SHE Malta is not qualified to offer medical advice nor prove the efficacy of alternative treatments. This article should not be used to make any final decisions about perimenopause or menopause management or treatment. Its sole aim is to provide clarifications and information to help you better understand menopause.

Our final part of the SHE Menopause Matters series addresses the most common myths and misconceptions that seem to surround menopause. The first two articles addressed the sociology and biology of menopause, the history and explanation of HRT  and looked at some possible alternatives to help women through what is often a challenging and difficult time of life. In this third article, we’re changing things up to bring you an easily digestible 21 point list of things you should know about perimenopause, menopause and postmenopause. 

We delve into the biggest areas of misunderstanding, uncover essential truths and answer your questions (including the ones you didn’t know you had!) to save you wading through an exhausting number of websites and books in the search for helpful information to help you navigate this stage of life.

1. After puberty, menopause is the only other stage in a woman’s biological life 

Myth. Before a woman reaches menopause, her body’s oestrogen levels start dropping and her hormone levels fluctuate for several years. This stage is the body’s transition towards menopause and is called perimenopause (literally meaning ‘around menopause’). For some women, this can last as long as eight years and in others a much shorter period.

2. Women’s mental and physical condition doesn’t change until menopause.

Myth. Perimenopause can actually be much harder for women than menopause – the physical symptoms of Irregular periods, night sweats, increased perspiration, headaches, frequent urination, dry skin and dry eyes are just the tip of the iceberg. Many women don’t realise the mental and emotional impact of perimenopause. 

Putting your phone in bizarre places, losing your keys constantly, failing to recall basic words or people’s names, struggling to process or retain what you read (recipe instructions, a page in a book or work document), having difficulty ‘thinking straight’ or planning/finishing everyday tasks, getting angry easily, feeling weepy … The daily toll on personal and professional level can be exhausting and distressing. 

3. I’m in my late 30’s/early 40’s so i can’t be in perimenopause

Myth. Depending on your lifestyle, stress levels and other factors, perimenopause can begin as early as your mid-30s or as late as your mid-50s (although the latter is not the norm). The most common age for the start of perimenopause is between 40 to 44 years of age. 

4. A woman’s life is pretty much over when she hits menopause

Myth, myth, myth! While menopause can make women feel invisible, unfeminine and irrelevant due to their changing appearance and ‘failing’ body in a society that values youth, vitality and beauty, menopause does NOT have to automatically signal the end of life as you know it! 

Women today have more options than ever for continuing to live a healthy, active, fulfilling life.  Mindful eating, controlling stress levels as well as smoking and alcohol intake, HRT, menopause-specific supplements, targeted weight-bearing exercises, cardiovascular exercise and sport, acupuncture, Ayurvedic hormone-balancing massage, yoga, meditation, regular self care routines…the list of options to help you navigate and enjoy your midlife years and beyond is a long one. Automatically feeling like you have been ‘put out to pasture’, are too old for most activities or that you have nothing valuable to contribute doesn’t have to be your story.

5. Hot flushes, night sweats and weight gain are the only symptoms of menopause.

Myth Hot flushes (or flashes to use the Americans term), night sweats and weight gain may be the most well known  menopause symptoms. But oestrogen loss can cause a domino effect of (an astonishing 30+!) symptoms as follows:

Joint aches and stiffness, absence of sex drive, vaginal dryness, incontinence, palpitations, low bone density, hair loss, prickly skin sensation, dry itchy skin, night sweats, hot flushes, weight gain, bleeding gums, height loss, nail breakage, more fatigue, poor concentration, information retention, brain fog, confusion, memory loss, clumsiness, anxiety/nervousness, overwhelm, depression, lack of motivation or interest in life, reclusiveness and withdrawing socially, lower self confidence, loss of self identity.

6. My sex life will be over once I hit menopause.

Myth: while sex drive can grind to a halt and vaginal dryness is a major issue, HRT or certain supplements can reunite you with your lost libido and resolve vaginal atrophy, relieving the pain that intercourse can cause at this stage of life.

