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The following ‘Ask the Experts’ questions were sent in to The Menopause Exchange by our members, the answers were provided by our ‘Ask the Experts’ panel and included in issues 73 (summer 2017), 74 (autumn 2017) and 75 (winter 2017/2018) of The Menopause Exchange newsletter. If you would like to read the questions and answers in the latest issue of The Menopause Exchange newsletter sign up for FREE emailed newsletters.

How long do menopausal symptoms last?

Kathy Abernethy, senior nurse specialist, replies:

There’s no way to predict this.  Many women get very few symptoms at all.  Others have quite bothersome symptoms but the duration varies.  Two to three years is quite common, but a few women have menopausal symptoms for around five years (not always troublesome).  A few women continue to have menopausal symptoms for much longer than this, and occasionally the symptoms can continue for 10 years or more.  More long-term symptoms such as vaginal dryness can worsen in the years after the menopause and continue indefinitely if left untreated.

I have heard that turmeric helps aches and pains. Is this true? Which supplement dose should I take, rather than adding it in food?

Angie Jefferson, consultant dietitian, replies:

Turmeric is used as a spice in cooking and also as a traditional Indian (Ayurveda) or Chinese medicine to relieve pain and inflammation. Its active ingredient is curcumin (also called curcuminoids). Clinical evidence is limited (trials have been too few and too small in size) so curcumin is unlikely to be recommended as part of routine medical care. Recent reviews of existing evidence suggest that curcumin (typically around 1000mg/day) may help to relieve arthritic joint pain but more research is needed. Curcumin isn’t easily absorbed, so supplements often contain much higher doses that you may or may not be able to make use of. Choosing a reputable manufacturer is important. Although few side effects are associated with curcumin, the spice can react with other medicines, so speak to a pharmacist or GP.

I am 59 and came off HRT six months ago. My night sweats have come back with a vengeance. I don’t want to go back on HRT. The only medicines I’m taking are thyroxine tablets for an underactive thyroid. Which supplements do you recommend?

Dr Nuttan Tanna, pharmacist consultant, replies:

It’s important to have blood tests to make sure you’re on the right dose of thyroxine. Many women with thyroid dysfunction suffer from vasomotor symptoms, such as hot flushes and night sweats. If the thyroxine dose is too high, it could be causing some damage to your bones. Once you’re taking the right thyroxine dose, your doctor can look at whether you could try any supplements. Changes in thyroid function have been reported in postmenopausal women using modified dietary soy or isoflavones in a few studies. But the interaction isn’t significant enough for doctors to advise against trying isoflavones for vasomotor symptoms. Red clover isoflavones (a food supplement) at a dose of 40 or 80 mg daily have been shown to help control vasomotor symptoms. You could also try herbal medicines. However, there are concerns that these aren’t regulated so the dose, and the quality of their ingredients, could vary. Not much is known about how herbal medicines affect thyroid function. If you decide to try a herbal medicine, it may be beneficial to get advice from a qualified herbalist. Exercise and weight loss can help to control vasomotor symptoms. So even with supplements, you should be looking at combining all these strategies to improve your quality of life.

Is there anything I can do to relieve the aching in my knees?

Dr Jenifer Worden, GP, replies:

The most common cause of aching knees is an underlying problem with your knee joint, either wear and tear (‘degenerative change’ or early osteoarthritis). Body weight has an important role to play here, as does a lack of exercise. When going upstairs, we place three times our body weight on our knee stepping up. This is why knee surgeons often ask patients to lose weight before joint replacement. Non-weight bearing exercise such as swimming or cycling (on the road or in the gym) can help keep your joint supple and to strengthen your thigh muscles, which help your knee work more easily. There are many joint supplements in the health food shops, such as glucosamine, turmeric and devils claw, but there is little or no firm evidence that they’re effective. Anti-inflammatory rubs or liniments are worth trying, as are anti-inflammatory tablets such as ibuprofen. If the aching persists despite self-help, consult your doctor or practice nurse for further advice.

What tests and checks will be carried out before I start HRT?

Dr Sarah Gray, GP, replies:

Other than checking your height, weight and blood pressure, it’s rare that you would need any specific tests or checks before starting HRT. The menopause is diagnosed and assessed on the basis of your period pattern and your symptoms. I would expect your doctor or nurse to ask questions about your general health, medical history and family history to determine your risk profile and then assess what effect HRT may have on top of this. Investigations will be arranged if your doctor or nurse has any concerns, or if results will affect the decision. An example may be that a bone density scan is arranged for you if you’re believed to be at risk of osteoporosis and if the answer would affect your decision to take, or not to take, HRT.

What can you tell me about using natural progesterone cream to help menopausal symptoms?

Dr Sarah Gray, GP, replies:

Natural progesterone cream is available from a variety of sources but not on NHS prescription. This is because scientific assessment has shown that very little, if any, progesterone is absorbed through the skin. Some years ago, a study showed that natural progesterone cream didn’t bring about the protective changes to the uterine lining that are required to balance the effect of oestrogen. It’s not recommended by menopause experts.

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Dragos D et al (2017) Phytomedicine in Joint Disorders Nutrients. 9: 70. Published online 2017 Jan 16. doi: 10.3390/nu9010070 PMCID: PMC5295114.

Daily JW et al (2016) Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Med Food. 19:717-29. doi: 10.1089/jmf.2016.3705.

Adverse effects – none listed in the EU Compendium Botanicals


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