Oestrogens are very important to maintain bone strength. We all have bone changes with age but these changes happen much quicker after menopause because of the lack of oestrogen.
This can result in osteoporosis or brittle bones, a condition in which any small injury can result in a fracture.
For many women this does not seem to be worrying and certainly does not appear to be as scary as cancer.
Unfortunately osteoporosis is a very debilitating disease. Reaching older age having good bones makes a huge difference in your quality of life.
It can make the difference between staying at home or requiring assisted accommodation.
It can limit your ability to travel and enjoy our life.
About 30 per cent of patients die after a major fracture.
There are many ways to improve your bones strength including HRT.
Make sure you include a bone discussion in your health plan.
At least one a week if not more often I encounter a patient who will tell me this story:
“I have not been feeling myself lately. I snap at the kids for no reason and then get really upset over it. I also get very anxious about things that did not bother me before and this is really affecting my work. I saw my doctor who checked my bloods test. It came back normal and therefore I was told it cannot be menopause and I should consider taking and antidepressant or antianxiety medication”
My dear patient if you are in the right age group you simply are perimenopausal.
I often tell my patients the story of similar things happening to me and recall of when I would not sleep at night over my first son starting secondary school and losing half of his uniform routinely at school. I laugh about it now.
Antidepressant can be a solution if you do not want to consider hormonal treatment. I would recommend you have an informed discussion with a menopause specialist as chances are that you will change your mind and that a low hormonal dose will make your life much easier.
When you start reading menopause website you will find an endless list of symptoms. From your joints to your hair every possible human symptom will be listed. This can be very confusing and in clinical practice I have shortened the list to four main symptoms.
These are the the symptoms that do affect your everyday quality of life and that is why I simplified the list.
If you score at least three of them and are in the
right age group (over 45) then your diagnosis is made. As I explained before don’t worry about your hormonal blood tests results as they will be often be normal.
The symptoms are:
-hot flashes and night sweats
-trouble in sleeping (very often caused by the night sweats but not only)
-mood changes including anxiety and irritability
-tiredness (again very often caused by not sleeping well)
You can decide to put up with all of this baring in mind it could continue for 10 years or to get some help. The choice is yours.
Not all medical professional have experience in looking after women who are experiencing menopause. Treatment can be quite difficult as it needs to be tailored to your needs. It is also important to address myths and anxiety about treatment so that you do not end up making the wrong choice.
Some general practitioners are very sympathetic and helpful in this situation. There a couple of things that might help you decide if you need to see a menopause specialist.
1- Did your doctor listen to your symptoms or just suggested a blood test to make a diagnosis?
2-Did you get help in formulating a general plan to take care of your health that goes beyond just helping you with your symptoms. This is very important as menopause will affect the rest of your life and your ageing process.
Consider these two points and you will be very clear in knowing if you need further help!
One of the most common myths around menopause is that it will last a short period of time and then it will be over.
Most women talk about being through and done with it. Let’s clear this out:
-PERIMENOPAUSE is the leading time to the end of your ovarian function. It can last from 2 to 15 years. This is the time when most women experience transition symptoms like hot flashes and mood changes.
-MENOPAUSE is the period of your life from when your ovarian functions declines till the end of your life.
The rest of your life after menopause will hopefully be a long wonderful time but you are going to live it without the help of oestrogens. This is a major change that affects different part of your body.
This is one of the most common questions i get ask by patient. Diagnosing menopause can be tricky because it is a gradual process. Contrary to common belief it is not possible to do a blood test to tell you if you are starting menopause or not. Changes in blood levels will only be evident after menopause has happened and that is not very helpful because the vast majority of women feel unwell before than that and when their blood test is well within normal level. In medical terms we call this a retrospective diagnosis.
You really should not worry about pinpointing the exact time of going through the transition but you should worry instead about how the process is affecting your health and quality of life.