Hot flushes and HRT: everything you need to know about the menopause explained


The menopause is one thing each girl is aware of she’s going to ultimately have to take care of. At what age, how lengthy for and what signs she can have, nonetheless, differ broadly. That’s what makes this stage of life so tough to outline, as a result of one girl is nothing like her mom, her sister, her aunt or her buddy. Everybody’s physique and hormonal stability is particular person, however we should perceive the fundamentals so as to work out how to finest sort out our personal actuality.

The solely expertise Dubai resident Anna Yates, 66, had of the menopause earlier than she began going by means of it had been that of her mom’s. “She was completely doolally for a couple of years,” she says with amusing. “We never knew what she was up to next – she used to do all sorts of crazy things.” That included going to courtroom for shoplifting when she by accident put a loaf of bread in her personal bag slightly than the trolley. “Fortunately she had physician who went along with her to courtroom to say: ‘Look, this woman’s going by means of the menopause, so she doesn’t know what day of the week it’s, by no means thoughts the place her bread is’.”

Thankfully, for Britain-born Yates, who has been going by means of menopause for the previous 15 years, her expertise was not like her mom’s. “I was not looking forward to it, but it was nothing like that for me.” The most inconvenient signs she skilled had been recognizing and evening sweats. “It was much easier than I expected it to be.”

What is the menopause?

The menopause is the time that marks the finish of a lady’s menstrual cycles. “Menopause occurs to each girl, however only a few really know a lot about it,” says Alexandra Collishaw, a physiotherapist and scientific lead at Dubai clinic OptimalTherapy. Collishaw has labored in Dubai since 2011 and specialises in girls’s well being physiotherapy, treating complaints resembling pelvic flooring points, diminished muscle energy, and aches that may be widespread throughout menopause. “We hear stories about hormone replacement and hot flushes, but that is about as much as most women know.”

Menopause can begin, on common, between the ages of 40 and 58, she explains. It begins with the perimenopausal stage, which might final between two and 15 years. This is when a lady’s ­menstrual cycle turns into irregular. Once you have gone and not using a interval for 12 months, then you will probably be identified with having reached the menopause stage. “This is associated with hot ­flushes, poor sleep, weight gain, incontinence, night sweats, emotional ­changes, dry skin, decreased libido and vaginal dryness, joint pains, headaches and memory loss,” says Collishaw, including that a few of these signs will even be current when perimenopausal. “You are post-menopausal when these symptoms start to fade away and you start to get your energy back.”

It’s totally different for everybody

Yates, who’s a psychotherapist and hypnotherapist, believes her comparatively simple expertise of “The Change” has quite a bit to do with the lack of stress in her life. “My body wasn’t so busy making stress hormones and so it could make the hormones to help me get through the menopause,” she explains. “There are some women who sail through the menopause because they’ve got very easy lives. If you’ve got a stressful life, chaotic husband, crazy kids, stressful job, you’re so busy making the hormones to cope with that.”

Anna Yates, hypnotherapist and psychotherapist in Dubai, has been going through menopause for 15 years. Courtesy Anna Yates
Anna Yates, hypnotherapist and psychotherapist in Dubai, has been going by means of menopause for 15 years. Courtesy Anna Yates

Dr Tara Wyne, scientific psychologist and director of wellness clinic The Lighthouse Arabia, agrees that psychological well being can have a huge effect. “I think going through the menopause is primarily associated with a sense of loss; not having a menstrual cycle means being unable to conceive and a critical shift in identity and status,” she explains. “Women often catastrophise and imagine the worst outcomes, like significant weight gain, loss of sexuality and many other visible and humiliating symptoms.” Dr Wyne provides that ladies can typically really feel inferior to or jealous of others who can nonetheless reproduce and having no management over this part of life makes them fearful. “Lack of acceptance of this phase can result in a less resilient coping response and a much greater sense of impact than is strictly necessary.”