7. I don’t need to use contraception as I hardly have periods.

Myth: Although fertility declines significantly during perimenopause, you can definitely still get pregnant. In fact, you should still use contraception for a year after what you think might have been your last period as there is still a risk, however small, of getting pregnant before you reach the ‘safe haven(!)’ of postmenopause.

8. I’ve heard my menopause will be the same as my mother’s.

Myth: Although it is believed women generally reach menopause around the same age as their mothers, that is where the genetic similarity ends. Your mother’s own menopause experience doesn’t automatically foreshadow yours or dictate the symptoms you will experience. Factors such as lifestyle, general health and stress levels play a larger part. 

9. Menopause starts after 50 and continues for the rest of your life

Myth. Some women actually go into menopause early (usually because of specific medical factors). The average though is 51. The specific stage of menopause is defined as the timeframe of 12 months after your last menstrual period. Once you have passed this timeframe, you are no longer in menopause and have proceeded to postmenopause. Postmenopause refers to the final biological stage of your life. 

10. I can only see my regular GP for menopause advice

Myth It depends on the system where you live. In many cases, gynaecologists are more up to date on menopause factors and have the most accurate advice on treatment than general/family doctors. However, booking directly with a gynae may not be possible and you may require referral by a GP. Many countries also have specialist clinics dealing in menopause.

11. Taking antidepressants is the best way to relieve perimenopause mood swings and mental health issues. 

Myth (an unfortunate one): In certain countries there has been a tendency to prescribe antidepressants to women suffering the mental health impact of menopause. However, antidepressants do not address the hormonal imbalance which is the root cause of psychological changes to a woman at this time of life. HRT, menopause supplements, oestrogen-boosting foods and reduced gluten consumption can be lower risk and healthier for tackling the mental and emotional impact of menopause.

12. Hormone Replacement Therapy is the only way to fix menopause symptoms

Myth. Many symptoms of menopause (including hot flushes, vaginal atrophy, low mood and absent sex drive) are certainly  relieved effectively by HRT and it is a game changer for thousands of women whose life was intolerable before starting HRT. However positive lifestyle choices such as a conscious (menopause-friendly) diet, exercises tailored towards the effects of over 45s’ hormonal imbalance, meditation, breathwork, menopause-targeted supplements  (to name just a few things) can significantly soothe and reduce  symptoms. Note: If you choose to take supplements for  your symptoms and future health, consider getting professional advice from a relevant practitioner or pharmacist on the correct doses you need. Be aware that supplements such as black cohosh and red clover have not undergone rigorous trials to measure efficacy although credited with potentially helping with several menopause symptoms. 

13. HRT is the only way to safeguard against osteoporosis

Myth: Although one of the much mentioned benefits of taking HRT is its potential to prevent osteoporosis, it is not the only way to safeguard against this condition. Medically prescribed biophosphonates, strength training and weight bearing exercises, foods that support bone health, calcium and Vitamin D supplements are among the non HRT ways to keep your bones strong and reduce the risk of developing osteoporosis.

14. HRT is seriously high risk and to be avoided

Myth: A lot of worry and fear over HRT came from dramatic headlines about the early 2000’s Women’s Health Initiative clinical trial and Million Women Study (you can read more on this in our article To HRT or Not to HRT?.) Both organisations retracted their findings and the projects were discredited after improper procedures and unreliable analyses were discovered. That is not to say HRT is totally risk free. Risk level and potential is influenced by several factors. These involve the type of HRT (synthetic, body identical or custom compounded) you are considering using, the method your doctor suggests (eg. oral tablets, spray, gel, patch, pessary, cream), the length of time you are considering taking it for and your own medical history (high blood pressure, history of certain cancers, cardiovascular issues, being overweight and smoking increase the risk of an adverse outcome from taking HRT). Note: some HRT is only topical and local (vaginal pessaries for instance) and carries no risk. Tablets, patches, sprays are systemic and therefore enter the blood stream.

