expensive and have not been subject to the strict regulations and safety testing that surround prescription medicines.

 What tests do I need?

Hormone testing is not usually necessary to diagnose or treat Menopause.  It is important however to have your general health assessed and check that you have had all necessary routine screening recommended for your age such as

• Blood pressure and BMI check
• Cholesterol Check
• Cervical Screening (Pap Smear)
• Skin Check
• Bone Health Check
• Mammogram

 If you have any concerns or questions about options to manage your menopausal symptoms OR if you are due for your routine screening you should visit your doctor.

 Dr Dale Garred is an Australian Menopause Society doctor with a specific interest in women’s health at midlife and menopause.