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Contents

  1. I wasn’t expecting this…
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  3. Menopause: Symptoms, causes, and treatments
  4. Preparing for Menopause

This means your menstrual cycles change thanks to your hormones fluctuating. Periods may get closer together or farther apart.


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Bleeding may be heavy one month and lighter the next. Eventually, periods will stop completely. A definite upside to this stage! In addition to those irregular periods, you may have tender breasts and bad PMS. Find yourself crying one minute, irritable the next? As you approach menopause, symptoms may increase, including insomnia, vaginal dryness, low libido sex drive and the infamous hot flashes , where you suddenly feel warm or flushed for no reason.

Shifts in estrogen production trigger hot flashes. For people sensitive to those shifts, it can be like riding a roller coaster.

I wasn’t expecting this…

Evans says. Talk to your doctor if you feel like help is needed for your symptoms. Hormone replacement treatments and lifestyle changes like tweaking your diet and managing stress can turn the roller coaster into more of a carousel. Being a woman is fun, right?! Many symptoms mimic the signs of menopause but there might be other causes.

Some of those can mimic the signs of menopause. For example, juggling work, kids and aging parents can contribute to anxiety and depression. Weight gain , which is often blamed on menopause, has more to do with an aging metabolism. Thyroid disorders can mimic menopause as well. To help keep you waltzing through menopause, consider these lifestyle choices that go a long way to keeping perimenopause symptoms in check:.

If menopause symptoms are getting you down, medications can help. Talk to your doctor about low-dose birth control pills, which can regulate heavy or irregular periods during early perimenopause. Closer to menopause, hormone therapy can improve symptoms such as hot flashes. Evans adds.

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God, yes, even though my free tote bag is beginning to bulge. Isoflavones that supposedly balance oestrogen upheavals? Why not? Unused to the glare or even interest of the press, the BMS treated my request for an invitation with puzzlement before accepting. I had already attended the morning session in a hall packed with doctors, nurses and therapists and listened to presentations on premature ovarian failure, new and better drugs for endometriosis, and the risks of pulmonary embolism changes in oestrogen levels can affect how the blood clots.

I learned a lot from the speakers: that cardiovascular disease is the most common cause of death in women, outstripping breast cancer tenfold according to cardiologist Peter Collins , and that women can be prescribed remedies thoughtlessly and crassly. Trudy Hannington, a psychosexual therapist, described a woman who had been given a big tube of vaginal lubricant for dryness and an equally big recommended dose. The overwhelming message was consistent: a condition that personally affects half the population is woefully neglected. There is neither enough data nor are there enough drugs.

Menopause: Symptoms, causes, and treatments

In the early s it became much harder. In , women who approached the medical profession for help with menopausal troubles were routinely prescribed HRT. The standard formulation for women who still had a uterus was a combination of oestrogen and a progestogen: either progesterone derived from plants or progestins synthetic progestational agents which act like progesterone.

By the mids, it was the fifth-most-prescribed drug in the country, and it is still one of the largest-selling, most commercial HRT products in the US. According to sales figures, in it was the 38th most prescribed branded drug in the US.

Between and , 27, women aged 50 to 79 enrolled in the WHI hormone study. Of these, 16, women who had an intact uterus were in the study of oestrogen plus progestin and 10, without a uterus participated in the trial of oestrogen alone.

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Preparing for Menopause

The results were so shocking that the study was stopped in The press headlines were loud, immediate and everywhere. Some articles were better than others, but the worst ignored the fact that the oestrogen-only HRT study was continuing. They also failed to distinguish between relative risk — the risk posed to that particular study group of women being given oestrogen and progestin relative to the risk posed to those being given a placebo — and excess risk, the actual increase in risk between the two groups.

In fact, as the WHI researchers wrote in the Journal of the American Medical Association, in terms of breast cancer and stroke, the excess risk was just eight more strokes and eight more invasive breast cancers per 10, person-years. The results seemed to show that breast cancer risk was doubled in women taking HRT. The study ascribed 20, cases of breast cancer per decade to HRT use, with 15, of those related to oestrogen-progestogen use. The effect of all this was profound.