15. HRT hasn’t changed since the 60’s

Myth: Pharma companies including Pfizer and Wyeth still make the original form of HRT i.e. synthetic oestrogen from horse urine explained in eye-opening detail towards the end of this article. This is usually prescribed along with progestogen (synthetic form of the human hormone progesterone)  However, there is an increasing demand by women worldwide for body identical plant-based HRT known as bHRT (derived from soybean and yam oil) as it is viewed as more natural. Even though these compounds are then laboratory altered, the result is identical to the body’s natural oestrogen (unlike the equine-derived HRT which is similar but not identical). This bHRT is prescribed with micronised progesterone, an exact duplicate of human progesterone, which is currently considered safer.

16. HRT is just one medical product taken in one form.

Myth: There are many brands on the market making several different forms of HRT, too many to list here. Your consultant will help you choose the one most suited to your symptoms and based on what is available where you live. HRT actually comes in several different forms and is prescribed according to the particular symptoms of the patient and type of HRT recommended/requested/available. This can be oral and vaginal tablets, dermal patches, dermal gels, dermal creams, pellets under the surface of the skin, oral spray, vaginal pessaries.

17. Supplements don’t really work for menopause

Myth: This is probably one of the most contested areas of menopause management and a lot of it comes down to personal opinion (in a flash survey I conducted among 20 women who are taking HRT, only one of them had considered taking supplements). Numerous companies offer supplements to tackle many of the most aggressive symptoms of all three menopause stages, for women who cannot or do not wish to take HRT. While research and testimonials exist for the relevance of certain supplements such as turmeric, curcumin, Vitamin D and the B vitamins, opinions vary on the efficacy of others including black cohosh and red clover. Individual women will react differently to various supplements.

18. HRT only works during menopause and stops working when menopause ends

Myth: Even though HRT is most commonly prescribed closer to the end of a woman’s periods or during peri-menopause, it can still be taken in post-menopause as long as your periods ended no more than ten years before starting HRT and as long as you start it before the age of 60. 

19. You can stay on HRT for life. 

More discovery needed: Even more than supplements, this is the source of much debate! The official advice from most medical professionals is to get on HRT as close as possible to the end of your periods and to stay on it for as short a time as possible. Whether this refers only to synthetic equine HRT or bHRT is not clear at the time of writing. Most women discontinue HRT after their most severe symptoms end (although this can of course lead to a return of symptoms.) However, many official menopause organisations are now suggesting that it may be beneficial for a woman to stay on HRT well into her post-menopause and past the age of 60. Any woman considering HRT is advised to seek out a doctor who is well read on the most accurate data age safety.

20. I’m not elderly so I don’t need a bone density scan.

Myth: Unfortunately some healthcare systems do not educate the population on the importance of having a DEXA scan early enough. Leaving bone density scanning til your 60’s can be detrimental and it is much more advisable – especially as a woman suffering far more hormonal impact than men – to do a bone density scan in your late 40’s/early 50’s in order to determine the presence of osteopenia and/or risk of osteoporosis. Note: increasing your oestrogen hugely helps joint ache and bone loss. Tip: if you have daughters in their teens, encourage them to do weight-bearing exercise to lay down a solid skeletal foundation which will help them in older years. Osteoporosis can kill which is not well known!

21. Menopause is just a women’s issue.

Myth: Rather than a myth, just plain wrong! A woman’s menopause journey can have a profound impact on her family and loved ones and of course work colleagues. It’s important that family members know what you are going through and that you feel supported and heard. While frank open discussion about menopause is still taboo in many societies, awareness has come a long way since the 1960’s. Adverts aimed at husbands with lines about coming home “to the turmoil of a woman going through the change of life” and promoting HRT as a way of making their wives “pleasant to live with once again”(!) are thankfully a thing of the past. 

We’re only just starting to remove the stigma around menopause so there is a long way to go before employers fully recognise and understand the impact of menopause in the workplace but initiatives are underway in some countries to better support this. So no, it is not just a woman’s issue and needs to be understood by husbands, brothers, fathers, sons, employers and work colleagues everywhere.  