When it’s time to search medical assist

The different cause Yates discovered it really easy to cope was as a result of she used hormone substitute ­remedy (HRT), which might are available in the type of tablets, patches or lotions. At first, she took the ­common HRT remedy, however then, seven years in the past, her gynecologist put her on bioidentical hormones – man-made hormones derived from plant oestrogen designed to be chemically similar with these the human physique produces. “I was told I could stay on it forever if I wanted to, but I thought I’d be ­sensible and try and carry on without it,” says Yates, who was involved about experiences that present oestrogen will increase the danger of ­getting breast most cancers.

Over the years, HRT has brought on controversy, however not all of it’s true, says Dr Aagje Bais, a advisor obstetrician and gynecologist at Mediclinic Arabian Ranches. “There was this big study done … when they found people using it had increased risk of breast cancer, ­endometrial ­cancer and cardiovascular disease,” she explains. “But we found out that by really analysing the data [that] these ladies were over 60 years of age and used HRT for longer than five years … It is a balance and you have to find what is suitable for you.”

Everybody responds in a different way to the menopause, all people has totally different signs

Dr Aagje Bais, advisor obstetrician and gynecologist, Mediclinic Arabian Ranches

Importantly, says Dr Bais, girls need to know that they don’t have to undergo by means of uncomfortable signs. “­Everybody responds differently to the menopause, everybody has different symptoms. Some people say it is what it is and that’s fine, but a lot of females struggle and it gets in the way of their day-to-day activities. In this case, you should do something about it.” However, this additionally depends upon affordability, as many insurance coverage corporations working in the UAE exclude HRT and menopause therapies of their well being protection.

Depending on the troubling signs you have, there are a selection of therapies to go for, she provides. One of the most up-to-date attention-grabbing developments in ­medication for menopause is vaginal laser remedy, which has been used for vaginal atrophy, she explains. “You have dryness, ­urinary tract infections, infections, bleeding – that may all be handled fairly simply with laser remedy. [It] has had some good outcomes up to now. Of course it’s not been on the market that lengthy, however so far as I can see, persons are pleased with the results.”

Another not too long ago introduced remedy by British firm ProFam that caught the medical trade’s consideration guarantees to delay the onset of menopause by as many as 20 years. However, will probably be just a few years earlier than this sort of process, which includes performing keyhole surgical procedure to take away a small piece of ovarian tissue, is offered in the UAE.

Yates, for one, extremely recommends in search of medical recommendation when it’s crucial. “If you’re struggling, then look for help,” she says. “If the first doctor you go to says get on with it, then go somewhere else. Wait until you find a doctor who is sympathetic with the challenges of going through the menopause – not all doctors are.”

Going down the pure route

Some girls desire to undergo it alone and sort out this pure organic course of with out medication. Paula Newby, 60, an entrepreneur who lives in Dubai, has been going by means of the menopause for the previous 10 years. Before she began, she’d had her uterus eliminated, so her physician instructed oestrogen patches as a substitute of full HRT to handle her menopause signs as they’ve a decrease most cancers danger, Newby explains. “I tried them, but I didn’t sense there was any real impact. I’m not a pill-popping person. If I don’t need something, I don’t take it … I come from a family who generally don’t reach for the medicine cabinet very quickly. We tend to crack on and get on with it.”

So, Newby turned to ­pure cures, resembling night primrose oil and the herb, black cohosh. “I’m afraid I was too impatient with those. They take a while to take effect.” Instead, she diminished her alcohol and espresso ­consumption, adopted a primarily vegetarian weight-reduction plan, and began intermittent fasting, which she’s discovered has helped enormously. “I’ve battled through, really.”