In the US, prescriptions of the two most common HRT brands, Premarin and Prempro, dropped from 61 million in to 21 million in Newspaper headlines bombarded women with the message that HRT was dangerous. The bombarding must have worked: even when I was in great distress with my chemical menopause, losing days of work to insomnia and hot flushes, struggling with depression and not far from a breakdown, I resisted it. I could sleep and think straight again. But I still came off it as quickly as I could. There was uproar.

There are days when I lie in bed and dream of the good old days of PMS. She might start crying and stab you. Her hot flush was so bad, it steam-cleaned my carpet. According to a video interview on the excellent website healthtalk. There is also empowering humour on websites, fridge magnets and tea towels. I like the dramatic sound of it, because, having had one menopause already, I know that it can feel dramatic: tragic and comic all at once.

The biological fact of the menopause pre-dates this vocabulary. As Louise Foxcroft wrote in Hot Flushes, Cold Science: A history of the modern menopause, Aristotle, Galen and others knew that a woman stopped bleeding and lost her ability to reproduce. Throughout history, postmenopausal women have been variously considered sexless, shrewish, whorish, dangerous, hysterical and pointless. Plenty of studies since have persuasively punctured the WHI findings — that HRT causes breast cancer — but they have received little publicity. A special issue of Climacteric in re-examined the trials and their reception 10 years on.

It would be widely understood that prescribing HRT to perimenopausal, menopausal or recently postmenopausal women is far different to prescribing it to women 10 years into the menopause. Shapiro and his co-authors say that their critiques were not funded by the pharmaceutical industry and were independent. The footnotes of their review of the Million Women Study confirm that the review was not commissioned and was peer-reviewed. The paper also says that all of the authors had consulted in the past with manufacturers of products discussed in the article and that all but one were doing so at the time of publication.

It is not uncommon for researchers working in this field to have conflicts of interest, such as lecturing on behalf of and consulting for HRT manufacturers. When I reached her by phone, Beral would not comment on seismic changes in menopause research, such as the upcoming Nice guidelines. We do understand them very well. We know the effects on the ovaries, breasts, [we know about] thrombosis. We know that the risks start as soon as you start taking it. Where are we now? Go to your GP and anything could happen. Hannah Short, a trainee GP, and Natasha North, convener of Menopause UK, launched the ChangeTheChange campaign in March in frustration at the confusing, poor information available not only to women, but to medical professionals.

She has heard of women going to one GP to be put on HRT, then going to another who takes them off it. She has heard of one GP who said that women just need to pull themselves together. She told me of a nurse, who had gone through a surgical menopause, who was treated as a hypochondriac when she complained her treatment was not working.

This would infuriate some speakers at the BMS, where John Stevenson, a consultant metabolic physician at the Royal Brompton Hospital, presented research on the protective role that HRT can have on the heart. Great for a year-old, absolute poison for a year-old. No one in this room would do that. He is slender, tanned and looks 20 years younger than his 73 years, and he is evangelical about the benefits of bioidentical hormones.

They are better, he said when we met over coffee near his clinic, because the oestrogens are derived from plants such as yam and soy, and the progesterone is micronised finely ground. Both these facts, he claims, mean bioidentical hormones are better processed by the human body than conventional preparations. He gives me a handout that explains further. With his bioidentical therapy, patients have blood taken and are prescribed a particular hormone combination according to their hormonal levels, which is made by a compounding pharmacy one that can make up its own preparations.

To listen to Gordon, you might think that he had found the holy grail.


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Gordon is persuasive. I leave almost tempted to make an appointment, despite the hefty private fees and the cost of the treatment itself though Gordon says the HRT, daily, costs little more than a cappuccino. But other menopause specialists are circumspect. There are so many types of HRT. I noticed a few months ago that my brain now hesitates, very slightly, when asked to choose between left and right.

I drop things more often and am clumsy. I wrote a blogpost recently that details some of these occurrences. Current ailments: jaw pain, dry eyes that make me feel like my eyeball is actually a hedgehog, poor sleep, constant tiredness. All can be linked to hormonal changes in my body. But am I ill? With all this talk of symptoms, you would be forgiven for thinking so.

Yet this position would be questioned by many clinicians and professionals working in the field, and many women in the midst of this life stage. Perhaps, she must be patient, and become a patient. Nice is deciding which treatments are available on the NHS.