Conclusion

The chain reaction caused by your changing hormone levels should not define your life. 

Your 40’s don’t need to be an intolerable rollercoaster due to you not knowing anything/early enough about perimenopause and its potential impact on your everyday mental, emotional and physical health. Your 50’s shouldn’t require you ‘putting life on hold’ while you spend all your energy and time searching for clear information on how to just feel like yourself again.  Your postmenopause years shouldn’t be a mere ‘over the hill’ existence where you feel that truly living just stops, decay takes over and you grieve over the ‘former you’ who is now a distant memory.  No woman should spend any of the stages of menopause barely able to recognise herself and feeling powerless or too confused to do anything about it. 

Even if a woman goes through her 40’s without making any lifestyle changes or getting regular checkups, this does not mean her menopause years and beyond will automatically be an ordeal. Everyone’s journey is different. Some women suffer from severe symptoms at one stage or another while others are hardly aware of any difference and enter post menopause doing nothing beyond standard breast and cervical cancer screening.  

So bottom line, do what feels right for you. This is your midlife health (not your mother’s, sister’s, friend’s etc). Read, discuss, explore, ask, consult. If you don’t feel supported by your doctor, find another one. 

The decisions you make, the steps you take (including reading quality informative pieces like our Menopause Matters series!) can make a dramatic difference to your life. 

SHE Malta is not qualified to offer medical advice nor proof of the efficacy of conventional or alternative treatments. This article should not be used to make any final decisions about perimenopause or menopause management or treatment. Its sole aim is to provide clarifications and information as a starting point for a consultation with your doctor to discuss the best route for you individually. 

Today’s increased life expectancy means more women are living a third – even half – of their lives in a post menopausal state. As the SHE Malta community is made up of women who will either hit this life stage in the future or already have done so, we’re departing from our usual business-focused content and looking at this significant and inevitable health and life issue. An issue that the SHE Word host Trudy Kerr tellingly describes as “affect[ing] every single woman on the planet but the most un-talked about topic I think I have ever come across”.  This is no exaggeration. Menopause and everything surrounding it seems to be the elephant in the room.

While we can’t cover this topic entirely, we will be addressing the main aspects in a three part series, starting with this article.  Part 1 presents an overview of menopause, historically and sociologically and explains the biology of what happens to the female body and the consequent health implications. We’ll list the available options for symptom reduction and relief. Part 2 will look at HRT, the background, options, benefits and risks. Part 3 will address some common misconceptions about menopause and hopefully answer many of your own questions (including the ones you didn’t know you had!) in the hope of forging a path through the confusion.

Society…a brief history of menopause

Often referred to as “The Change”, menopause is a stage of life that all women – fortunate enough to reach a certain age – inevitably experience. While many things in life are a woman’s choice, menopause is not. It is unavoidable. The chain reaction it sets off is complex and goes way beyond the simplicity of its name (Greek: ‘meno’ = month, ‘pausis’ = cessation) and its impact on female health and quality of life is far-reaching and profound.

Yet for some reason, this significant health issue has often been misunderstood, misdiagnosed, overlooked or incorrectly treated. The hush hush taboo status that has been – and continues to be – attached to this part of a woman’s life has compounded the situation, resulting in generations of women feeling that menopause is an automatic life sentence of decay and deterioration to be simply endured in silence.  In fact, some of us may recall it affecting our mothers/grandmothers/older sisters but not understanding what was ‘wrong’ with them.

Many societies have commonly viewed women going through this change as permanently depressed, crazy and written off as no longer useful (as if the physical and mental realities of menopause are not punishing enough). Vanessa Coleiro – brand consultant and natural health enthusiast – mentions that American women in the 1950’s were routinely told their menopausal symptoms were “in their head’ and that they were simply bored, attention-seeking housewives who should join the PTA!

Moira Delia, speaking on Trudy Kerr’s podcast admits people tended to react in shock when she mentioned she was in early menopause and also feels denial is a big issue.

