Thursday 19 April 2018

The menopause myth buster every woman should read

Woman taking an hormone replacement therapy pills.
Woman taking an hormone replacement therapy pills.

Radhika Sanghani

The menopause is the end of menstruation and occurs in all women, typically between the ages of 45 and 55.

It can be treated in a number of ways, with the most common being HRT (hormonal replacement therapy), although there is some uncertainty about the safety of HRT - as well as stigma around the changes a woman's body goes through at this uncertain time.

Symptoms can range from debilitating night sweats to hot flushes. Now, a major new study by the University of Pittsburgh says there are four distinct categories of menopause symptoms into which all women fit, depending on their race and weight and lifestyle. The findings could change the way we view and treat the menopause.

But there is still too much uncertainty around this major milestone in women's lives. Indeed, a recent report by the UK's Menopause Society, has found that half women going through the menopause haven't visited a doctor, as many are 'too embarrassed'. What's more, only  three per cent know about new guidelines from the National Institute of Health and Care Excellence (Nice), which aim to clear up any misconceptions and stop women from suffering in silence.

It recommends that GPs give women more information about the possible risks and benefits of treatment – not just expect them to “grit their teeth and get on with it”. The advice is the first guidance from the watchdog to examine treatment and diagnosis of the menopause.

It's why we thought it was time to set out a few facts around menopause. Dr Justine Setchell, a GP at King Edward VII’s hospital and member of the  UK's Menopause Society, busts some of those myths – as well as the general misconceptions women typically have about its symptoms.


Myth: ‘HRT isn’t safe’

“There’s been a lot of worry and concern about the prescribing of HRT,” explains Dr Setchell, referring to a 2002 study that linked the treatment to an increased risk of breast cancer.

“But we’ve known for a long time that a lot of that was unfounded and the research was flawed, and now the Nice guidelines supports this. It’s suitable for the vast majority of women if they’re managed correctly.”

If 1,000 women aged 50 were not taking HRT, around 22 would be expected to develop breast cancer over seven years, Nice found, in its review of the evidence. If the same number were put on combined oestrogen and progesterone treatment, there would be around five more cases and the slightly increased risk only lasts as long as women are on the therapy.


Myth: ‘Menopause always happens post 50’

The average age for women to begin the menopause is 51 - though most women experience it between the ages of 45 and 55. But Dr Setchell says women should be aware that early menopause can occur any time after 40, and premature ovarian failure can happen at any age before.

“There are a lot of misconceptions around young women going through the menopause. Doctors aren’t looking for that because they’re not aware it can happen. Women need to be aware that it can occur early.”

It’s particularly important for younger women to receive medical help, as a lack of oestrogen can lead to more serious conditions such as osteoporosis.


Myth: ‘Menopausal women have hot flushes’

One of the most common symptoms of the menopause is hot flushes (and night sweats). But not everyone woman will experience this.

“Some women sail through the menopause,” says Dr Setchell. “But others are completely debilitated. The symptoms can vary from mood changes to people complaining about joint pain. Not everyone gets the classic hot flushes – people need to be aware there are many symptoms.”


Myth: ‘A loss in sex drive is down to hormones’

This is partly true. It is common for women to experience a loss of libido, caused by a lack of oestrogen or testosterone. But Dr Setchell says it can also be down to vaginal dryness - another symptom of the menopause - which can make sex painful, and will naturally lead to a drop in sexual desire.


Myth: ‘The symptoms are all physical’

A number of the symptoms are - such as hot flushes, vaginal dryness and headaches. But women can also experience mood changes, depression and anxiety, or even ‘brain fog.’

This is a symptom Dr Setchell has noticed in a number of a high-achieving women.

“They just can’t think straight. They can’t find the right word and that can be part of the menopause transition. It could be down to them not sleeping properly and being tired.”


Myth: ‘The menopause leads to lighter periods’

Sadly this isn’t always the case. Some women will notice their periods gradually becoming lighter before eventually stopping.

But for others the perimenopause can be a difficult time as their periods become heavier and more painful.

“Often leading up to the menopause periods can get worse before they get better,” says Dr Setchell. “People present with really heavy bleeding, clots, and some really struggle to cope.”


Myth: ‘The menopause only lasts a few years’

Actually it can vary. Some women will find their periods stop immediately and they have bypassed any symptoms. Others will experience the perimenopause (initial stage) for up to 10 years.

The average duration is around four years. The menopause is said to have ended when a woman has gone 12 months without having a period.

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