Menopause awareness month
October is Menopause Awareness Month. World Menopause Day is a global campaign, held every year on the 18th of October. The purpose of the day is to raise awareness of the menopause and the support options available for improving health and well being.
Menopause is a natural process that all women experience when the ovaries no longer produce the hormones oestrogen and progesterone. This usually occurs between the ages of 45 and 55 years. It is officially called menopause after 12 successive months without a period. The perimenopause, leading up to the menopause, can last years – at this time, irregular periods happen, and hormone levels can fluctuate. While menopause is a natural transition in life, its effects will be different for everyone. Women who have had surgery to remove their ovaries or womb will also experience menopause if the operation was at a younger age.
Hormone Treatment for the menopause.
The International Menopause Society describes the 5 “W”s of hormone treatment for Menopause:
(1) Who will be helped by hormone treatment?
(2) What hormone treatment and what doses?
(3) When should hormone treatment be started and stopped?
(4) Why use hormone treatment?
(5) Where do women get hormone treatment?
Expanding on these pillars further…
(1) Who will be helped by hormone treatment?
Menopause can cause distressing symptoms, and hormone treatment can help greatly with symptoms such as hot flushes and night sweats, as well as urinary or vaginal symptoms.
Evidence exists that hormone treatment improves bone health (osteoporosis risk) and heart health, although this alone is not a reason to start hormones. It should be remembered that hormone treatment is not an anti-ageing treatment. Finally, caution is advisable if a woman has had some types of breast or womb cancer, or some types of blood clots.
(2) What hormone treatment is best for me?
There are clear guidelines that help to decide which hormones will help you personally, e.g., the severity of your symptoms, if you’ve had a hysterectomy (removal of the womb) and so on. These guidelines provide options which should be matched with your lifestyle and preferences.
The main hormones are oestrogen and progesterone. Different forms of these are available, and their doses can also be adjusted. They can be taken as a tablet, a skin patch or as a gel. The dose and method of using hormones should be tailored to you as a person, as mentioned above.
Small doses of testosterone can occasionally be used for low libido (sex drive), but this is not yet part of the standard guidelines and should only be done under the guidance of an endocrine expert (although testosterone is mainly a male hormone, it is naturally present at low levels in all women).
(3) When should hormone treatment be started and stopped?
The main reason for thinking about hormone treatment is to help with symptoms. There is no “normal” blood test level which will help plan hormone treatment. Sometimes, a little “trial-and-error” is needed to find the best choice for you. The options depend on what symptoms are most troubling.
In general, if someone is already on menopause hormone treatment that is helping them, there is no fixed rule about how long it can be used before stopping. This is a personal decision based on relief from symptoms and personal risk which should be discussed clearly.
Most experts advise against routinely starting hormone treatment after the age of 60 if not already started.
(4) Why use hormone treatment?
It is important to help women use hormone treatment to get relief from their symptoms, rather than seeing it as a medical treatment of a “condition”. Some menopause symptoms will naturally improve over time, so this should also be kept in mind while choosing treatments and changing them over years.
It is very important to remember that there are various non-hormone treatments that are also available for some symptoms, and these should all be discussed.
(5) Where do women get hormone treatment?
Most women will get their menopause hormone treatment from their GP or Pharmacist. A lot of useful information is also available on various official websites. However, getting personalised support and information to make a good choice for the individual woman is extremely important. This is especially true in this age of social media information and claims.
In Summary, menopause is a natural process that affects women in different ways. There are a number of methods available to help women feel better if they have symptoms, and hormone treatment is an important part of that set of options. Our approach to menopause symptoms at Hourglass Wellbeing, is to present you with the evidence and consensus from official guidelines, and direct you to the available official resources, so that you can make an informed choice.