It is also not inconceivable to suggest women (more so in certain parts of the world than others) are more likely to address the visible signs of midlife by going to a med-aesthetic practitioner for Botox, dermal fillers etc than they are to address the physical and mental aspect by going to a gynaecologist for HRT.

Menopause and Geography

The Western view of menopause as being something to be dreaded is vastly different from the one held by certain other cultures.  The Japanese for instance appreciate this as a welcome transition towards renewal and regeneration. In New Zealand, traditional Maori culture respects middle aged women for the wisdom they can offer. And the Mayans value older women so greatly they place them at the very centre of their culture and community for the life experience they can teach future generations.

It’s worth noting that women’s symptoms vary according to country (lifestyle including diet could play a part in this). In her article “An Overview of Menopausal Disorders”, Dr Heidi Grech mentions that Japanese and Chinese women tend to suffer fewer symptoms than North American women.

Although we are beyond the decades-ago thinking mentioned earlier, menopause education and treatment has still not advanced to the level one might expect. And it seems to be a case of geographical lottery as the BBC also recently revealed. Depending on where one lives, the level of attention and support given to peri menopause management can vary greatly, either resulting in a woman feeling supported, well informed and able to make the right decisions for her health and quality of life. Or instead unaware, in physical discomfort, abandoned and helpless to take charge of her current and future medical safety.

A 2021 study conducted in the USA found 73% of women were not treating their menopausal symptoms and 45% of women didn’t know the difference between perimenopause and menopause.

On a positive note, many women themselves can feel liberated by no longer having to endure pain, weakness from blood loss, expenditure on sanitary products or limited activity due to monthly periods.

Awareness

The fact there is an entire month dedicated to menopause awareness each year perhaps bears proof of the incredibly common scenario that is emerging: many women themselves often fail to recognise what is happening to them or know what to do even when they have realised their body and health is changing negatively. The commentary I see on menopause forums, the interviews and research I’ve done (and indeed my personal experience) all confirm this.

As Yvonne Midolo, Podiatrist, says “Health literacy is not automatically connected to one’s intelligence”. Below are just a few of the discoveries I’ve made the last few years from talking to several friends across the UK, France, Germany and Malta:

-Many women revealed their difficulty in obtaining clear advice – some women ‘laughed out of’ their appointment by a dismissive doctor (in most cases male) unwilling to offer relief options to any woman under the age of 50.

-Conversely, three people in Malta said any ailment they mentioned to their GP was automatically associated with perimenopause with no discussion of other possible causes.

-Only two people – including myself – in their mid 50’s had done a bone density scan.

-Several of my friends have never seen a consultant or done independent research for HRT

-Hardly anyone had heard of perimenopause until their early 50’s (i.e. after it had finished)!

-Almost everyone was initially uncertain over which medical professional to see: general practitioner, gynaecologist, endocrinologist?

-Absolutely everyone said they no longer recognised themselves but couldn’t pinpoint when they started feeling this way.

On her podcast, Trudy admits she only discovered she was well into menopause after visiting a doctor regarding unexpected symptoms she was experiencing: “I had not prepared for it but of course, I’m 48 and you would expect that this might happen!,” she says, adding “I had never heard of perimenopause”. 

Maybe it’s not so surprising then that Dr Olivia Anne Cassar, Malta-based gynaecologist, revealed that out of all her annual patients, only two visit her to discuss menopause (interestingly, these are usually expat, not Maltese patients).

What are the possible contributing factors?

-The inadequate infrastructure within many healthcare systems resulting in a lack of obvious, accessible and robust information on menopause – in stark contrast to the amount of information (depending on country) on other female health areas such as breast cancer screening, pregnancy and fertility, contraception, STD’s, cervical cancer screening etc.

-A tendency in many Western medical cultures to only deal with the mental aspect of menopause via antidepressants instead of adressing the other symptoms via HRT or supplements etc.

The frequent inability – and in many cases unwillingness – of partners or family to understand or provide support for their female partner’s/relative’s mental and physical state in midlife.