Paula Newby decided to go down the natural route when dealing with her menopause symptoms. Chris Whiteoak / The National
Paula Newby determined to go down the pure route when coping with her menopause signs. Chris Whiteoak / The National

Dr Marilyn Glenville, a number one nutritionist in the UK who specialises in girls’s well being, is an enormous proponent of weight-reduction plan and way of life change when it comes to managing nasty signs. “The more you can look after yourself, especially during those early perimenopause years, the more comfortable and easier the transition through the actual menopause can be,” Glenville explains. “The menopause is a time of change and the female hormones are going to be fluctuating up and down at this stage. What you eat as you go through [it] can make the difference between having a difficult or easy menopause.”

Research has proven that consuming oily fish, which comprises omega-Three important fatty acids, may delay the menopause by three years, Glenville says. “They stimulate antioxidant capacity in your body and antioxidants help to slow down the ageing process in ­general and that would include your ovaries, too.”

Eating quantity of legumes, beans and soya merchandise, that are phytoestrogens, are additionally thought to assist delay onset, cushioning the results of the “hormone roller coaster” girls go on and serving to to stability hormones, she provides. On the different hand, “eating a diet high in refined carbohydrates can cause you to reach the menopause a year and a half early”. This is as a result of meals resembling white rice and white pasta could cause issues with blood sugar and lead to insulin resistance, she explains.

Hummus made with peas rather than the more usual chick peas and presented in style with triangles of flat bread and vegetables cut into dipping sticks.
A nutritious diet helps. Jeff Topping / The National

Collishaw, who not too long ago accomplished a postgraduate course specializing in the menopause, additionally has loads of recommendation for girls happening the all-natural route. “­Ensuring that your levels of vitamin D and vitamin B are optimal can assist in improving your liver function, which is important in optimising your hormone balance,” she explains. “Vitamin C may help to enhance your intestine microbiome thus serving to with temper by optimising the gut-brain axis.

“Curcumin has been reported to help aches and pains, sage with hot flushes and rosemary for brain function – so these may all be things to introduce into your diet along with the polyphenols, such as dark berries, to help modulate inflammation in the gut.”

Most importantly: discuss about it

Whether you use tablets or not, Newby says she feels strongly that these items need to be talked about in a extra open discussion board so that ladies, after they get to a sure age, are getting into with their eyes open. “When they do find themselves waking up to start the day and feeling terribly emotional and tearful, they don’t have to feel like they’re going mad.”

Collishaw agrees that schooling is vital, as a research by BodyLogic MD Survey in 2018 discovered that solely 19 per cent of perimenopausal girls had been reasonably conscious of menopause expectations, she explains. That identical research confirmed the 53 per cent of girls who weren’t knowledgeable, felt offended about what was taking place to them. “We know that knowledge is power and acceptance, and an understanding of menopause often leads to feelings of healthiness and relief … So it is vital that we get the information out to ladies about what is happening, and empowering them so that they can control their own symptoms and make informed decisions regarding areas such as hormone and supplement therapy.”

I encourage girls to be radically self-­compassionate, perceive that menopause could trigger some battle and struggling, however that they need to meet this with kindness

Dr Tara Wyne, scientific psychologist and director of wellness clinic The Lighthouse Arabia

Dr Bais’s recommendation is easy: “Discuss it. Discuss your situation with someone who you trust or you like – a doctor or a friend or family – to see how other people experience menopause and do realise everyone is different. They might have some tips on how they dealt with certain complaints.”

Above all, don’t be shy and don’t really feel ashamed, she advises. “There are solutions. Sometimes it’s not easy to find the right solution and it takes time, but there are always solutions.”

From a psychological well being standpoint, Dr Wyne echoes this sentiment. “I encourage women to be radically self-­compassionate, understand that menopause may cause some struggle and suffering, but that they should meet this with kindness, a lack of judgment and acceptance that this is part of our journey and our identity. Women need to uphold that their life experience can still be enriched and we can still be of great value and experience joy, despite menopause.”

And that’s whether or not you by accident steal a loaf of bread or not.

Updated: February 2, 2020 11:28 AM



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