Author: Rita Galimberti (Page 1 of 3)


Menopause happens when your ovaries start working less and then eventually stop working altogether. One of the main functions of the ovaries is to produce hormones in particularly oestrogen. You always will have some levels of circulating oestrogens even when menopause has occurred but it will be less then what you used to have.

This is the clue of the problem as oestrogens have a lot of beneficial effects on your body and not having them anymore can cause lot of symptoms and problems.

Not all women experience symptoms. Some women will have a more gradual transition and might not have any issue at all. We are all different and every woman will have a different experience.

Changes in periods will normally happen in the time leading up to menopause and they eventually will stop.


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 there are health problems associated with ageing that you can reduce if you are careful about your health.


This is one of the most common questions  I get asked 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 will have symptoms well before that stage. In medical terms we call this a retrospective diagnosis.

What we do instead is look at a woman’s symptoms and age. Listening to symptoms is enough in the vast majority of cases to make this diagnosis easily.

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.


Deciding what to do in menopause depends on many things.
For some women symptoms have a big impact on their quality of life and for some other women the transition is seems very easy. We are all different and that is why an individual approach is required.
Whatever the symptoms need treatment or not has to be your decision.
If you decide that your symptoms are not significant you still need to consider what impact menopause has on your health and how are you going to ensure your well being in older years.
Menopause affects your bone and cardiovascular health. There are many ways to look after your bones and heart and making your health plan means to find out which one is the best for you.


I recently went home to visit my parents in Milan and found myself joining a Sunday morning exercise class with some old friends.
It was very enjoyable despite the heat and during a break a friend asked a few questions on vaginal dryness which was tormenting her. We started chatting about vaginal problems in menopause and I was giving her my best advice on what to do.
As we were chatting I realised that many of the other women (we were all of that age) were trying to listen and the chat become a lively group discussion. They were all keen on getting information and they all admitted to be plagued by the same problem.
I was quite surprised as I thought that Italian women would be normally be more open in relation to sexual issues. I turned out that when it comes to vaginal dryness and menopause even in Italy women are not happy to discuss it openly (apart from that protected environment) as it is embarrassing to admit that you have reached that stage.
So my message to all menopausal women is:
* You are not alone. We all have the same problem and we should not be afraid to discuss it and get advice
* Vaginal dryness is caused by the lack of oestrogen in menopause and it causes discomfort and painful sex
* This problem is treatable and there are new very effective remedies like vaginal laser that can greatly improve your quality of life
* Talk to your gynaecologist for advice and when you get better share your knowledge with your friends so we can eliminate this taboo

Treating vaginal symptoms can involve HRT but it can also be done without it.

Options without systemic HRT are:

-localised (vaginal) oestrogen. Using local oestrogen does not affect you risk of breast cancer or any other systemic disease.

-using proper lubricants. Silicone based ones are a better options.

-laser treatment. A non invasive non surgical approach to improve the quality of your vaginal tissue.

for more info :



Oestrogens are very important to maintain bone strength. We all have bone changes with age but these changes happen much quicker after menopause in women because of the decline in 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.
for more info visit the irish osteoporosis website:


When you start reading menopause websites you will find long lists of symptoms. From your joints to your hair every possible human symptom will be listed. I don’t like these symptoms checkers lists as they can  be very confusing. Many of the listed symptoms are actually due to ageing and affect men as well.
In my clinical experience  I have shortened the list to four main symptoms.
These are the the symptoms that do affect your everyday quality of life.
If you score at least three of them and are in theright age group (over 45) then your diagnosis is made.
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 you can get some help. The choice is yours.


Hot flashes and night sweats? You all know about those. What I would like to do here  is to inform on the things that you might not know about menopause.
Many women experience other symptoms that they find quite difficult to identify.

For example, they might find themselves much more irritable or moody. Some women suddenly find hard to cope with tasks or family life problems that were not an issue before. The problem is that these changes very often happen before the classical symptoms and therefore are very often misdiagnosed for something else like normal depression.

On top of that many women and doctors at times might rely on a blood test to see if what they are experiencing is due to menopause or not. The blood test comes back invariably normal because as I explained to you before the blood level of FSh will change usually after your periods have stopped.

The conclusion usually is that you get labelled with depression or anxiety disorders and you get prescribed with medication. The correct answer is that you are not going crazy and that menopausal changes can be responsible for the way you feel. Many other women have had the same and unfortunately, women in Ireland are not very keen in sharing this type of experience.

So talk to your friends about it and maybe consider menopause as a diagnosis and menopause treatment as a solution.


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 and make the decision that is right for you. We are all different and there is more than one solution.


There are some menopause classical consequences that women are not always aware of.

The main one would be changes in your vagina and bladder. The vaginal mucosa is a primary target organ for oestrogens. Once the oestrogens are not there anymore the mucosa will thin and change. This physiological change will manifest with discomfort in having sex and often symptoms that women label as recurrent thrush.

This is a symptom that will happen to all women at some stage, unlike hot flashes and night sweats that can vary from woman to woman. You need to decide if this is an important issue or not for you when you are looking at treatment options.

This symptom will usually manifest itself in your late 50’s if you are not on HRT but can start earlier in some cases.

There are effective treatments available which your doctor will be able to discuss with you.

The main thing for now is that you understand that this change WILL HAPPEN and if your sex life is important for you, you need to make a plan.

Treating vaginal symptoms can involve sistemic  HRT but it can also be done without it.

Options without systemic HRT are:

-localised (vaginal) oestrogen. Using local oestrogen does not affect you risk of breast cancer or any other systemic disease.

-using proper lubricants. Silicone based ones are a better options.

-laser treatment. A non invasive non surgical approach to improve the quality of your vaginal tissue.

for more info :


« Older posts

© 2024

Theme by Anders NorenUp ↑