-The absence of guidelines or policies within the workplace to support female employees, a valuable and vital part of the economy – in menopause. (400k women resign annually in the UK due to the grave mental and physical impact of menopause – a huge amount of the workforce and skills force lost.)

Doctor, doctor.

In light of this, it is not that surprising that many general practitioners or family doctors are not well equipped to help patients in this area. Edinburgh GP Dr Maria, admits “Menopause is barely covered at medical school: the onus is really on individual general practitioners to ensure that they are up-to-date and knowledgable about current menopause management guidance, by paying to attend or study specific courses on the subject.”

In fact, a doctor I spoke to at a leading clinic in Malta admitted to feeling embarrassed at her lack of menopause knowledge. It also transpires that doctors only recommend synthetic HRT in Malta, despite there being a clinic offering customised bioidentical hormones.

So you could be forgiven for thinking menopause matters don’t…well…matter. But menopause is a hot (flush) issue…

So WHAT exactly are perimenopause, menopause and postmenopause?

In the bloom of life, the female body’s ovaries produce the key reproductive hormones oestrogen, progesterone and testosterone. Around ages 40-44 (on average), oestrogen levels decrease, throwing off the balance with progesterone.  (Testosterone decrease is more a symptom of natural ageing rather than menopause.) This is perimenopause. As oestrogen and progesterone are both responsible for ovulation and menstruation, their decrease inevitably leads to unpredictable menstrual cycles. Perimenopausal hormone levels can resemble a rollercoaster, causing numerous symptoms including anxiety, mood swings, brain fog, hot flushes and increased sweating, all marking the transition towards the next stage.

Menopause (between ages 45-55, but most commonly 51 years) is defined as the point at which 12 months have passed since your last period. This is the stage where your body is making so little oestrogen that your ovaries stop releasing eggs altogether, causing the end of menstrual periods.

Once more than a year has passed after the last period, the body enters postmenopause. This stage defines  the rest of a woman’s biological life, from which there is no return or further stage.

What does the female body experience?

The list of symptoms is long and the number and intensity of symptoms experienced varies between individuals. Some symptoms are short term and more prevalent in an individual stage eg perimenopause and other symptoms are connected to long term postmenopause health.

Physical: 

Joint aches and stiffness (unrelated to previous illness or injury)

Weight gain

Increased sweatiness

Tension headaches due to hormonal changes

Low libido and pain from intercourse

Palpitations

Hot and cold flashes (most often together)

Night sweats

Osteopenia

Vaginal dryness (atrophy)/itching

Frequent urination

Incontinence

Increased fatigue

Hair loss: widening parting, receding hair line, thinning hair texture

Nail breakage and dry skin

Formication prickly skin sensation

Bleeding gums

Height shrinkage

Mental

Poor concentration (causing slower learning time) and brain fog

Confusion and less ability to think logically, plan simple tasks and make decisions

Memory loss (difficulty recalling everyday words, placement of items, names of people and places)

Clumsiness from impaired judgement of space and distance.

Emotional

Anxiety, overwhelm and nervousness

Feeling low and/or easily weepy.

Apathy, feeling directionless or uninterested in life, reclusiveness and withdrawing socially

Feeling invisible, loss of identity, self confidence, feminine self (also connected to physical sexual dysfunction above)

My menopause, your menopause.

No two women’s experiences are the same.  Some women are lucky enough to pass through the various stages with mild symptoms and little physical discomfort while others suffer greatly, to the point where they can barely function. Chances are if you chat to a handful of friends, you’ll all have different stories and symptoms about the same natural physiological event!

Dr Olivia Anne confirms: “I have seen women who sail through these years without any problems and I have encountered patients who burst into tears in clinic as they cannot put on a spot of make up without it melting off their faces within the hour.” 

A few things are certain: it is important to be aware of your symptoms in order to know what to do about them.  And it is essential to be kind to yourself. Self care is not a nice-to-do but a must at this stage of life.

What options are available to relieve or minimise symptoms? 

