Menopause & HRT

The average age of menopause in the UK is 51. For many the menopause occurs between the age of 45-55 years and is a natural process. We typically know we have reached menopause when we have an absence of menstruation for 12 months. This means the ovaries have stopped releasing eggs and our hormone levels of oestrogen, progesterone, and testosterone fall.

The tricky thing is if you are using hormonal contraception including a Mirena coil it is hard to know when you have reached menopause as you may have stopped your periods due to the products you are using.  This was certainly the case for Sharon who used a Mirena coil throughout her 40’s to the age of 51 and had quite literally no idea about the perimenopause or menopause despite experiencing ongoing symptoms of worsening migraine, formication of the skin, palpitations, and anxiety. With the absence of typical hot flushes and night sweats throughout the perimenopause Sharon had no idea that her symptoms were hormone related.

Every person experiences the menopause differently with a diversity of mild, moderate to severe symptoms and experiences. Menopause may present itself as health issues which do not neatly fit the stereotypical menopause symptoms traditionally thought of and this can be a barrier to accessing appropriate services for help and support. 

The psychological impact of menopause is often underestimated and can have significant impact on not just the person but partners, family, friends, and work colleagues. 

There are a multitude of physical & psychological symptoms experienced.

This relates to anyone experiencing their final period between the ages of 40-45 and typically occurs in 1:100 people. Having an early menopause means your overall hormones have dropped. This can affect bone and cardiovascular health. Having HRT does not appear to increase your risk of breast cancer before the age of natural menopause and can improve your overall long-term health outcomes.

Premature menopause is believed to occur in approximately 1:1000 people and represents those who’s periods have stopped before the age of 40.

This can occur spontaneously, and for which no known cause can be found. POI can also be due to other health conditions, surgery to remove the ovaries, medical induced menopause due to chemotherapy, radiotherapy, or treatments to suppress the ovaries such as PMDD and endometriosis.  It can also be from the impact of smoking or infections. We would recommend https://www.daisynetwork.org/ for more detailed information on premature ovarian insufficiency.

Mandy experienced a surgical menopause at 32 having struggled with endometriosis all her reproductive life. Mandy started HRT following the surgery however she stopped it 6 months later due to the concerns regarding the impact of HRT on breast cancer from research released in 2002. The impact of this for Mandy was enormous with a period of 10 years without HRT Mandy developed tinnitus, hot flushes and night sweats, memory loss and joint pains. Mandy is now well established on her transdermal unopposed body identical HRT and will not be stopping it again!

This is the time in which your hormones are fluctuating and can be a turbulent, chaotic, and disruptive phase of your menopause transition. Getting the right type and dose of HRT can be hard and frustrating initially with lots of tweaks and changes needed to get that ‘right fit’ for you. The perimenopause can last as little as months or up to 10 years.  The nature of perimenopause can be a period in which some days you experience very little symptoms and others can be overwhelming. This is a time in which you are still fertile and where contraception is still an important consideration.

This is described as 12 months following your last menstruation until the end of your life!  We can be living in our post menopause for 30 years so our is vital to ‘get it right’ to live as vibrantly and as fully as possible.

A focus on lifestyle and embracing a holistic approach to address and improve long term health to support the impact of menopause can only be a good thing! This can often be lost or not adequately addressed when navigating your way through your menopause transition.

We want to focus on improved quality of sleep, hobbies and relaxation, reducing alcohol and caffeine intake, cessation of smoking, regular exercise, optimising a balanced diet, supplement use and maintaining a healthy weight, enjoying time with friends and relationships as we recognise these are equally important when considering a holistic approach to the menopause.