Getting the better of the menopause

Chiswick Medical Centre is hosting another of their Women’s Health evenings. Dr Stephanie Goodwin will be talking about the menopause, along with specialists on breast health and dermatology.

Thursday, 10 October, from 6:30pm-8:00pm at Chiswick Medical Centre, 347-353 Chiswick High Road, W4 4HS. There’s a £5 charge, which will be to be passed to the children’s rugby charity, Wooden Spoon.

Stephanie is a GP with a special interest in the menopause. I talked to her about treatments on offer which ameliorate some of the worst effects of the menopause, which many women don’t realise are available to them. She says GPs don’t know enough about it, even though it affects all women, and some prescribe antidepressants to women who aren’t depressed, but just going through the change. There are now effective treatments which not only mitigate the effects of menopause but reduce other long term health risks, she says.

‘As I started to approach the menopause, as did many of my patients, I realised that my knowledge around the subject was a bit patchy! So I took it upon myself to learn and train with the British Menopause Society. I’m so glad I did. After all, as a doctor, the only condition that all of my female patients will experience is the menopause. That’s a lot of women.

Symptoms of menopause

‘Menopause is a definition. It means you haven’t had a period for over a year. So you don’t know you’ve had it until it has passed. The time leading up to that is called the perimenopause. That can last anything from a few months to several years. The main symptoms of depleted hormones are hot flushes, night sweats, poor sleep, anxiety, joint pains, brain fog, vaginal dryness, lack of libido. Your periods may stop, the irregular or remain regular. Sounds horrendous doesn’t it!

Not enough doctors know about it
“Doctors don’t know about it” she told me. “They don’t know about the recent data and some prescribe anti depressants instead of the treatments they should be offering”. Women don’t take them she says, because they know they’re not depressed. Her recommendation is that women ask their GP surgery who on the staff specialises in menopause, and book in to see them.

HRT

HRT is Hormone Replacement Therapy. It replaces the female hormones – oestrogen, progesterone, and sometimes testosterone. Oestrogen is vital for our bone strength, it protects the bones, the brain, the vagina and bladder. Progesterone helps with mood regulation and sleep. Testosterone is good for the heart, the bones, drive and focus and sexual desire. ‘In the short term, when you use HRT the symptoms of the menopause are controlled, and in the long-term, we are investing in significantly better health for when we are old ladies’.

I put it to her that HRT has had a bad reputation. In many women’s minds it’s connected with breast cancer.

‘My view is that the benefits of HRT far outweigh the risks. Women often ask me about the risk of breast cancer. For every thousand women taking HRT, there may be an extra 5 diagnosed with breast cancer after 7.5 years. HRT may promote the growth of breast cancer cells already there, but it will not give you breast cancer. The evidence seems to suggest that the synthetic progesterone is maybe the problem and personally I don’t prescribe synthetic progesterone. There are other alternatives. Remember also that most women die from heart disease and evidence suggest that HRT is can significantly reduce the risk of heart disease. By the way, HRT doesn’t make you fat….. It’s a lack of the hormone oestrogen that does that’.

She says it comes as news to many women that HRT can be beneficial for long term health risks. “It does help if you have joint pain. It seems to help with anti-inflammatory. It’s also has a good effect on cardio and on reducing your risk of bowel cancer”.

Types of HRT

There are different types of HRT: those which use Bioidentical hormones, which are widely available on the NHS and those treatments that are specifically formulated with mixtures of different hormones.

‘Bioidentical hormones are hormones that are structurally the same as those that we produce in our bodies. I prefer to call them body identical hormones to differentiate them from hormone treatments that are specifically formulated with mixtures of different hormones. In my opinion, the vast majority of women don’t need these bespoke mixtures and body identical hormones are widely available on the NHS, but many GPs aren’t aware of it.

‘I feel that these hormones are better tolerated as our bodies recognise them as familiar structures. I do, however, feel that every woman needs an individual assessment of her symptoms and of her risk of other conditions. It’s an important time of life to stop and take stock of where you are both physically and emotionally. It should be a liberating time of life and sometimes it isn’t. Make sure that you speak to a doctor or nurse who is interested and clued up on the menopause so that you get the best possible advice. It’s well worth it’.

An initial 45 minute consultation with Stephanie will cost you £295. “Normally by the end of that I can tell a patient what their prescription should be and I write to their GP”.

This page is paid for by Chiswick Medical Centre. Book tickets for the Women’s Health evening here.

Read more stories on The Chiswick Calendar

See also: Plans for a new Chiswick Health Centre

See also: How to set goals for a healthier lifestyle