The adage prevention is better than cure couldn’t apply more and it is a good idea to take steps during the perimenopause years to increase your chances of a more comfortable menopause. Nevertheless, whatever stage of menopause you are at (peri, menopause transition or post menopause), it is not too late to tackle your symptoms as long as you do not leave it til many years after your last period. (Post menopause, if left unsupported, can have serious ramifications for long term health including osteoporosis, heart disease, osteoarthritis and dementia.)

Many women wish to address this stage in life as naturally as possible, without pharmaceutical intervention. This requires a ‘whole life style’ approach including the aid of:

– exercise – cardiovascular, weight-bearing, yoga, pilates

– consistent sleep schedule and sufficient rest

– diet high in proteins, vegetables and food groups that are low on the glycaemic index

– low to moderate alcohol consumption

– mindfulness – meditation

– acupuncture

– massage – abhyangha (Aryuvedic), aromatherapy and Swedish

– supplements

Interestingly, Vanessa Coleiro, Brand Consultant and Natural Health Enthusiast, has spent time studying the connection between liver and colon health and the endocrine system, discovering that menopausal hormonal imbalance is potentially worsened by a clogged up liver and colon. A big believer in the new generation of plant-based detox and power nutrition programmes, Coleiro is convinced that cleansing the liver and colon – thereby supporting the endocrine system – greatly reduces and even eliminates many significant symptoms including weight gain, hot flushes and poor sleep.

Supplement Me 

The potential use of supplements for menopause is worthy of an article in itself (or even its own three part series!). Evening primrose oil, curcumin, moringa, turmeric, collagen, Vitamin D, calcium, red clover, black cohosh, Flaxseeds, Ginseng, Valerian have been shown to deliver benefit (to different degrees) when used with an understanding of dosage and potential side effects.

In addition, an increasing number of menopause-specific supplements are hitting the market, designed for those women not wishing to go down the ‘pharmaceutical HRT’ route. Companies such as Happy Mammoth and Better Body are tackling some of the most common symptoms such as the midlife tyre, hair loss and fatigue with a range of different products including Bloat Banisher and Provitalise. Biocare and Vitabiotics have been offering their own ‘complete menopause’ supplements for years.

Meanwhile, Femarelle® is another leading provider of menopause-focused supplements. Available in several territories worldwide, the Femarelle®  range consists of three different lines designed to support different stages of the menopausal journey: Rejuvenate, Recharge and Unstoppable. We’ll be taking a closer look at how the Femarelle® products work in Part 2 of our Menopause Matters series.

HRT

Today, HRT is credited as being the most effective way of relieving the most common menopause symptoms and reducing the risk of osteoporosis and dementia. Combined HRT – oestrogen and progesterone – can either be taken in separate forms or both hormones are combined in one preparation called progestogen. Different factors influence what is prescribed for the patient. Oestrogen-only HRT is only for women who have had a hysterectomy.

HRT is available in three forms: 

– traditional ‘classic’ synthetic (chemically produced and not identical to human hormones, sometimes the only form available in a country)

– body identical HRT (increasingly preferred, considered by medical professional as safest and available in many countries)

– bio identical (less commonly available depending on where you live and currently not FDA approved).

HRT can be taken in numerous ways such as oral tablets, sprays, dermal patches, creams, gels, vaginal pessaries and intrauterine coil, depending on the symptoms, medical history and needs of the patient. Not all methods are available in all countries or available in bioidentical HRT form. We’ll be delving into HRT more in Part 2 of our Menopause Matters series.

Let’s turn the tide.

Awareness campaigns are being seen in certain countries. Known media personalities such as Davina McCall are publishing books on menopause and raising an immense amount of publicity about the daily struggle of women in menopause. Conversations are happening aimed at destigmatising menopause. Gynaecologists are also more willing to prescribe HRT as treatment. It’s a step in the right direction.

As Dr Oliva Anne puts it: “Patients are also more aware that menopause is not something they have to endure but rather something they have to live through with a positive attitude. I feel this shift in mentality is a healthy one and I look forward to seeing it improve further in the coming years as I approach my own!”

DON’T MISS PART 2: “To HRT or not to HRT?”