Dr Daisy

Your Personal Agony Aunt

Here to answer all your Contraception & Sexual Health, Menopause & Internet Dating queries!

November 19, 2017

I’m worrying  about menopause. I’m 57, and I’m not having the hot flushes...

Dear Daisy,

 

I’m worrying  about menopause. I’m 57, and I’m not having the hot flushes, but what it is, is I can’t sleep. It’s so terrible, I’m exhausted and my GP won’t give me any sleeping pills. And I’m thinking about things like my bones and my general health. I’m tired all the time, and ratty, and tearful. Should I be feeling like this? What should I do? I’ve heard awful stories about HRT and I’m scared.

 

Can you advise me please?

 

Denise

 

Hi Denise,

 

I’m so glad you contacted me. The thing is, going through menopause affects women in so many different ways. Not everyone has hot flushes and night sweats.

 

It is important you see your doctor and have a basic check up and maybe some blood tests to be sure your tiredness is not due for example to something like thyroid disease or diabetes. However it may well be due to the hormonal changes that occur when you are going through menopause.

 

Insomnia is a common sympathise as it is exhausting not being able to sleep.symptom at menopause for reasons that are not clear. I do

 

It hard for me to advise you without a full medical, social, drug and family history, and also I don’t know if you have any risk factors such as being overweight, drinking or smoking for example. All this needs to be discussed at a menopause consultation with your doctor.

 

There are many natural remedies for menopause, but these are generally not well researched, and none of them would have a significant impact on your bone health for example., which you have mentioned in your letter.

 

Bone thinning is more common in women than men and does start at menopause. Our bodies were never designed for us to live this long! The problem is that once your bones have become thin, it is impossible to thicken them up again – at least not very much! Thin bones are 2-4 x more likely to fracture, and if you fracture a long bone like your hip, 20% of people will die and many of the rest lose their mobility and independence. So – it is vital to keep you bones healthy and strong.

 

To retain strong bones need 3 things: enough dietary calcium and  vitamin D, weight bearing exercise and oestrogen (HRT). If bone health is a priority, you need to get started on this regime right away.

 

There are many potential benefits of HRT. It will help you sleep, have more energy and feel more like your old self. Oestrogen has a positive effect on skin and hair. Oestrogen is favourable for  cholesterol probably beneficial for your heart (if started at an appropriate time, monitored etc). It will also aid vaginal dryness, make sexual intercourse more comfortable and treat some bladder symptoms.

 

There are some risks with HRT such as a small increase in breast cancer. This equates to 2-3 extra cases of breast cancer per 1000 women per 5 years of use - not a huge number. There is a very small increased risk of blood clots (DVT/PE).  There may be a very small number of strokes and heart attacks but this is usually in women who have previously had these, and this by definition increases their chance of having another one in the future.

 

The British Menopause Society  state that used for 5 years around the time of menopause in an otherwise fit person, HRT is far more likely to confer benefit and not harm.

 

Have a look at www.menopausematters. com where there is a lot of information.

 

I hope this helps towards you making a decision. Remember if you try it, to persevere for 3 months and then go back and discuss it with your doctor or nurse. It’s worth persevering as any initial side effects are likely to settle. But you don’t need to make a snap decision to take it today for the rest of your life! - Why not try it for 3 months and then review how you feel. You’ll never know unless you get started!

 

Kind regards,

 

Daisy

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