At Private GP Services, we take hormonal changes in a woman very seriously and our GPs are trained to support women through this period of their lives. It is important to stress that many women go through this period without any problems at all. Quite rightly the subject of menopause and HRT is now being discussed more openly in the media, in government and there is a lot of legislation being introduced to support women at work going through this period of their lives.
There are several phases to the “change”, which we will discuss below.
If a woman’s menstrual cycle stops before the age of 40, this is considered early menopause, or premature menopause. They may experience a number of symptoms from a younger age and this is more common in those who have family members who have been through early menopause. This can happen naturally and it is also sometimes called premature ovarian failure.
Premature ovarian failure can be caused by:
You might experience some of the following symptoms, but it’s important to check with your doctor to ensure there are no other alternative causes:
Doctors may prescribe a combined contraceptive pill or HRT to manage the effects of early menopause. It is likely you will be recommended to take the treatment until the natural menopause age. Those who have had certain types of cancer may not be able to have hormonal treatment but your GP can advise on this after further detailed discussion.
Perimenopause is the period when the body begins to transition into menopause. It marks the end of the reproductive years and does not have a fixed age when it begins. Everyone is different, so it is important to make a note of any changes to discuss with your doctor. Some people can experience menopause symptoms as early as their thirties, most will be in their 40s.
During the transition to menopause, your body will change and there are a number of changes you may notice:
On discussion with your GP, HRT can be prescribed even if still having periods. Areas to discuss will include contraceptive needs, family history, past medical history, smoking and alcohol habits. If there are no contra-indications; HRT will help and some women may benefit from additional vaginal oestrogen too.
For women where HRT is contra-indicated, then other things to consider include keeping active with regular exercise, a consistent sleep schedule, reducing caffeine and alcohol intake, practising mindfulness and stress reduction and maintaining a healthy diet.
Some may even benefit from supplements, antidepressants or gabapentin (all licensed for use in menopause)
Following perimenopause, your periods will stop, often between the ages of 45 and 55. Post-menopause is when you have not had a period in 12 months or more, signalling the end of ovulation. There are a range of symptoms that are most common, however, every individual is unique, so your symptoms may differ.
Everyone is different and symptoms can last anywhere from a number of months, with the average menopausal transition lasting for around 7 years. Symptoms can last for up to 14 years, depending on lifestyle factors. Symptoms can alter in severity as time goes on, with some long-term symptoms levelling out and others continuing throughout the entire transition.
Evidence overwhelmingly is in favour of prescribing oestrogen transdermally, through patches or gel or spray. If progesterone is needed then this can be prescribed as a patch, as a tablet or as a Mirena coil.
HRT uses two hormones; Oestrogen to manage the symptoms of menopause and is available as skin patches, gel or spray for skin, implants and tablets. Progesterone is also offered, if a woman has a womb, as a (combined) patch, coil (Mirena) or tablets.
HRT has been shown to reduce the risk of
Women can now remain on HRT indefinitely but would be advised to see their doctor each year for review. Need to check the suitability of dose, suitability of regime, any concerns, and check up to date with a mammogram.
During post-menopause, your symptoms should subside significantly. Some people will continue to experience symptoms for longer, but they should be more manageable.
Post-menopause brings about an increased risk of health conditions including heart disease, weak bones and urinary tract infections.
You may experience loss of urine when coughing, laughing or lifting, which can be frustrating, but there are preventative measures to try:
It’s not just cisgender people who experience menopause. A person who is undergoing transition has previously undergone transition or simply has an ovarian system, will go through menopause symptoms at some point in their life. The information on menopause in trans and nonbinary people is less prevalent, however, it is important to remember everyone has a right to discuss their menopause concerns with a GP and receive relevant treatment.
If a trans woman chooses to stop hormone therapy, they may experience menopausal symptoms. This is due to the same effects triggered by menopause, a sudden drop in oestrogen. They will experience symptoms typical of menopause, although the cause is different.
As a trans woman ages, they might choose to lower their oestrogen dose, which can also result in menopausal symptoms, however, they may be less severe as their body will still produce testosterone.
If a trans man chooses not to undergo a hysterectomy as part of their transition, they will experience the symptoms of menopause. Additionally, if a trans man pauses or is unable to access their testosterone supply, they would begin to experience menopause symptoms.
A person who has an ovarian system will experience menopause, this includes nonbinary people, alongside cis women and trans men and women. All of these people can experience menopause and will be able to access support in finding management techniques through the help of a GP.
At Private GP Services, we offer menopause advice and support within a 30-minute appointment as part of our women’s health service, with the option to speak to our GPs through an in-person appointment or via video consultation. Where appropriate we can provide options and access to hormone replacement therapy (HRT).
For more information visit: https://privategpservices.co.uk/services/womens-health/
